We are in receipt of a Revdex.com Complaint dated 6/18/where the patient relays concernsthat they were not given opportunity to price compare the cost of services and were givenwrong information regarding their coverageThe physician office did verify coverage andbenefits with the patients insurance
plan and unfortunately was told wrong information bythe planThis wrong information from the health plan was relied upon by both the patientand the medical practice.The physician is a contracted provider with the patient's insurance plan and has acceptedthe contracted rateWe are entirely sympathetic to the patients concern for pricetransparency and we endeavor to provide that to all our patients as we know that theyhave a choice when selecting physician servicesUnfortunately the goal of getting accuratebenefit information up front was not met in this situationBut to assure the fairness of theprice being charged to the patient we have reviewed Health care Blue Book, an independentpricing service available to consumers to determine if our contracted rate with theinsurance company is a fair priceThe price we are charging is over $less than theHealthcare Blue Book fair price amountSo while the goal offull transparency was not metin this instance, the prices being charged are more favorable than Healthcare Blue Bookpricing based on the patient's residential zip codeThe physician is not price gouging asthe rates being charged are those established by contract with the patients insurance andthose rates do compare favorable to independent market analysis.The patient's insurance company offers online access to its members as well as customerservice phone representatives fully available to the patient for independent price andbenefit comparisonsThe patient is ultimately the purchaser of their insurance contractand responsible for knowing it's provisionsThe patient has signed a financial agreementwith the practice whereby they agree to pay any copayments, deductibles or coinsuranceamountsGenesis Healthcare Partners does its best as a courtesy to patients to verify thecoverage and benefits prior to services and communicate patient responsible amounts; butwe are not the financial guarantor of how each insurance company will process a claim
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
When shopping for any service, a consumer will look for the best priceGenesis Healthcare maintains that their price for service is nearly $less than Healthcare Blue Book's Fair Price Fee when it is in fact NOT a lower price, but 155.99% higherThe bill I received for service was for a total of $1212, minus the amount that my insurance company covered which left a remainder of around $693, the disputed amount which is why I firmly believe that this business is price gouging its patientsI'm certain anyone would agree that $is quite a bit more expensive than a $Fair Price Fee, especially when you don't get a bill (and a surprise at that) until weeks after your procedure.Text from the Fair Price Information reads as this: "This is Healthcare Bluebook's recommended price for health care servicesThe Bluebook price is based on the typical fee that providers in your area accept as payment from insurance companiesThis is the price you should have to pay, even if your provider charges moreYou can use this price to negotiate with your provider or shop for an in-network provider that charges a Fair Price. "My position on this remains steadfast regardless of when I pay this bill and how much that bill is at the resolution of this complaintGenesis Healthcare's price for service is not a fair price, there is a $difference between Genesis Healthcare's price and a Fair Price as set by Healthcare BluebookI was not informed/misinformed by Genesis Healthcare's staff about my out of pocket costs
Regards,
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We are in receipt of a Revdex.com Complaint dated 6/18/where the patient relays concernsthat they were not given opportunity to price compare the cost of services and were givenwrong information regarding their coverageThe physician office did verify coverage andbenefits with the patients insurance
plan and unfortunately was told wrong information bythe planThis wrong information from the health plan was relied upon by both the patientand the medical practice.The physician is a contracted provider with the patient's insurance plan and has acceptedthe contracted rateWe are entirely sympathetic to the patients concern for pricetransparency and we endeavor to provide that to all our patients as we know that theyhave a choice when selecting physician servicesUnfortunately the goal of getting accuratebenefit information up front was not met in this situationBut to assure the fairness of theprice being charged to the patient we have reviewed Health care Blue Book, an independentpricing service available to consumers to determine if our contracted rate with theinsurance company is a fair priceThe price we are charging is over $less than theHealthcare Blue Book fair price amountSo while the goal offull transparency was not metin this instance, the prices being charged are more favorable than Healthcare Blue Bookpricing based on the patient's residential zip codeThe physician is not price gouging asthe rates being charged are those established by contract with the patients insurance andthose rates do compare favorable to independent market analysis.The patient's insurance company offers online access to its members as well as customerservice phone representatives fully available to the patient for independent price andbenefit comparisonsThe patient is ultimately the purchaser of their insurance contractand responsible for knowing it's provisionsThe patient has signed a financial agreementwith the practice whereby they agree to pay any copayments, deductibles or coinsuranceamountsGenesis Healthcare Partners does its best as a courtesy to patients to verify thecoverage and benefits prior to services and communicate patient responsible amounts; butwe are not the financial guarantor of how each insurance company will process a claim
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
When shopping for any service, a consumer will look for the best priceGenesis Healthcare maintains that their price for service is nearly $less than Healthcare Blue Book's Fair Price Fee when it is in fact NOT a lower price, but 155.99% higherThe bill I received for service was for a total of $1212, minus the amount that my insurance company covered which left a remainder of around $693, the disputed amount which is why I firmly believe that this business is price gouging its patientsI'm certain anyone would agree that $is quite a bit more expensive than a $Fair Price Fee, especially when you don't get a bill (and a surprise at that) until weeks after your procedure.Text from the Fair Price Information reads as this: "This is Healthcare Bluebook's recommended price for health care servicesThe Bluebook price is based on the typical fee that providers in your area accept as payment from insurance companiesThis is the price you should have to pay, even if your provider charges moreYou can use this price to negotiate with your provider or shop for an in-network provider that charges a Fair Price. "My position on this remains steadfast regardless of when I pay this bill and how much that bill is at the resolution of this complaintGenesis Healthcare's price for service is not a fair price, there is a $difference between Genesis Healthcare's price and a Fair Price as set by Healthcare BluebookI was not informed/misinformed by Genesis Healthcare's staff about my out of pocket costs
Regards,
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