I am not satisfied with their response because I feel that they did nothing to help me resolve the issueI called them before the procedure and told them how it needed to be coded for the insurance to pay for itI thought the matter was taken care ofI did not receive a bill from them until September which does not match what they saidI had to appeal the insurance for the hospital coverage in June and July because this doctor's office did not code the procedure correctlyWhen I called their office in September I was talked to rudely and told that I would have to follow through and that they would do nothing to helpI asked if my primary care doctor sent in a letter would they resubmit, and I was told they wouldI contacted my primary care doctor and she sent a letterAgain, I thought it would be resubmitted, and then I receive a collections letter in DecemberEvidently, they did nothingIf the person who responded is the one I spoke to, then she is the one who could apologize for how she spoke to me, and for how she said she would resubmit, but then didn'tI had to file an appeal with my insurance and the insurance has paid them, but I still want others to know about the poor customer service they offerTherefore, I refuse to withdraw the complaint
Re: complaint ID [redacted]
Our office received a referral from Ms. [redacted]’s primary care
physician and...
the diagnosis was due to a medical condition, not for screening purposes. When Ms. [redacted] called our office to schedule
her procedure she was given a diagnosis code and a procedure code. We instruct patients to call their insurance
company to check on their benefits. We
also mail the patient instructions and on that instruction packet it also gives
the procedure code and the diagnosis code.
It also informs the patients the difference between a screening vs
diagnostic procedure. Since Ms. [redacted] came in with a diagnostic issue,
which is always subject to the patient’s deductible and/or coinsurance. The date of her procedure was 6/11/2014. We billed to her insurance company on 7/2/2014
and her insurance paid their portion on 7/11/2014. Patient has a balance of $79.35. We mailed her statements on 7/17/2014,
8/21/2014, 9/25/2014. 10/30/2014 and 11/21/2014. Since we did not get payment, her account was
placed in collections on 12/2/2014.
Ms. [redacted] called our office on 9/9/2014 and we did explain
this all to her. We explained the
difference between a screening and a diagnostic procedure. We also told her
that we did code her procedure appropriately.
We follow the ICD-9 coding guidelines that are mandated. Ms. [redacted] at that time demanded that we change
the coding. We told her we couldn’t do
that since that is insurance fraud. We
gave her the tools necessary to try to file an appeal with her insurance
company and she had said that she didn’t care if her account went into
collections and that she would not be filing an appeal with her insurance
because she didn’t want to help us get the money owed to us.
Ms. [redacted] primary care physician did not change her referral
as to why the patient came to our office like Ms. [redacted] said she did.
If you have any further questions, please feel free to
contact me ###-###-####
Sincerely,
[redacted]
Billing Supervisor
I am not satisfied with their response because I feel that they did nothing to help me resolve the issueI called them before the procedure and told them how it needed to be coded for the insurance to pay for itI thought the matter was taken care ofI did not receive a bill from them until September which does not match what they saidI had to appeal the insurance for the hospital coverage in June and July because this doctor's office did not code the procedure correctlyWhen I called their office in September I was talked to rudely and told that I would have to follow through and that they would do nothing to helpI asked if my primary care doctor sent in a letter would they resubmit, and I was told they wouldI contacted my primary care doctor and she sent a letterAgain, I thought it would be resubmitted, and then I receive a collections letter in DecemberEvidently, they did nothingIf the person who responded is the one I spoke to, then she is the one who could apologize for how she spoke to me, and for how she said she would resubmit, but then didn'tI had to file an appeal with my insurance and the insurance has paid them, but I still want others to know about the poor customer service they offerTherefore, I refuse to withdraw the complaint
Re: complaint ID [redacted]
Our office received a referral from Ms. [redacted]’s primary care
physician and...
the diagnosis was due to a medical condition, not for screening purposes. When Ms. [redacted] called our office to schedule
her procedure she was given a diagnosis code and a procedure code. We instruct patients to call their insurance
company to check on their benefits. We
also mail the patient instructions and on that instruction packet it also gives
the procedure code and the diagnosis code.
It also informs the patients the difference between a screening vs
diagnostic procedure. Since Ms. [redacted] came in with a diagnostic issue,
which is always subject to the patient’s deductible and/or coinsurance. The date of her procedure was 6/11/2014. We billed to her insurance company on 7/2/2014
and her insurance paid their portion on 7/11/2014. Patient has a balance of $79.35. We mailed her statements on 7/17/2014,
8/21/2014, 9/25/2014. 10/30/2014 and 11/21/2014. Since we did not get payment, her account was
placed in collections on 12/2/2014.
Ms. [redacted] called our office on 9/9/2014 and we did explain
this all to her. We explained the
difference between a screening and a diagnostic procedure. We also told her
that we did code her procedure appropriately.
We follow the ICD-9 coding guidelines that are mandated. Ms. [redacted] at that time demanded that we change
the coding. We told her we couldn’t do
that since that is insurance fraud. We
gave her the tools necessary to try to file an appeal with her insurance
company and she had said that she didn’t care if her account went into
collections and that she would not be filing an appeal with her insurance
because she didn’t want to help us get the money owed to us.
Ms. [redacted] primary care physician did not change her referral
as to why the patient came to our office like Ms. [redacted] said she did.
If you have any further questions, please feel free to
contact me ###-###-####
Sincerely,
[redacted]
Billing Supervisor