Fairfax Radiological Consultants, P.C

I have reviewed [redacted] ***'s follcomments in regards to Fairfax Radiological Consultants (FRC's) response to his initial complaint It is also FRC's desire for [redacted] Hospital to be forthcoming in explaining to patients that they will receive two bills for radiology services We are not trying to "pull the wool over anyone's eyes".regarding the billing of professional radiology services at [redacted] Hospital Unfortunately the staff at the hospitals are not FRC employees and we can not control how the hospital reprimands their staff when staff is unclear in explaining the billing of radiology services There is no further action I can take on this patien't behalfI can only redirect you to [redacted] Hospital Janet H [redacted] , Director of Professional Services

January 21, Dear Sir or Madam, face="Calibri">In response to Revdex.com Complaint [redacted] please be advised that [redacted] was seen at [redacted] Hospital on 11/24/ [redacted] Hospital has contracted with Fairfax Radiological Consultants, PC (FRC) for the provision of radiological interpretations but FRC is not in any way involved in patient scheduling, patient registration, or billing for [redacted] Hospital Upon arrival at [redacted] Hospital [redacted] was presented with and signed a document entitled “AUTHORIZATION FOR CLAIMS, PAYMENT AND REVIEWS” Item of that document addresses “Physicians Who are not Employees or Agents of [redacted] Health System” which clearly states that “most physicians and surgeons furnishing services to me including but not limited to emergency physicians, radiologists are independent contractors I understand I may receive separate bills for independent contractor services.” This document was signed by [redacted] and is attached for your review [redacted] had a CT performed at [redacted] HospitalThe CT images were viewed by a radiologist employed by Fairfax Radiological Consultants (“FRC”) and a written radiology report was created and placed in [redacted] ***’s hospital medical record [redacted] Hospital then provided FRC all the billing information they had on [redacted] so that FRC could bill for the professional services of our radiologist This is a standard industry practice It is important to note that insurance companies contract with each entity medical group separately and each entity must submit a bill for their portion of the services provided The [redacted] Hospital bill is for the ‘technical component’ which covers the cost of the facility, equipment, technologist and supplies FRC’s bill covers the ‘professional component’ which is for the supervision and interpretation provided by our radiologist [redacted] ***’s insurance company applied the entire contracted amount due to FRC ($87.62) to his deductible and [redacted] is responsible for paying his deductible as per his insurance coverage It appears that [redacted] ***’s chief complaint is that the hospital staff did not explain to him that he would receive more than one bill We have reached out the Patient Relations team at [redacted] ( [redacted] ) regarding [redacted] ***’s concerns and [redacted] advised that he will call [redacted] directly to discuss this matterHowever, that does not change [redacted] ***’s financial responsibility to FRC as determined by his insurance company Please let me know if I can be of further assistance in explaining [redacted] ***’s balance due to FRC Sincerely, Janet H [redacted] Janet H [redacted] Director of Patient Experience [redacted] @frcpc.net

January 21, Dear Sir or Madam, In response to Revdex.com Complaint [redacted] please be advised that [redacted] was seen at [redacted] Hospital on 11/24/ [redacted] Hospital has contracted with Fairfax Radiological Consultants, PC (FRC) for the provision of radiological interpretations but FRC is not in any way involved in patient scheduling, patient registration, or billing for [redacted] Hospital Upon arrival at [redacted] Hospital [redacted] was presented with and signed a document entitled “AUTHORIZATION FOR CLAIMS, PAYMENT AND REVIEWS” Item of that document addresses “Physicians Who are not Employees or Agents of [redacted] Health System” which clearly states that “most physicians and surgeons furnishing services to me including but not limited to emergency physicians, radiologists are independent contractors I understand I may receive separate bills for independent contractor services.” This document was signed by [redacted] and is attached for your review [redacted] had a CT performed at [redacted] HospitalThe CT images were viewed by a radiologist employed by Fairfax Radiological Consultants (“FRC”) and a written radiology report was created and placed in [redacted] ***’s hospital medical record [redacted] Hospital then provided FRC all the billing information they had on [redacted] so that FRC could bill for the professional services of our radiologist This is a standard industry practice It is important to note that insurance companies contract with each entity medical group separately and each entity must submit a bill for their portion of the services provided The [redacted] Hospital bill is for the ‘technical component’ which covers the cost of the facility, equipment, technologist and supplies FRC’s bill covers the ‘professional component’ which is for the supervision and interpretation provided by our radiologist [redacted] ***’s insurance company applied the entire contracted amount due to FRC ($87.62) to his deductible and [redacted] is responsible for paying his deductible as per his insurance coverage It appears that [redacted] ***’s chief complaint is that the hospital staff did not explain to him that he would receive more than one bill We have reached out the Patient Relations team at [redacted] ( [redacted] ) regarding [redacted] ***’s concerns and [redacted] advised that he will call [redacted] directly to discuss this matterHowever, that does not change [redacted] ***’s financial responsibility to FRC as determined by his insurance company Please let me know if I can be of further assistance in explaining [redacted] ***’s balance due to FRC Sincerely, Janet H [redacted] Janet H [redacted] Director of Patient Experience [redacted] @frcpc.net

[redacted] was seen at [redacted] Hospital Emergency department on 06/23/ Upon her arrival to the ED she signed a document entitled “ normal">Authorization for Claims, Payment and Review” Item #of that document addresses “Physicians Who Are Not Employees or Agents of [redacted] Health System” and clearly states that “some physicians including but not limited to emergency department physicians, radiologists are independent contractors I understand I may receive separate bills for such independent physicians services.” While in the Emergency Department, [redacted] received xrays These xrays were viewed by a radiologist with Fairfax Radiological Consultants (“FRC”) and a written radiology report was created and placed in the in hospital medical record [redacted] Hospital sent all the information they had on [redacted] to FRC so that we could bill for the professional services of our radiologist The information sent was that [redacted] was “self pay” and no insurance information was included FRC sent statements to [redacted] dated 07/04/2014, 08/04/2014, 09/04/14, 10/06/and 11/06/The address on the statements is the same as the address [redacted] has on this complaintIn addition to the statements, an automated call was placed to her on 08/19/regarding her account FRC received no correspondence or other contact from [redacted] to any of the statements sent and she did not return our August call - as a result her account was sent to a collection agency on 12/08/ On January 22, we received a call from [redacted] and our bill was explained, the fact that we had no insurance information for her and the status of her account was discussedShe was told that she would have to go through the collection agency On February 24, a representative from [redacted] ’s insurance contacted FRCDuring that call it was confirmed that the timely filing period for this charge had passed and the rep requested we send another statement to the patient so [redacted] could file a claim herselfFRC complied with that request We confirmed with our collection agency that they received insurance information from [redacted] and contacted her insurance on 12/22/(days after services were provided) and they contacted her insurance and spoke with “***” @ [redacted] who confirmed that the timely filing period (days) had passed and therefore the patient was responsible Had [redacted] contacted FRC in response to any of the statements that were sent between July and November which was well within the timely filing limits imposed by her insurance company, we would have been able to file the claim with her insurance

Patient's payment was located and account was adjusted to zero balance on 9/14/as per patient's father's request Thank you - Carla J [redacted] , CQI Coordinator, Fairfax Radiology

July 5th,
Dear *** ***,
I am in receipt of your request for a refund on a $payment you made for an exam performed at *** *** Hospital on June 1st, 2015, and a payment of $for an exam performed for your son at *** *** Hospital.
First I can address the bill for $for services rendered on June 1st, 2015. Fairfax Radiology mailed bills to your insurance company of record from a period of June 8th through October 7th, After receiving no response from your insurance company (neither a payment nor a denial notice) we converted your account to a self-pay status and began sending you bills directly. Bills were sent to you on October 8th, November 9th, December 10th, and January 11th. A more detailed, itemized bill was sent to you on February 3rd, so that you could file the claim to your insurance directly, if you wished to do so. Fairfax Radiology is not contracted with the *** *** *** Health Plan, and we were filing the claim to this health insurance as a courtesy only. If the insurance does not respond to our billings (with a payment or a denial), our only option is hold the patient responsible for submitting payment to us, and for the patient to work out the problems with their insurance directlyI believe your complaint should be directed toward the *** *** *** Health Plan that did not respond to two bills mailed to them (mailed August and October 2015) and did not respond to claims that were faxed to them from Fairfax Radiology on occasions
Regarding the request for a refund of $paid for services rendered on November 3rd, for your son, again our notes indicate that the claim was mailed to the *** *** Health Plan on November 20th but was never paid. Statements notifying you that the charges were pending were sent to you on December 14th, January 14th, February 15th, March 17th, and April 18th. On May 6th you contacted us to let us know that the proper insurance to be billed is *** Healthcare, however since more than six months had passed since the date of service were are unable to bill *** for these chargesWe have a limited amount of time to submit charges to an insurance company before the insurance will deny payment for lack of timely filing of chargesAt this point the remedy is to contact *** directly and ask them for reimbursement of the expense since they will no longer pay Fairfax Radiology
I apologize that the insurance processing of these claims turned out to be complicated and difficult for you and I can understand your frustrationsUnfortunately Fairfax Radiology cannot control how your insurance company processes or doesn’t process claimsWe submitted the claims as per your instructions to the insurance company addresses that you provided to usThe insurance lack of payment is unfortunate, but outside our controlI am sorry that I am not able to honor your request for a refund, but I encourage you to file a complaint with the insurance company
Sincerely,
Janet
Janet H***
Director of Professional Services, Risk Management, and Px

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because:
What they do not say is that I tried numerous times to give the collection agency permission to talk to my insurance agency so they would get paid, which is what the other providers at *** did, such as the doctors, who also did not seem to be part of the contract, etcIn these cases it was quickly resolved (!), so I thought the radiology bills were in errorBut Fairfax Radiology and their collection agency REFUSED (I repeat REFUSED) to work with *** Insurance until it was too lateIf you contact the collection agency you will learn how many times I gave them this permission to get paid by *** InsuranceI will only pay this bill if I am guaranteed that I will be reimbursed because I paid my co-pay in full and this issue was caused by Fairfax Radiology and their collection agencyAgain, I had to separately confirm that the doctors, etcat *** were paid, but each time I gave them the name and number of my health insurance it was quickly remediedNot so with Fairfax Radiology.
Regards,
*** ***

Dear *** ***,
Fairfax Radiological Consultants, FRC, is in receipt of your complaint regarding a refund/payment issueUpon researching your complaint I learned that Kim M***, FRC's Senior Director of Patient Accounts, has been in direct contact with you and the matter was resolved in
your favor. It is my understanding that you are now satisifed with the resolution and have no further grievance with FRC
I apologize for the difficulties you encountered that caused you to have to file a complaint with the Revdex.com, and I am glad that the matter was resolved in a postive manner
Sincerely,
Janet H***
Director of Patient Experience

Dear *** ***,
Fairfax Radiological Consultants, FRC, is in receipt of your complaint regarding a refund/payment issueUpon researching your complaint I learned that Kim M***, FRC's Senior Director of Patient Accounts, has been in direct contact with you and the matter was
resolved in your favor. It is my understanding that you are now satisifed with the resolution and have no further grievance with FRC
I apologize for the difficulties you encountered that caused you to have to file a complaint with the Revdex.com, and I am glad that the matter was resolved in a postive manner
Sincerely,
Janet H***
Director of Patient Experience

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me. Yes, she did contact me and apologize for the mistakeShe is taking the charge off realizing that it was in their error.I can't thank you enough for the hard work in helping me get this settled
Regards,
*** ***

January 21, 2016
Dear Sir or Madam,
In response to Revdex.com Complaint [redacted] please be advised that [redacted] was seen at [redacted] Hospital on 11/24/2015.  [redacted] Hospital has contracted with Fairfax Radiological Consultants, PC (FRC) for the provision of radiological...

interpretations but FRC is not in any way involved in patient scheduling, patient registration, or billing for [redacted] Hospital.
Upon arrival at [redacted] Hospital [redacted] was presented with and signed a document entitled “AUTHORIZATION FOR CLAIMS, PAYMENT AND REVIEWS”.  Item 1 of that document addresses “Physicians Who are not Employees or Agents of [redacted] Health System” which clearly states that “most physicians and surgeons furnishing services to me … including but not limited to emergency physicians, radiologists … are independent contractors… I understand I may receive separate bills for independent contractor services.”  This document was signed by [redacted] and is attached for your review.
[redacted] had a CT performed at [redacted] Hospital. The CT images were viewed by a radiologist employed by Fairfax Radiological Consultants (“FRC”) and a written radiology report was created and placed in [redacted]’s hospital medical record.  [redacted] Hospital then provided FRC all the billing information they had on [redacted] so that FRC could bill for the professional services of our radiologist.  This is a standard industry practice.
It is important to note that insurance companies contract with each entity medical group separately and each entity must submit a bill for their portion of the services provided.  The [redacted] Hospital bill is for the ‘technical component’ which covers the cost of the facility, equipment, technologist and supplies.  FRC’s bill covers the ‘professional component’ which is for the supervision and interpretation provided by our radiologist. 
[redacted]’s insurance company applied the entire contracted amount due to FRC ($87.62) to his deductible and [redacted] is responsible for paying his deductible as per his insurance coverage.
It appears that [redacted]’s chief complaint is that the hospital staff did not explain to him that he would receive more than one bill.  We have reached out the Patient Relations team at [redacted] ([redacted]) regarding [redacted]’s concerns and [redacted] advised that he will call [redacted] directly to discuss this matter. However, that does not change [redacted]’s financial responsibility to FRC as determined by his insurance company.
Please let me know if I can be of further assistance in explaining [redacted]’s balance due to FRC.
Sincerely,
Janet H[redacted]
Janet H[redacted]
Director of Patient Experience
[redacted]@frcpc.net

January 21, 2016
Dear Sir or Madam,

face="Calibri">In response to Revdex.com Complaint [redacted] please be advised that [redacted] was seen at [redacted] Hospital on 11/24/2015.  [redacted] Hospital has contracted with Fairfax Radiological Consultants, PC (FRC) for the provision of radiological interpretations but FRC is not in any way involved in patient scheduling, patient registration, or billing for [redacted] Hospital.
Upon arrival at [redacted] Hospital [redacted] was presented with and signed a document entitled “AUTHORIZATION FOR CLAIMS, PAYMENT AND REVIEWS”.  Item 1 of that document addresses “Physicians Who are not Employees or Agents of [redacted] Health System” which clearly states that “most physicians and surgeons furnishing services to me … including but not limited to emergency physicians, radiologists … are independent contractors… I understand I may receive separate bills for independent contractor services.”  This document was signed by [redacted] and is attached for your review.
[redacted] had a CT performed at [redacted] Hospital. The CT images were viewed by a radiologist employed by Fairfax Radiological Consultants (“FRC”) and a written radiology report was created and placed in [redacted]’s hospital medical record.  [redacted] Hospital then provided FRC all the billing information they had on [redacted] so that FRC could bill for the professional services of our radiologist.  This is a standard industry practice.
It is important to note that insurance companies contract with each entity medical group separately and each entity must submit a bill for their portion of the services provided.  The [redacted] Hospital bill is for the ‘technical component’ which covers the cost of the facility, equipment, technologist and supplies.  FRC’s bill covers the ‘professional component’ which is for the supervision and interpretation provided by our radiologist. 
[redacted]’s insurance company applied the entire contracted amount due to FRC ($87.62) to his deductible and [redacted] is responsible for paying his deductible as per his insurance coverage.
It appears that [redacted]’s chief complaint is that the hospital staff did not explain to him that he would receive more than one bill.  We have reached out the Patient Relations team at [redacted] ([redacted]) regarding [redacted]’s concerns and [redacted] advised that he will call [redacted] directly to discuss this matter. However, that does not change [redacted]’s financial responsibility to FRC as determined by his insurance company.
Please let me know if I can be of further assistance in explaining [redacted]’s balance due to FRC.
Sincerely,
Janet H[redacted]
Janet H[redacted]
Director of Patient Experience
[redacted]@frcpc.net

[redacted] was seen at [redacted] Hospital Emergency department on 06/23/2014.  Upon her arrival to the ED she signed a document entitled “
normal">Authorization for Claims, Payment and Review”.  Item #5 of that document addresses “Physicians Who Are Not Employees or Agents of [redacted] Health System” and clearly states that “some physicians including but not limited to emergency department physicians, radiologists … are independent contractors…  I understand I may receive separate bills for such independent physicians services.”
While in the Emergency Department, [redacted] received xrays.  These xrays were viewed by a radiologist with Fairfax Radiological Consultants (“FRC”) and a written radiology report was created and placed in the in hospital medical record. 
[redacted] Hospital sent all the information they had on [redacted] to FRC so that we could bill for the professional services of our radiologist.  The information sent was that [redacted] was “self pay” and no insurance information was included.
FRC sent 5 statements to [redacted] dated 07/04/2014, 08/04/2014, 09/04/14, 10/06/2014 and 11/06/2014. The address on the statements is the same as the address [redacted] has on this complaint. In addition to the statements, an automated call was placed to her on 08/19/2014 regarding her account. 
FRC received no correspondence or other contact from [redacted] to any of the statements sent and she did not return our August 2014 call - as a result her account was sent to a collection agency on 12/08/2014.
On January 22, 2015 we received a call from [redacted] and our bill was explained, the fact that we had no insurance information for her and the status of her account was discussed. She was told that she would have to go through the collection agency.
On February 24, 2015 a representative from [redacted]’s insurance contacted FRC. During that call it was confirmed that the timely filing period for this charge had passed and the rep requested we send another statement to the patient so [redacted] could file a claim herself. FRC complied with that request. 
We confirmed with our collection agency that they received insurance information from [redacted] and contacted her insurance on 12/22/14 (182 days after services were provided) and they contacted her insurance and spoke with “[redacted]” @[redacted] who confirmed that the timely filing period (180 days) had passed and therefore the patient was responsible.
Had [redacted] contacted FRC in response to any of the statements that were sent between July and November 2014 which was well within the timely filing limits imposed by her insurance company, we would have been able to file the claim with her insurance.

I have reviewed [redacted]'s follow-up comments in regards to Fairfax Radiological Consultants (FRC's) response to his initial complaint.  It is also FRC's desire for [redacted] Hospital to be forthcoming in explaining to patients that they will receive two bills for radiology services.  We are not trying to "pull the wool over anyone's eyes".regarding the billing of professional radiology services at [redacted] Hospital.  Unfortunately the staff at the hospitals are not FRC employees and we can not control how the hospital reprimands their staff when staff is unclear in explaining the billing of radiology services.   There is no further action I can take on this patien't behalf. I can only redirect you to [redacted] Hospital.
Janet H[redacted], Director of Professional Services

Patient's payment was located and account was adjusted to zero balance on 9/14/14 as per patient's father's request.  Thank you - Carla J[redacted], CQI Coordinator, Fairfax Radiology

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.  From my understanding is that the staff at the Radiological desk at [redacted] Hospital are staff of the hospital and not of the Fairfax Radiological Consultants.  Given this, this complaint should be reassigned from Fairfax Radiological Consultants to [redacted] Hospital since it was there staff who are not being honest and forthcoming to patients.  How do we reassign this complaint to [redacted] Hospital?  Thanks.
Regards,
[redacted]

Review: Six month delay in issuing a bill, then giving client less than one week to pay bill. I received a medical procedure on July 20, 2013, according to Fairfax Radiological Consultants (FRC) they heard from my insurance that the procedure would not be covered sometime in August, yet the only communication I received from FRC was a bill dated January 23, 2014, though was not received until 1/31/2014. The due date on the bill was 2/6/2014, thus giving me 6 days to pay the bill.

When I asked FRC why the long delay I was told that it was not their fault because they outsourced their billing to a new company. Giving clients less than a week to pay a bill, when it has been in their system for months creates a hardship on the consumer.Desired Settlement: FRC should be more cognizant of this problem and audit their system. When I called I was told they were not aware of other people receiving a bill months after they (FRC) had all of the information needed to issue a bill and they said it was not their responsibility because they don't issue the bills. If FRC is going to outsource their billing they owe it to their patients to ensure clients receive their bills in a timely fashion (a month or two after FRC has all the information they need to issue the bill) They also need to give their patients more than a week from the time the bill is postmarked to allow patients to pay. It would seem given these circu**tances giving patients a typical thirty day window to pay would be more than adequate, especially considering the months it takes them to issue the bill.

Business

Response:

RE Customer Review:

[redacted], VA [redacted]

Daytime Phone: ###-###-####

E-mail: [redacted]

To whom it may concern:

I'd like to take a moment to address **. [redacted]'s complaint. First, FRC implemented two new systems in 2013: a billing system, [redacted] and a new Radiology Imaging System, [redacted]. We went live with both systems in May 2013 and have been working feverously ever since to iron out billing process issues. **. [redacted] is correct when she states FRC did not bill her until January 23, 2014. While it is not an excuse for late billing, I can tell you the [redacted] system did not recognize the payer's ([redacted]) denial code and therefore a bill was not generated automatically. The account sat until it was worked manually which while not efficient does explains the delay. Our Patient Accounts senior director is working to implement workarounds to address these types of problems until [redacted] can implement an upgrade in the system. This particular payer denial code is flagged as a code that needs manual intervention to properly and timely address.

Having said that, it was confirmed with [redacted] that the patient did in fact receive an Explanation of Benefits on August 1, 2013. That EOB clearly indicated the amount owed by the patient. Many patients do not wait for a bill from their providers, but will pay their portion based on what their insurance company has communicated to them.

Our notes indicate the patient hung up with our accounts supervisor before she could fully explain payment options with her. The patient was however told there would be no penalty for delayed payment. The patient is free to make payment arrangements that allow her more time to meet her obligations. FRC is willing to work with her to help accommodate any financial hardship imposed by a two week payment timeframe. I have asked the assistance director of Patient Accounts to reach out to **. [redacted] to discuss payment options. In the meantime, if **. [redacted] is free to call ###-###-#### and ask to speak with a customer service representative about making payments. Her account has been updated to reflect this communication. If you have further questions, please contact me at [redacted], extension [redacted].

Thank you.

Director, Quality Improvement

Review: My daughter received services from Fairfax Radiological Consultants (FRC) on 2/17/2014; they sent a bill for $2.01 in March of 2014. This bill was paid on 3/28/2014; however, FRC did not apply any payment to my daughters account. I have call on numerous occasions, sent a fax and written and mailed a letter, all with bank payment information for this billing issue to be corrected. FRC states they did not receive any of these communications and is still requesting a payment $2.01; however small the bill is, the principal amount is they do not track payments and apply them where needed. I have a fax confirmation and spoken to customer service reps and managers without resolve, all I ask is for the bill to be corrected to reflect a $0 balance.Desired Settlement: Adjusted amount to $0

Business

Response:

Patient's payment was located and account was adjusted to zero balance on 9/14/14 as per patient's father's request. Thank you - Carla J[redacted], CQI Coordinator, Fairfax Radiology