Complaint: [redacted] I am rejecting this response because: Please see attached document to EvergreenToday, 5:PMStacy B [redacted] ( [redacted] @EvergreenEye.com); [redacted] Hello Stacy,Just for your reference, I have obtained prior approval from my insurance company for treatment coverage, which is why they are providing payments.However, the insurance company relies on your prompt and accurate submission of treatment rendered to me to provide payments.I don't see how this information has any bearing to this issue but I am providing it non-the-less for your reference.To simplify the issue, the total cost of all treatment is USD$6321.08.To-date, my patient responsibility per insurance statements is USD1,397.77.Since I have paid for all costs upfront, the difference between the total treatment cost and patient liability are to be reimbursed back to me.Does this make sense? Let me know if you have any questions.To reiterate, all I am asking for is the difference between total cost and my patient liability.Thank you.Sincerely, [redacted] Sincerely, [redacted] *** **Attachment redacted by Revdex.com Staff
See attachment and letter which was emailed on 1/10/Since letter was sent we have received response to appeal and Premera has made date of service 12/14/patient responsibilityThe patient should have received a copy dated 1/19/from her insurance company I have attached for review Revdex.comAttn: [redacted] Slst Place NEAuburn, WA 98002Dear [redacted] :I received your letter referencing ID number [redacted] .The patient received cataract surgery not Lasik surgeryCataract surgery requires areplacement of the lens in your eyeThe patient decided to pay extra for a premium lensinstead of the standard lensThis information was explained to the patient and she signed thepaperwork explaining that her insurance would not pay for a premium lensHer insurancecompany did pay for part of the premium lensEach time the insurance company sentEvergreen a payment, the patient was refunded the amount received.When the insurance company sent an estimate of benefits (EOB) form stating Evergreen had acontractual write off, our billing department resubmitted the claimWe explained that this wasfor a premium lens not a standard lensThe surgery date of 12/21/16, was reprocessed by theinsurance company and the EOB was sent to the patient showing this was her responsibilityand not a contractual write offEvergreen has requested the surgery date of 12/14/bereprocessed alsoThe request was sent again today to the patient's insurance company 1/9/18.Evergreen does not owe any refund to the patientI emailed an updated Excel spreadsheet on1// showing her financial responsibility as well as a copy of the insurance explanation ofbenefits for her to review which also show patient responsibility.If you have any questions, please call me at 206-212- [redacted] or Beth M***, Director of Finance at206-212-***Sincerely,Stacy B*** **Attachment redacted by Revdex.com Staff
Complaint: [redacted] I am rejecting this response because: Please see attached document to EvergreenToday, 5:PMStacy B [redacted] ( [redacted] @EvergreenEye.com); [redacted] Hello Stacy,Just for your reference, I have obtained prior approval from my insurance company for treatment coverage, which is why they are providing payments.However, the insurance company relies on your prompt and accurate submission of treatment rendered to me to provide payments.I don't see how this information has any bearing to this issue but I am providing it non-the-less for your reference.To simplify the issue, the total cost of all treatment is USD$6321.08.To-date, my patient responsibility per insurance statements is USD1,397.77.Since I have paid for all costs upfront, the difference between the total treatment cost and patient liability are to be reimbursed back to me.Does this make sense? Let me know if you have any questions.To reiterate, all I am asking for is the difference between total cost and my patient liability.Thank you.Sincerely, [redacted] Sincerely, [redacted] *** **Attachment redacted by Revdex.com Staff
See attachment and letter which was emailed on 1/10/Since letter was sent we have received response to appeal and Premera has made date of service 12/14/patient responsibilityThe patient should have received a copy dated 1/19/from her insurance company I have attached for review Revdex.comAttn: [redacted] Slst Place NEAuburn, WA 98002Dear [redacted] :I received your letter referencing ID number [redacted] .The patient received cataract surgery not Lasik surgeryCataract surgery requires areplacement of the lens in your eyeThe patient decided to pay extra for a premium lensinstead of the standard lensThis information was explained to the patient and she signed thepaperwork explaining that her insurance would not pay for a premium lensHer insurancecompany did pay for part of the premium lensEach time the insurance company sentEvergreen a payment, the patient was refunded the amount received.When the insurance company sent an estimate of benefits (EOB) form stating Evergreen had acontractual write off, our billing department resubmitted the claimWe explained that this wasfor a premium lens not a standard lensThe surgery date of 12/21/16, was reprocessed by theinsurance company and the EOB was sent to the patient showing this was her responsibilityand not a contractual write offEvergreen has requested the surgery date of 12/14/bereprocessed alsoThe request was sent again today to the patient's insurance company 1/9/18.Evergreen does not owe any refund to the patientI emailed an updated Excel spreadsheet on1// showing her financial responsibility as well as a copy of the insurance explanation ofbenefits for her to review which also show patient responsibility.If you have any questions, please call me at 206-212- [redacted] or Beth M***, Director of Finance at206-212-***Sincerely,Stacy B*** **Attachment redacted by Revdex.com Staff