Classic Cars

Complaint: ***
I am rejecting this response because:Response to DrErik S***’s Rebuttal
DrS***’s rebuttal is not
responsive to the essential
elements of my claim
He failed to address the issue that Medicare Guidelines state
that a provider must have a Medicare Provide Number and a National Provider
Identifier, at the time of service, to file claims for serviceDrEric S***
had neither
In addition, he has not provided documentation that his
treatments were medically necessary as required for reimbursement from Medicare
and secondary insurance
The citing of a signed ABN is invalid since my signing was
predicated on my belief and assurance that DrS*** would submit a valid
claim to MedicareMedicare has determined he could not submit a valid claim
due to his lack of proper documentationIn addition Medicare has determined
that Slovin Family Chiropractic is responsible for the cost of the servicePlease
see Medicare’s decision attached
Regarding the unnamed National Government Service
Specialist, I question if they were given all the information regarding Dr
S***’s lack of proper documentationWhy would one reference the Medicare
Processing Manual as a defense when DrS*** is probably in violation of the
Mandatory Claim Submission Rule for failing to have the required Medicare
Identification numbers
Therefore, I renew my claim for reimbursement
Thank you,
*** ***

Our office has received your complaint from the Revdex.com. Our insurance biller is reviewing the caseThank you for your patience as we work to resolve this issue

Complaint: [redacted]
Mr. [redacted],
After continued conversation with a
National Government Service specialist, it appears the claim made to Medicare
on your behalf was indeed valid.  Because
your claims were submitted from Slovin Chiropractic Center, and Slovin
Chiropractic Center did maintain a valid National Provider Identifier number at
the time of your services, the claims are considered valid and are subject to
the rules of the signed ABN and consequently do not entitle you to a refund for
services rendered.
However, it is Slovin Chiropractic
Center’s error that Dr. Erik S[redacted] did not have a valid Medicare Provider
Number and National Provider Identifier number during your time of service.  We have corrected his status and these identification
numbers have been reinstated.
Because you had no possibility of
reimbursement from Medicare for your 10 dates of service with our office, we will
refund you the dollar amount Medicare and your secondary insurance would have
refunded you had those numbers been valid.
Our office will be sending you a
check for $392.30.  This is reimbursement
for your services labeled 98941. 
Medicare does not cover the cost of examinations and x-rays in a
chiropractors office and therefore would not have provided you reimbursement
for these services.
Thank you.
Slovin Chiropractic Center