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Eriver Neurology of NY

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Eriver Neurology of NY Reviews (4)

We apologize for the dissatisfaction of one of our patients and would like to better explain why there is a discrepency in the patient's bill.
-In our standard fee for procedure code *** was $This fee was billed to the patient's insurance company whose contracted rate was
$This amount was applied to the member's deductible and was billed to and paid by the patient's parents.
-Our standard fees are based on a certain percentage of Medicare rates and are calculated at a rate high enough to encompass the multitude of insurance company rates that are often higher than Medicare ratesHowever, regardless of what we charge as a standard fee, the insurance companies will not approve or pay more than their contracted rate.
-In 2013, Medicare's rate for this procedure increased and our practice reviewed our standard rate and adjusted our charge amount for this procedure to $1,The patient had a different insurance company in and had the test repeatedThis insurance company had a contracted rate of $740.75, which was also applied to a deductibleDue to the higher contracted rate for this procedure, the member ended up being responsible for a much higher bill than the one in Therefore, it was the insurance contracted fee that increased the patient's bill, not just the increase in the standard billed fee
-The patient's mother had stated that she spoke with the provider prior to the second test and asked if the fee would be comparable to the previous time, and he had told them that it would beWe apologize for this as our providers are not involved with the specifics of the fees and the insurance plansHe should have referred the parents to contact the billing department and we could have called the insurance on behalf of the patient and received a better idea of what the bill might have been before the test was completed.
-We understand that this is a substantial difference and that the patient's family is asking that we adjust the bill amount to $as this was closer to what was paid previouslyUnfortunately, due to the fact that the insurance processed this claim and applied the amount to a deductible, we are legally obligated by our contract as a participating provider to collect this from the memberThe balance of $remains the patient's responsibility
-On 5/**/we received additional coorespondence from the Revdex.com that the patient's mother was charged an additional fee for a missed appointment on 4/**/and she believes that this is in retaliation to her original complaintWe wish to assure that family that this was not the case as we had not received the original complaint until 5/**/and the fee was already waived per a conversation with our billing department on 5/**/2014.
-Additionally, the mother had mentioned that she felt that a refill/form was not completed due to the balance on the accountIt is not our company policy to withhold clinical requests due to balances on accountsThe mother called the office on 4/**/about needing a refill and a formWe had informed the mother that there was a billing issue (the no show fee as stated previously) and she needed to speak with the billing department, but the form was not completed at that time as we had not received the formThe following day we were contacted by the patient's primary care physician who sent us the form which was completed by our clinical staff that afternoon and we contacted the mother to make arrangements for the form to be picked up
-Finally, we apologize again for any misunderstandings this patient has hadWe appreciate the feedback from patient's parents as there was obviously a breakdown in communication between our practice and the patientWe will work diligently in educating our providers to refer patients to the billing department for any sort of billing related questions so that we may avoid this type of issue in the futureOur staff will also try to find better ways of explaining fees to the patients to make it clearer as to why rates may differ from year to year or from insurance to insurance

This is a response to the complainant's issue that the complaint has not been resolved. Again, we do offer our apologies that there was such an extreme difference in the price of the repeated test. Our representatives were trying to explain to the parents that no matter what we charge the insurance company for a test, it is the contracted rate we have with the insurance that dictates the amount that is billed to the member. (The example that our representative used was a charge of $3,000.00, but we cannot bill the member more than what the insurance states is the member responsibility.) Unfortunately, our representative must not have been clear enough and the parents felt that she was being arrogant and this led to a further breakdown in the relationship with this family. 
We had also advised the patient's parents to contact the insurance company with any questions or concerns with the balance they were being charged, and to our knowledge they were not contacted. Perhaps the member services department of the insurance could have better explained the amount being billed to the member. 
We do not wish to send this account to a collection agency, and our department will work with the family directly to resolve this balance if they choose to contact us.
We will absolutely provide the family with a copy of the patient's medical record. As a courtesy, we will waive the $0.75 per page copying fee that is normally associated with obtaining medical records once we receive an official request for the records. (Which would be a phone call to the office or a request in writing to the office.) We cannot use this forum as a request for medical records.
It is evident that the provider/patient relationship has been severely compromised by the patient's parents extreme dissatisfaction with the practice. Even though the family has chosen not to accept our apologies, this is what we can offer to the member. As stated in the original response, we are unable to discount the balance because of the fee being applied to the member's contracted deductible with the insurance company. We wish the patient good health in the future.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:
1. I received several answers,(to me it is an indicative that they are not being honest) the first one from the lady in the billing department was the price difference was because [redacted] had a different test, which was completely inaccurate, of course that was not true because the only test my son had was the sleep deprived EEG.
2. Then the [redacted] told me there was an error.
3. After a long wait on the phone the [redacted] told me that the insurance forced them to charge me more.
4. The provider(the doctor) in front of my son told me the test cost between $300 or $400. I asked specifically because the test wasn't absolutely necessary. According to the [redacted], she asked the provider and he denied that he said that.
This is not only false but also a lack of ethics and professionalism, if he did not know the price of the test, he should have told me to ask the billing department and I could explain my situation but I trusted the doctor, BIG MISTAKE, so their apology does not solve my problem created by them in the first place, since they don't instruct their providers to follow a procedure when asked about fees by the patients, otherwise the provider should be responsible for the mistake. 
5. They also stated the insurance I had last year applied the amount to the deductible, which last year we did not met, so it does not make a difference, in any way will affect their balance, actually we have new insurance since January 2014. I wonder if by law they are obligated to collect always! what happened when are errors in billings? I honestly doubt very much they are errorless. We are a living proof.
6. They said they contracted with my insurance a fixed price of $740.75 for this test, but one of the times I spoke to [redacted] on the phone she did not mention at all any contract fixed price for this specific test, she actually told me if she wanted she could bill my insurance for $3,000.00 for this same specific test. So who are they kidding? are they obligated by law?
Obviously I don't believe their statements let alone their apologies, my husband correspondence from January, was never answered, the [redacted] spoke to me after more than a month only because I called her again and again, she only called back once not to speack to me or to try to solve anything she said she called just to let me know she heard my message and she will call but that never happened.
I heard the arrogance of their staff on the phone, telling me not to complain because of the fee because if she wanted she could bill me $3000 for the test, and also multiple episodes with excuses.
 You can contact my son's pediatrician any time to coroborate the treatment we received and how he intervened twice to get us precriptions and a school form.
I hope they have the coutesy, they say they have to give me my son's records now that I am transferring to a new provider, this doctor/provider besides ordering the wrong test once, and telling me and my son a wrong price and now  is costing us an extra $340.75,  can no longer be our provider and I don't wish my worst enemy having to deal with the Eriver staff, didn't they state they don't withhold anything because of billing issues? I will find out now...
Although very unfair I believed I will end up paying this bill, because of THEIR ERROR, but I firmly belive I will not get a hold of my son's records and obviously they will send me to collections and ruin our credit, this is what happens when you deal with Eriver, the doctor tells you a price and they bill you double the amount. But you are responsible.
During a school meeting I inquired about pediatric neurologists,I found out Eriver does not have a good reputation and I am so sorry I didn't find out this early! Well I guess I learned from experience and it cost me a lot of money, waste of my time, several problems and headaches and what I received was horrible service, rude treatment and a bill double the price because of their mistake!
 
 
Sincerely,
[redacted]

Review: My son is a patient with [redacted] at Eriver, he was order a sleep deprived EEG on 2012, and my insurance company and myself were charged for the amount of $400 which I paid. The next year although the test was not mandatory he asked me to do it again, so my son took the test on October 2013 at their [redacted] office, (by the way we noticed he ordered the regular EEG instead of the sleep deprived, my son was sleep deprived and they made him wait another 45 minutes) and for this service and test we were charged $765, almost twice the amount from the previous year, I must also mention the doctor ordering the test ([redacted]) assured me the amount will be between $300 or $400.

I did send a payment of $400 for the last test since I thought the difference would be settled. I was wrong.

My husband wrote a letter showing the difference for the exact same service between one in the year 2012 and the one in 2013, but they did not even acknowledge, and they sent us a bill exactly the same.

I called the Eriver billing department I spoke to someone called [redacted], and not only they did not solve anything with a lot of arrogance they told me if they wanted they could charge up to $3000 for that test, and to talk to her [redacted], who never returned my called so I called again one moth later, and the first excuse was the statutory fees, and then she came out with another excuse saying that it was the insurance company telling them how much they could charge us and they were charging us to little.

Since we have a very high deductible, we wrote them checks to Eriver not the insurance company, is an insult to the intelligence and dignity of the people, who trust their service and fees and never expected to pay double for the same thing, I could have expected a little more like maybe 15 or 20% increase but never a 97% increase. I have proof of everything I wrote.Desired Settlement: Since I already paid $400 ,which was the amount for the previous year, I expect the debt to be paid off or if I must pay a adjustment due to inflation or something it can not exceed $50 or what the general practice considers fair.

Business

Response:

We apologize for the dissatisfaction of one of our patients and would like to better explain why there is a discrepency in the patient's bill.

-In 2012 our standard fee for procedure code [redacted] was $695.00. This fee was billed to the patient's insurance company whose contracted rate was $398.90. This amount was applied to the member's deductible and was billed to and paid by the patient's parents.

-Our standard fees are based on a certain percentage of Medicare rates and are calculated at a rate high enough to encompass the multitude of insurance company rates that are often higher than Medicare rates. However, regardless of what we charge as a standard fee, the insurance companies will not approve or pay more than their contracted rate.

-In 2013, Medicare's rate for this procedure increased and our practice reviewed our standard rate and adjusted our charge amount for this procedure to $1,014.00. The patient had a different insurance company in 2013 and had the test repeated. This insurance company had a contracted rate of $740.75, which was also applied to a deductible. Due to the higher contracted rate for this procedure, the member ended up being responsible for a much higher bill than the one in 2012. Therefore, it was the insurance contracted fee that increased the patient's bill, not just the increase in the standard billed fee.

-The patient's mother had stated that she spoke with the provider prior to the second test and asked if the fee would be comparable to the previous time, and he had told them that it would be. We apologize for this as our providers are not involved with the specifics of the fees and the insurance plans. He should have referred the parents to contact the billing department and we could have called the insurance on behalf of the patient and received a better idea of what the bill might have been before the test was completed.

-We understand that this is a substantial difference and that the patient's family is asking that we adjust the bill amount to $400.00 as this was closer to what was paid previously. Unfortunately, due to the fact that the insurance processed this claim and applied the amount to a deductible, we are legally obligated by our contract as a participating provider to collect this from the member. The balance of $340.75 remains the patient's responsibility.

-On 5/**/2014 we received additional coorespondence from the Revdex.com that the patient's mother was charged an additional fee for a missed appointment on 4/**/2014 and she believes that this is in retaliation to her original complaint. We wish to assure that family that this was not the case as we had not received the original complaint until 5/**/2014 and the fee was already waived per a conversation with our billing department on 5/**/2014.

-Additionally, the mother had mentioned that she felt that a refill/form was not completed due to the balance on the account. It is not our company policy to withhold clinical requests due to balances on accounts. The mother called the office on 4/**/2014 about needing a refill and a form. We had informed the mother that there was a billing issue (the no show fee as stated previously) and she needed to speak with the billing department, but the form was not completed at that time as we had not received the form. The following day we were contacted by the patient's primary care physician who sent us the form which was completed by our clinical staff that afternoon and we contacted the mother to make arrangements for the form to be picked up.

-Finally, we apologize again for any misunderstandings this patient has had. We appreciate the feedback from patient's parents as there was obviously a breakdown in communication between our practice and the patient. We will work diligently in educating our providers to refer patients to the billing department for any sort of billing related questions so that we may avoid this type of issue in the future. Our staff will also try to find better ways of explaining fees to the patients to make it clearer as to why rates may differ from year to year or from insurance to insurance.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

1. I received several answers,(to me it is an indicative that they are not being honest) the first one from the lady in the billing department was the price difference was because [redacted] had a different test, which was completely inaccurate, of course that was not true because the only test my son had was the sleep deprived EEG.

2. Then the [redacted] told me there was an error.

3. After a long wait on the phone the [redacted] told me that the insurance forced them to charge me more.

4. The provider(the doctor) in front of my son told me the test cost between $300 or $400. I asked specifically because the test wasn't absolutely necessary. According to the [redacted], she asked the provider and he denied that he said that.

This is not only false but also a lack of ethics and professionalism, if he did not know the price of the test, he should have told me to ask the billing department and I could explain my situation but I trusted the doctor, BIG MISTAKE, so their apology does not solve my problem created by them in the first place, since they don't instruct their providers to follow a procedure when asked about fees by the patients, otherwise the provider should be responsible for the mistake.

5. They also stated the insurance I had last year applied the amount to the deductible, which last year we did not met, so it does not make a difference, in any way will affect their balance, actually we have new insurance since January 2014. I wonder if by law they are obligated to collect always! what happened when are errors in billings? I honestly doubt very much they are errorless. We are a living proof.

6. They said they contracted with my insurance a fixed price of $740.75 for this test, but one of the times I spoke to [redacted] on the phone she did not mention at all any contract fixed price for this specific test, she actually told me if she wanted she could bill my insurance for $3,000.00 for this same specific test. So who are they kidding? are they obligated by law?

Obviously I don't believe their statements let alone their apologies, my husband correspondence from January, was never answered, the [redacted] spoke to me after more than a month only because I called her again and again, she only called back once not to speack to me or to try to solve anything she said she called just to let me know she heard my message and she will call but that never happened.

I heard the arrogance of their staff on the phone, telling me not to complain because of the fee because if she wanted she could bill me $3000 for the test, and also multiple episodes with excuses.

You can contact my son's pediatrician any time to coroborate the treatment we received and how he intervened twice to get us precriptions and a school form.

I hope they have the coutesy, they say they have to give me my son's records now that I am transferring to a new provider, this doctor/provider besides ordering the wrong test once, and telling me and my son a wrong price and now is costing us an extra $340.75, can no longer be our provider and I don't wish my worst enemy having to deal with the Eriver staff, didn't they state they don't withhold anything because of billing issues? I will find out now...

Although very unfair I believed I will end up paying this bill, because of THEIR ERROR, but I firmly belive I will not get a hold of my son's records and obviously they will send me to collections and ruin our credit, this is what happens when you deal with Eriver, the doctor tells you a price and they bill you double the amount. But you are responsible.

During a school meeting I inquired about pediatric neurologists,I found out Eriver does not have a good reputation and I am so sorry I didn't find out this early! Well I guess I learned from experience and it cost me a lot of money, waste of my time, several problems and headaches and what I received was horrible service, rude treatment and a bill double the price because of their mistake!

Sincerely,

Business

Response:

This is a response to the complainant's issue that the complaint has not been resolved. Again, we do offer our apologies that there was such an extreme difference in the price of the repeated test. Our representatives were trying to explain to the parents that no matter what we charge the insurance company for a test, it is the contracted rate we have with the insurance that dictates the amount that is billed to the member. (The example that our representative used was a charge of $3,000.00, but we cannot bill the member more than what the insurance states is the member responsibility.) Unfortunately, our representative must not have been clear enough and the parents felt that she was being arrogant and this led to a further breakdown in the relationship with this family.

We had also advised the patient's parents to contact the insurance company with any questions or concerns with the balance they were being charged, and to our knowledge they were not contacted. Perhaps the member services department of the insurance could have better explained the amount being billed to the member.

We do not wish to send this account to a collection agency, and our department will work with the family directly to resolve this balance if they choose to contact us.

We will absolutely provide the family with a copy of the patient's medical record. As a courtesy, we will waive the $0.75 per page copying fee that is normally associated with obtaining medical records once we receive an official request for the records. (Which would be a phone call to the office or a request in writing to the office.) We cannot use this forum as a request for medical records.

It is evident that the provider/patient relationship has been severely compromised by the patient's parents extreme dissatisfaction with the practice. Even though the family has chosen not to accept our apologies, this is what we can offer to the member. As stated in the original response, we are unable to discount the balance because of the fee being applied to the member's contracted deductible with the insurance company. We wish the patient good health in the future.

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Description: PHYSICIANS & SURGEONS-MEDICAL-M.D.

Address: 21 Fox St Suite 102, Poughkeepsie, New York, United States, 12601


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