Comstar, Inc.

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Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #***I understand that by choosing to accept the business response that my complaint will be closed as resolved.
Regards,
*** ***

Chronology of this Patient Account:Comstar correctly billed the patient's insurance. The full amount of the bill was initially denied by the insurance carrier as applied to the deductible.Per direction from our client, The Town of Wallingford, Comstar billed the patient for the balance
due. The patient disputed the claim handling to the insurance carrier. The insurance carriers responded to the patient dispute and issued a check dated 12/7/paying the claim. Comstar received and posted this payment on 12/21/. Given the check date, and our posting date (after posting it is sent to the Wallingford bank for deposit) claims of the payment being cashed earlier cannot be true. Also, Comstar has no access to client funds. All checks, in this case, are made payable to the Town of Wallingford and deposited into a Town owned account which Comstar has not negotiating rights to.Please note, an invoice to the patient was issued on 12/just prior to the payment being posted and the account marked fully paid. The patient should disregard this invoice as is was issued just before payment was received. Such crossing of payment and invoices (they are run in an auto sequence in per client specifications...) is not uncommon. That invoice was mailed yesterday. their is no way the patient could have received it yet. Comstar will send a zero balance due invoice to the patient to confirm this payment in full by their insurance carrier as requested.A review of the call recordings reveals that Comstar staff maintained a professional demeanor throughout each of the each calls made to Comstar by the patient/their representative. A female representative of the patient made all the calls to Comtar. The female caller was extremely abusive to both Comstar staff and the insurance carrier staff (during one conference call...). The Comstar Team is trained to deal with such situations in a professional and respectful manner regardless of the callers demeanor. Call recordings indicate my team maintained that standard to a T.Please contact me anytime with additional questions on this matter. Sincerely, *** ***, Owner

The insurance claim was properly coded per regulation and your insurance carrier denied the claim.  The issue is between the patient and the insurance carrier.  The ambulance service did everything per the regulations.

the patient has asked us to change the coding of the claim we submitted so that their insurance company will pay.    He wants it coded as an emergency instead of a non-emergency transport.     [redacted] is the billing agent for Oak Bluffs ambulance,  the...

transport provider.  The documentation we received from our client supports a non-emergency transport which are often not covered by insurance .  I wish we could change the  coding as [redacted] does not get paid unless we  make a collection.  However, rule are rules and we can only code based on what the transporting service documents.  I reviewed the documentation again and see not avenue to make a change in our coding.  To code differently than we did would be insurance fraud.

Revdex.com:
I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # [redacted]. Please add your rejection comments below. I will fax the er record 6/15/16 You will see it was acute cholecystitis were Dr [redacted] and Dr [redacted] felt it was best to go to a bigger Hospital.  Thank you [redacted]
Regards,
[redacted]