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Drs. Schwartz, Funari, Poshni & Chen, P.C.

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Reviews Drs. Schwartz, Funari, Poshni & Chen, P.C.

Drs. Schwartz, Funari, Poshni & Chen, P.C. Reviews (7)

Thank you for your letter dated 11/9/which was received, via fax, in our office on 11/16/regarding Ms*** ***'s complaint, Our office saw both *** and *** *** for consultations regarding extraction of their wisdom teethOur office policy is to check with each patient's
insurance company to verify benefits for any proposed proceduresWe mail a written treatment plan to our patients, providing them with the estimated out-of-pocket expense for their procedureThis written treatment plan is based on the information provided to us by the patient's insurance company.These benefit verification procedures were followed for both *** and ***At the time they presented for their consultations we were in network with their medical insurance, *** ***Our office was in contact with *** *** regarding coverage for each child's treatment within days of each child's consulation and written treatment plans, again based on the information we were provided by the ***'s medical insurance and dental discount plan, were mailed to them.It appears that no claim was filed for ***'s surgery not because we "didn't think” a claim would be paid, but because we were specifically told by her insurance company that there was no benefit for the procedures through *** ***We posted the appropriate dental discount, based on the information we were given by the *** Dental Discount Network, and statements were sent accordingly.Ms*** did contact our office, and we were in contact with *** *** on numerous occasionsEach time we were told that there was no benefit for the procedure, for either *** or ***When we questioned a pre-authorization that *** *** had issued for ***'s extractions we were informed by *** *** that the authorization had been cancelled the same date it was issued and that no payment would be issued by themStatements continued to be sent to the ***s because we had not received any written or verbal confirmation from *** *** that any payment would ever be issued.We processed a discount of $per *** Dental's instructions to ***'s accountBased on the same 20% discount, again per *** Dental, a $discount was posted to ***'s account, When *** *** eventually did make their payment for *** in August Ms*** received a refund from our office in the amount of $489.94, which was created in part by the $discountIn actuality neither *** nor *** are eligible for the dental discount once the medical insurance coverage becomes primaryWe opted not to remove those discounts as a courtesy to the ***'s due to the frustration their insurance company was creating and as an indication of our willingness to work with them and for them to get the issues resolved as quickly and accurately as possibleOur office responded to each inquiry immediately and we continued to work with Ms*** and her insurance company to resolve this issue, Unfortunately, we are only able to provide information about a patient’s insurance plan using the information their plan provides to usWe in no way administer any insurance plan or havé any say in what is covered or not coveredThe type of misinformation, wrong information and confusion regarding the ***'s coverage was a typical occurrence with *** *** and our practice stopped participating with their medical insurance plans effective 11/30/as a direct result of this type of poor performance.This practice understands that many patients who need our services may be nervous, in pain, concerned their procedure will be painful or that they will be in pain afterwardsOur practice tries very hard to make their experience as pleasant as it possibly can beWe definitely do not want our patients to feel that the surgical process itself was satisfactory and the doctors and staff were great, but that the billing process was unsatisfactoryWe inform our patients of the expected out-of-pocket expense, in writing, based on the information made available to us by their insurance before any procedures are doneThis is done not simply to inform patients of their estimated out-of-pocket expense but also to provide ample time and opportunity to discuss any questions about the estimate prior to the procedure when the estimated amount is collected,Our billing was based on information provided to us by the ***'s insurersIn fact, until 11/16/(a full months after we first checked benefits for ***) *** *** continually told us that there was no coverage for either child's procedureWe contacted them again the day that we received your letter, 11716/16, and that was the first time that *** *** stated that the extraction of full-bony teeth, including wisdom teeth, was a covered benefit under ***'s medical planThey offered no explanation or excuse as to why it took months to provide accurate benefit information, nor was any offer made to correct the error or assume any responsibility for the errors.We are of course happy to credit ***'s account in full and have done soWe would hope that both the ***'s and the Revdex.com now have a better understanding that our billing was merely in response to the information given to us by the ***'s insurance companies,Please contact our office if you have any questions or need any additional information.Sincerely,The Practice of DrsSchwartz, Funari, Poshni and Chen

Thank you for your letter dated 11/9/which was received,
via fax, in our office on 11/16/regarding Ms*** ***'s complaint, Our office saw both *** and *** *** for consultations regarding extraction of their wisdom teethOur office policy is to check with each patient's insurance company to verify benefits for any proposed proceduresWe mail a written treatment plan to our patients, providing them with the estimated out-of-pocket expense for their procedureThis written treatment plan is based on the information provided to us by the patient's insurance companyThese benefit verification procedures were followed for both *** and ***At the time they presented for their consultations we were in network with their medical insurance, *** ***Our office was in contact with *** *** regarding coverage for each child's treatment within days of each child's consulation and written treatment plans, again based on the information we were provided by the ***'s medical insurance and dental discount plan, were mailed to themIt appears that no claim was filed for ***'s surgery not because we "didn't think” a claim would be paid, but because we were specifically told by her insurance company that there was no benefit for the procedures through *** ***We posted the appropriate dental discount, based on the information we were given by the *** Dental Discount Network, and statements were sent accordinglyMs*** did contact our office, and we were in contact with *** *** on numerous occasionsEach time we were told that there was no benefit for the procedure, for either *** or ***When we questioned a pre-authorization that *** *** had issued for ***'s extractions we were informed by *** *** that the authorization had been cancelled the same date it was issued and that no payment would be issued by themStatements continued to be sent to the ***s because we had not received any written or verbal confirmation from *** *** that any payment would ever be issuedWe processed a discount of $per *** Dental's instructions to ***'s accountBased on the same 20% discount, again per *** Dental, a $discount was posted to ***'s account, When *** *** eventually did make their payment for *** in August
Ms*** received a refund from our office in the amount of $489.94, which was created in part by the $discountIn actuality neither *** nor *** are eligible for the dental discount once the medical insurance coverage becomes primaryWe opted not to remove those discounts as a courtesy to the ***'s due to the frustration their insurance company was creating and as an indication of our willingness to work with them and for them to get the issues resolved as quickly and accurately as possible
Our office responded to each inquiry immediately and we continued to work with Ms*** and her insurance company to resolve this issue, Unfortunately, we are only able to provide information about a patient’s insurance plan using the information their plan provides to usWe in no way administer any insurance plan or havé any say in what is covered or not coveredThe type of misinformation, wrong information and confusion regarding the ***'s coverage was a typical occurrence with *** *** and our practice stopped participating with their medical insurance plans effective 11/30/as a direct result of this type of poor performanceThis practice understands that many patients who need our services may be nervous, in pain, concerned their procedure will be painful or that they will be in pain afterwardsOur practice tries very hard to make their experience as pleasant as it possibly can beWe definitely do not want our patients to feel that the surgical process itself was satisfactory and the doctors and staff were great, but that the billing process was unsatisfactoryWe inform our patients of the expected out-of-pocket expense, in writing, based on the information made available to us by their insurance before any procedures are doneThis is done not simply to inform patients of their estimated out-of-pocket expense but also to provide ample time and opportunity to discuss any questions about the estimate prior to the procedure when the estimated amount is collected,
Our billing was based on information provided to us by the ***'s insurersIn fact, until 11/16/(a full months after we first checked benefits for ***) *** *** continually told us that there was no coverage for either child's procedureWe contacted them again the day that we received your letter, 11716/16, and that was the first time that *** *** stated that the extraction of full-bony teeth, including wisdom teeth, was a covered benefit under ***'s medical planThey offered no explanation or excuse as to why it took months to provide accurate benefit information, nor was any offer made to correct the error or assume any responsibility for the errorsWe are of course happy to credit ***'s account in full and have done soWe would hope that both the ***'s and the Revdex.com now have a better understanding that our billing was merely in response to the information given to us by the ***'s insurance companies,
Please contact our office if you have any questions or need any additional informationSincerely,
The Practice of DrsSchwartz, Funari, Poshni and Chen

[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.]
Revdex.com:
From: *** *** ***Date: Tue, Dec 13, at 6:AMSubject: Satisfied with outcome.To: ***I am satisfied with the outcome of claim #***. Thank you for all of your help.Sincerely,*** ***Sent from my iPhone

[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.]
Revdex.com:From: [redacted]<[redacted].[redacted]@gmail.com>Date: Tue, Dec 13, 2016 at 6:59 AMSubject: Satisfied with outcome.To: [redacted]I am satisfied with the outcome of claim #[redacted].  Thank you for all of your help.Sincerely,[redacted]Sent from my iPhone

August 8,2014
To Whom It May Concern:
This letter is in response to the complaint filed against our practice on August 4, 2014, The patient is disputing the remaining balance on his account from February 7, 2012 of $505.00. The patient presented to our office on the above date of...

service for emergency treatment for a medical condition. Our practice is a specialty practice and the patient signed and dated out Office Financial and Insurance Policy which states in paragraph 3 "Please be aware that if a referral is required by an insurance company for office visits or treatment, it is the patient's responsibility to obtain these referrals. If a referral is not presented at the time services are rendered, the patient is fully responsible for any expenses incurred for those services."The patient was seen in our office on April 17, 2012 as well as April 22, 2013 for other medical procedures and the patient obtained an insurance referral from his PCP and those dates of Service were filed to the insurance company and processed and paid.The patient states in his complaint that he did not receive a statement bill from our practice until November 2013. As you can see from our records the patient was sent 8 billing statements from May 2012 to November 2013 to which he did not contact our office until December 2, 2013,On December 2, 2013 the patient contacted our office regarding his outstanding balance and spoke to the office manager. She explained to the patient "Documented" what his balance was from. The office manager contacted the patient's insurance company on December 2,2013 and December 26, 2013, as you can see by all the documentation, to try to help the patient get the claim paid.The patient has received 4 billing statements since the last verbal contact with him on December 30,2013. The patient received a final notice from our office on July 31,2014.
In conclusion, it is the patients responsibility to be aware of his medical insurance policy and if it needs referrals for office visits and treatment. The patient was sent a total of 13 billing statements from May 2012 to July 2014 and which indicated an outstanding balance with our practice. The patient is responsible for the total amount of $505.00.
Sincerely,Kim HPractice Manager

The matter has been resolved....

Review: The Office of Drs. Schwartz, Funari, Poshni & Chen, PC (referred to thereafter as Office) -- located at [redacted], MD [redacted] -- sent me a bill on November 2013 informing me that I owe the Office $505. When I contacted the Office, I was told that the charges are from my visit on February 7, 2012. I was told that the Office submitted a claim to my insurance company, United Healthcare, more than three times, and every time the claim was denied because it did not have the proper referral. For more than three times, the Office received that response from the insurance company, and did not bother to alert me to rectify the situation and obtain the proper referral from my primary care provider (The Office did not even request the proper referral on the day of my visit). I even had a procedure done at the Office in April 2013 and the Office told me that I don’t owe any money. I assumed, since the Office did not alert me to the problem with this claim, that it has been paid by my insurance company, until I received a bill from the Office 1 ½ years after the visit, when it was too late to correct the situation. I should say that I was able to work with the insurance company before to resolve a similar issue with this Office with the appropriate referral once I was notified by the Office on another claim in a timely manner. I sent an appeal to the my insurance company in January 2014 after I was notified with the problem, however the appeal was denied as it was more than 6 months after my Office visit. I understand that the payment is the responsibility of the patient, however, if the Office took it upon themselves to process the insurance claim, the Office has the responsibility to notify the patient with any issues associated with the claim in a timely manner, not wait for 1 ½ years to notify me of the problem when it is too late to resolve anything. It is not fair or right to ask me to pay these charges and I respectfully ask the Office to erase these charges from my account as clearly this is not due to a fault of mine.Desired Settlement: I respectfully ask the Office of Drs. Schwartz, Funari, Poshni & Chen, PC to erase the $505 charges from my account as clearly this is not due to a fault of mine

Business

Response:

August 8,2014To Whom It May Concern:This letter is in response to the complaint filed against our practice on August 4, 2014, The patient is disputing the remaining balance on his account from February 7, 2012 of $505.00. The patient presented to our office on the above date of service for emergency treatment for a medical condition. Our practice is a specialty practice and the patient signed and dated out Office Financial and Insurance Policy which states in paragraph 3 "Please be aware that if a referral is required by an insurance company for office visits or treatment, it is the patient's responsibility to obtain these referrals. If a referral is not presented at the time services are rendered, the patient is fully responsible for any expenses incurred for those services."The patient was seen in our office on April 17, 2012 as well as April 22, 2013 for other medical procedures and the patient obtained an insurance referral from his PCP and those dates of Service were filed to the insurance company and processed and paid.The patient states in his complaint that he did not receive a statement bill from our practice until November 2013. As you can see from our records the patient was sent 8 billing statements from May 2012 to November 2013 to which he did not contact our office until December 2, 2013,On December 2, 2013 the patient contacted our office regarding his outstanding balance and spoke to the office manager. She explained to the patient "Documented" what his balance was from. The office manager contacted the patient's insurance company on December 2,2013 and December 26, 2013, as you can see by all the documentation, to try to help the patient get the claim paid.The patient has received 4 billing statements since the last verbal contact with him on December 30,2013. The patient received a final notice from our office on July 31,2014.In conclusion, it is the patients responsibility to be aware of his medical insurance policy and if it needs referrals for office visits and treatment. The patient was sent a total of 13 billing statements from May 2012 to July 2014 and which indicated an outstanding balance with our practice. The patient is responsible for the total amount of $505.00.Sincerely,Kim HPractice Manager

Consumer

Response:

The matter has been resolved....

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Description: Physicians & Surgeons - Medical-M.D.

Address: 3401 Olandwood Court Suite 104, Olney, Maryland, United States, 20832

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