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Diversified Remodeling Service Reviews (9)

I do understand the Urological Services were provided by a private doctor from within the [redacted] My claim should be directed to the doctors office.Unfortunately the bill from the Urologist and the Collection Agency were a single sheet of paper that was returned with the check[redacted]

Ms***' visit of April 16, 2014, with Dr*** *** has been refiled and paid by Medicare on 12/2/Her*** insurance has been refunded appropriately for having paid as primary on this claim however has yet to reprocessas secondaryAdditionally, we received a call from her *** insurance on 12/16/indicating they were in theprocess of reviewing her claims see if other payments needed to be reprocessed as secondaryPatient payments havebeen appropriately moved to other open patient balance charges, and until a patient overpayment/credit on the account isshowing, a system refund cannot be generatedAll of this is part of our standard processesMs*** currently hasa -0- patient balance with several newer charges pending insurance.Ms*** expressed her expectations on the billing systemSince the billing system is handled at our CorporateCentral Billing Office (CBO), this concern was forwarded to the CBO Practice Support team for review and we are unableto fully meet the expectations outlined her letter at this timeMs*** is always welcome to call our customer serviceline for questions regarding her account.Respectfully,LewisGale Physicians***, CPC, CCP-P, CRSDirector, Goding, Compliance & EducationLewisGale Physicians, LLC

This letter is to respond to the above complaintWhile the complaint is indicated as being sent on 10/23/14, we could not
locate the original requestPlease excuse the tardiness of this response
Ms*** was seen on April 16, 2014, by Dr*** *** as stated in her complaintHowever,
Dr *** did not bill
her for a "physical exam" rather for a detailed office visitThe diagnosis code he billed for the visit was "encounter for
prescriptions" which is code VMedicare considers many "V" codes to be routine and many routine services are not
coveredMedicare denied this claim, as preventive or routine, due to the diagnosis code submitted, On May 12, 2014,
Ms*** called and the customer service representative sent the claim for coding review which, unfortunately, did
not get completedMs*** called again on July 21, 2014, and the claim was then reviewed by a coder and, on July
31, 2014, corrected the order of diagnosis codes The claim was sent to the central billing office requesting a correcting/
appealing the claim to MedicareHowever, Medicare would not reopen the claimTo further confuse the issue, Ms
*** secondary insurance, ***, paid the claim as primary and needed to be refundedWith the above activity on
this claim showing processed from both Medicare and ***, the billing system moved the balance on the claim to
patient responsibility On November 12, 2014, a new claim was resubmitted to Medicare and the balance moved from
patient responsibility and is now showing as pending insuranceMedicare typically takes days to process new claims
I apologize on behalf of LewisGale Physicians for the confusion in resolving this complaint and getting Ms***'
claim billed correctly and processed by insurance
Should you need additional information, please don't hesitate to contact me
*** ***

Dear Ms*** at, and Ms***, Coding and Compliance
at LewisGale Physicians,
Thank you for replying to my concerns about improper handling
of charges to my LewisGale account. I
understand that a new bill has been sent to Medicare, that LGP recognized that
*** needed to be refunded for overpayment, and that the balance on the
account has been temporarily removed from my responsibility pending responses
to proper billing of my insurers. Also, Ms
***, I appreciate your apology on behalf of LGP
This is a start toward resolution of my concerns, but only a
start. I have reviewed the response offer 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
Please recall my requested
outcomes: “Most important I wish the LGP
Group to redesign it's accountability so that people are expected to bill
and/or adjust bills accurately the first time, and to correct any problems
promptly and effectivelyI want my payments to be credited to the charge I've
been billed for, not placed into a pool from which LGP can disburse the payment
to any charge they chooseI want a refund and an explanation of how they will
prevent such errors from occurring in the future, especially for me and all
other disabled, very young or elders like meLast I would ALWAYS like to be
issued a refund promptly on any bill that my insurers and I have paid for at
the agreed upon rate.”
Certainly some time must pass for Ms*** to complete
the corrected billings to Medicare and *** and to obtain their responses. I suggest that that on behalf of myself and
the, you, Ms***, plan to re-contact LGPhysicians in days to obtain
an update about that
So far, so good. Now,
what steps has Ms*** taken to address the systemic problems that my
case has uncovered? Is not her own
inability to acknowledge the initial notification sent on 10/23/an
indication of lapses in the company’s handling of correspondence and
I expect any needed
refunds to go promptly to the agent who overpaid. I trust that Ms*** can see that I
have already overpaid on this bill, yet I received a collection letter from the
corporation‘s collection arm last week.
While I do expect she will cancel that collection order, it is another
example of “the billing system” acting in a way that is unsatisfactory. “The
billing system” needs to be ably monitored and controlled by humans who can
discern commonsense responses to information that a machine cannot. Without that, in the future, how can I be assured
that billing to insurers and to me will be accurate?
*** ***

I have reviewed the response offer made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. 
Thank you
for looking further into the inconsistencies in billing practices, and also
Lewis Gale Physician's inappropriate dunning of me over this bill for 04/16/14
with Dr. [redacted].
This week, I
contacted my secondary insurer in regard to a different Lewis Gale Physicians bill.   I
triggered the company's discovery that 
they, [redacted], has processed nearly all of my medical bills since 10/01/13
under a previous policy number inappropriately and incorrectly.  Probably it will be many weeks until we know
what total amount  I truly am responsible
for down to the penny.  The insurer did
contact the hospital to advise them of this, per my request. Thus, they share
responsibility for mixed up claims processing of my bills.
As regards
the flawed structure of the billing process itself, why am I not surprised that
the hospital's spokesperson states that she must refer me to another department
out of the area?  I'm also unsurprised
that the name and contact information for the supposed responsible party has
not been offered.
What do I
request now?
1.)  A full reevaluation of current billing
practices.  I would much appreciate
learning that there has been the program's redesign, so that bills are created
correctly the first time.  I would like
to learn that there is then a new staff training which also empowers them to
make reasonable patient accommodation when errors occur.  Any reasonable  person looking at this bill's history can see
that far too many payments I've made have been credited to this overcharged
bill.  Would it be too much to ask for
LGMC to refund all but the expected amount of patient responsibility after both
insurers have reprocessed the claim?
2.) The
name, address, email address, and phone number of the department head  for the CBO Practice Support Team.
3.)  That refund originally requested.
I appreciate
the medical care I receive through LGP. 
I hope the billing issues get resolved in skilled and thoughtful ways.

We are putting a brand roof on tomorrow.  She had incorrect venting system on the roof from previous contractors that had leaked.  This was a property that had been flipped improperly that was discovered after she showed us the flooring repairs.  The roof did not leak for 6 months...

until we had a major snow storm.  This is being resolved and our company has never had any complaints in 27 years.

I do understand the Urological Services were provided by a private doctor from within the [redacted].  My claim should be directed to the doctors office.Unfortunately the bill from the Urologist and the Collection Agency were a single sheet of paper that was returned with the...


[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
[redacted] From: [redacted] <[redacted].com>Date: Mon, Aug 22, 2016 at 11:33 AMSubject: ID:[redacted]To: [redacted] [redacted],The issue has been resolved. The roof was replaced and there is no water entry. -- [redacted]

A guy came and gave a good quote, but when I followed up asking if they could provide copy of license, owner's driver license and produce receipt, he backed off and said was not interested.

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Description: Siding Contractors, Windows, Kitchen & Bath - Design & Remodeling, Home Improvements - Additions, Roofing Contractors

Address: PO Box 101, Port Tobacco, Maryland, United States, 20677-0101


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