ENTAA Care Reviews (%countItem)
ENTAA Care Rating
Address: 1132 Annapolis Rd Ste 105, Odenton, Maryland, United States, 21113-1672
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+1 (410) 367-2464 |
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Address: 1132 Annapolis Rd Ste 105, Odenton, Maryland, United States, 21113-1672
Phone: |
Show more...
|
Fax: |
+1 (410) 367-2464 |
Add contact information for ENTAA Care
In 7/2020 I had an appt with Dr. *** who advertises herself as specializing in reflux disorders. As I was relating my varied symptoms that have been getting progressively worse, some that started years ago, she told me she didn't have time to hash through all my frustrations that have built up over the years. I said I was only interested in treatment approaches she would recommend for reflux other than PPIs/H2 blockers that haven't worked for me in the past and she said she couldn't answer me. I said I wouldn't continue with her services unless she had options other than the PPIs/H2 blockers. She asked if she could examine my throat and I agreed and opened my mouth. She said she would look through my nose and inserted a tube for no more than 30 seconds and reported no sign of a blockage. She then told me she didn't have any other treatment options and couldn't determine the source of my reflux and that she was not in a research practice like *** I questioned why this practice is advertised as a Member of *** Medicine, and if I could at least get a reference; she asked me to wait until after her seeing another patient and she did provide two(neither from *** I later received my insurance statement with a charge of $487 for a surgery done in that visit. I called the billing office and was told that the scope used on me was considered an in-office surgical procedure that I had authorized when I signed their new patient forms back in 3/2019. I asked for a billing manager to call me since I didn't consent to a laryngoscopy and was smugly told by her that I signed the form and said yes for her to look at my throat and she would not remove the charge but would tell the Dr. to be clearer next time. Don't these forms have a legal expiration date since every other doctor I see requires forms to be resigned after a year? I also noticed that my on-line health record incorrectly states I had an active Feeling of Foreign Body in the Throat; I never stated that.
Product_Or_Service: Doctor office visit
Billing Adjustment I want the surgery charge removed from my account. I clearly told the doctor that I wanted to know her potential reflux treatment options before continuing with her services. When she asked to look at my throat, I considered it part of the office visit. If I had been asked to have a laryngoscopy, I wouldn't have it done since I had no need for it. I find the new patient paperwork wording deceptive and predatory; patient pre-approval of in-office procedures should be given at time of the service.
ENTAA Care billed the wrong Provider which made me responsible for the bill.
Called on 12/1/18 and spoke to the insurance department in regards to my responsibility for that date of service, Melissa stated it will only be $10 for the copay. I received the EOB and of course it stated I owe $47.33. The company lied and used the wrong Provider. I called my insurance company and they stated the provider billed wrong and used the wrong provider. I spoke to the insurance department at ENTAA and of course they were rude and was not helpful.
Write off the $37.33
Document Attached***
To address that the "wrong provider" was billed, I have attached records indicating that the claimant was seen by Dr. Andrew ***. The claim was billed to the claimants insurance carrier correctly under Dr. Andrew ***, and the Johns Hopkins Regional Physicians Group. The correct provider and group is listed on the attached insurance remittance, showing that they processed the claim under the correct provider that the claimant was seen by. There is no error in the provider that was billed.
I could not find a record of the call made to Melissa on 12/01/2017. However, any assistance in understanding potential out-of-pocket costs in advance of medical services would only be an estimate is subject to the processing of the claim by the patient's insurance carrier. The claimant signed an agreement on the date of her service that she understood she would be responsible for any co-insurance, copays, and/or deductible and has been attached for your review.
I do have a record of the claimant contacting our office on 3/15/2018 indicating that she had contacted her insurance carrier to dispute her out-of-pocket cost, as she felt her benefit was not appropriately applied. The insurance carrier ultimately ruled that the claim processed correctly and did not change the patient out-of-pocket cost. We have not been contacted from the insurance carrier alerting us to any inappropriate or incorrect billing.
There seems to be a dispute with the patient and her insurance carrier as to her out-of-pocket cost when she sees a "Hopkins Preferred Provider". I have attached a record from her insurance website indicating that Dr. Andrew *** is, indeed, a "Hopkins Preferred Provider". However, any dispute over what her insurance deems to be her out-of-pocket cost should be made with them, as they make that determination on what providers are considered "Hopkins Preferred" and process her claim according to her benefits. We can only bill what the insurance company tells us is the patient's responsibility.
Please feel free to contact me with any further questions or concerns.
Kristi ***
Billing Manager
(The consumer indicated he/she DID NOT accept the response from the business.)
Kristi, your staff is rude and most important ***. I called your office multiple times and spoke to multiple people regarding this issue. The first time I called before my appointment. Melissa checked my insurance and stated I will only be responsible for a copay because, your office is in network with my insurance. I am sorry you and your staff is not knowledgeable with insurances. You and your company has did this to multiple people including Johns Hopkins employees which is why I made this complaint. I will not pay for 37.33 because, you and your staff is not knowledgeable and unable to give me the right information. I spoke to my insurance company and they stated your staff called in and stated themselves they were wrong. The staff needs to be trained on Hopkins Preferred Provider. I would have went to another provider that told the truth and not scam people to think you are in network with their insurance.
Our phone calls are recorded for quality assurance and I was able to pull the following timeline of information:
11/30/2017: (recorded call) Complainant spoke to Shelby to schedule appointment. When complainant asked "how much will I be responsible for?", Shelby responded "Whatever you pay for a specialty provider. But if you have a deductible, we collect a $200 deposit in advance". Patient indicated "I met my deductible". No further specific amount was discussed.
12/07/2017: Appointment held in which front desk collected $10 copay listed on patient's insurance card, as is typical for front desk collection. We do not collect additional funds unless you have a large deductible to be met - which you did not.
3/15/2018: Phone recording system was down at this time - per our IT department. But we have written documented records that you called and spoke with Donna in which you advised us that you contacted your insurance company because you felt your balance was incorrect and they mis-processed your claim and that you should only be responsible for $10. We also contacted your insurance company and spoke with Wanda that day - she advised that they, indeed, were reprocessing your claim. We held off continuing to bill you during the reprocessing.
5/17/2018: We called *** to determine status reprocessing. They indicated the claim was processed correctly according to the patient benefit. No change was made to the claim. We had a requested our provider rep, Connie, to review for accuracy due to the "preferred provider" status of our provider affecting the patient's benefit.
6/27/2018: Connie, our provider rep for ***, contacts us back to indicate that if "customer service says the claim is processed correctly, there is nothing she can do".
12/18/2018: (recorded call) Receive phone call from complainant who speaks to Evelyn. Complainant advised Evelyn that she has contacted her insurance company and her insurance company states that we "miscoded" our claim. Evelyn reviews claim and EOB with patient and states claim is accurate and if she believes she should owe less, she should contact her insurance. Complainant states "I'm not going to do that. I'm having this issue escalated. You're not getting your money" and hangs up the phone.
12/18/2018: (recorded call) Complainant calls back and speaks to Suray. Complainant indicates adamantly that she "contacted my insurance company and I'm only supposed to pay the $10 and you're supposed to write off the $37.33" and that the claim was "not processed correctly" and that the insurance advised us of such. Suray indicated that we received no notification of the reprocessing of the claim and transferred patient to Melissa - who handles *** accounts in our office.
12/18/2018: (recorded call) Melissa explains to patient that *** advised her that the reason the claim will not reprocess is because our provider is not considered a "preferred provider". The patient disputed that we were advised by BOTH our practice and her insurance company that she would only be responsible for $10. Melissa advised patient that our front desk would not know her responsibility and, ultimately, we can only go by what the insurance company advises on the claim. Claimant became frustrated and ended the call stating she "wasn't paying the bill" and we could "kiss my a". Again, this call was recorded.
Ultimately, I have found no record of us indicating to the claimant specifically what she would be responsible for in advance of the appointment, but rather, the patient contacting her insurance company several times and advising US what she "should" have been responsible for. Certainly our provider is listed as a "preferred provider" on the *** website, so it made sense for the patient to dispute that with her insurance company. However, *** makes the final decision on patient responsibility and the processing of the claim according to the patient benefit. We even attempted to assist the dispute of "preferred provider" with our provider rep, who ultimately stated there was nothing she could do. The balance of $37.33 is owed to the provider. The insurance company determines whether they will pay that balance, or the patient is responsible for that balance. Right now, *** continues to state that the patient is responsible for that balance.
In response to the rudeness of the staff: I listened to every available call (in which I could only find one made with Melissa) and I did not find that any of my staff spoke rudely or inappropriately. And although all of your phone calls started off quite professional and mild, it was apparent that you had a growing frustration that ended with dissatisfaction and you telling Melissa to "kiss my a". None of my staff used profanity. If you have a specific example of how my staff was "rude", I'd be happy to look into it further.
I am sorry that you are dissatisfied with the outcome of our decision, but I do feel that the dispute is with your insurance carrier for providing both you and our practice inaccurate information regarding our provider being "preferred" and subsequently processing your claim with a higher out-of-pocket cost.