EMMI Physician Services, Inc.

Review: To Whom it May Concern;I am writing this letter because I have not been able to resolve an issue that I have had with my doctor's billing office and Stockton Path Med Grp. after going for my anual exam 9/9/11. I have tried multiple times to get this matter taken care of but with no success. After speaking with my insurance company, Blue Shields of California implied that they will pay the full amount, 100%, of Stockton Path Med Grp if they would change their code to the correct one but Stockton Path Med Grp. said that they will not change the code nor do anything and in fact they have stated today 5/30/13 that they just sent me to collection on 5/28/13. Before I made my initial appointment to have my anual exam done, I contacted Blue Shields of California to confirm that my annual exam and lab work were covered. Blue Shields of California confirmed that it was infact covered 100%. I have been a victim the entire time and I have done everything in my power to call and send letters to get this matter taken care of. I have always been a responsible person and taken care of my expenses but this is not acceptable. The amount that I am being charged and now being sent to collection is $363.68. I have been going around in circles to get this bill taken care of from talking to my insurance company to my doctor's office to Stockton Path Med Grp. I should not have ever been charged for my lab work in the first place, this is covered under my insurance but Stockton Path Med Grp will not input the correct code for my insurance to pay for it.

Account_Number: SP XXXXXX

Desired Settlement: DesiredSettlementID: Other (requires explanation)

I would like this issue to be resolved between Stockton Path Med Grp and Blue Shields of California like it should have been done in the first place.

Business

Response:

Business' Initial Response

Contact Name and Title: M [redacted]/Dir of Ops

Contact Phone: [redacted]

Contact Email: [redacted]@emmicorp.com

Ms. [redacted] came to our offices 5/31/13 with her complaint. She shared with me her frustration and all the facts surrounding this issue. I told her I would research and get back to her via phone on 6/3/13 or 6/4/13. I ended up calling her insurance carrier, Blue Shield. Blue Shield told me "they would pay" if we re-submitted the claim with a Preventative Diagnosis. We confirmed with her physician that the Diagnosis was not a Preventative Diagnosis, therefore, it would have been fraudulent to change the diaqnosis. In seeing the many hours our staff has spent trying to explain this to the patient, I made the administrative decision to "recall the Collection and write off the amount due so that the patient has a zero balance due. I also called the patient on 6/4/13 and explained she does not owe anything. Case closed.