Complaint: [redacted]
I am rejecting this response because:I called and spoke to Sherry at the Shields office. I offered to hand deliver the Explanation of Sharing (EOS) from [redacted]. At that time, she refused to take the EOS from me, stating she would only accept it from [redacted]. So I verified the fax number she wanted it sent to and called [redacted]. They said they would fax the EOS to Sherry and read back the fax number for verification. They told me she would get it by the next day. So the day after, I called Sherry to verify that she got [redacted]'s fax. She said she did not. Next, I called [redacted] and they confirmed that they did fax the EOS to Sherry. Unfortunately, this happened several times. I would like to point out that [redacted] contracts with [redacted]. According to the [redacted] website, A Step Ahead is part of Multiplan (which is a part of [redacted]). Providers who are part of [redacted] agree to charge a fixed rate for a given service with [redacted] insurers and [redacted]s. Please see the attached screenshot showing Dr. B[redacted] as a [redacted] provider.I have provided a copy of my Estimate of Sharing for A Step Ahead. Please see the attached. As mentioned above, I offered to bring it to their Shields office personally months ago. However, from the response to my complaint, it does not sound like A Step Ahead honors contracted [redacted] rates.
Regards,
[redacted]from: [redacted] <[redacted]@gmail.com>to: [email protected]: Sat, Aug 12, 2017 at 11:57 AMsubject: Complaint ID [redacted]Hi,I just want to let you know that I am forwarding emails between myself and [redacted]. They go back as far as February of 2017 and show that I tried to get [redacted] to send an Estimate of Sharing to A Step Ahead. They discuss the difficulty I was having and the resolution I was asking for. I also can ask [redacted] for my call record. I made lots of calls regarding this problem.Thank you![redacted]from: [redacted] <[redacted]@gmail.com>to: [email protected]: Sat, Aug 12, 2017 at 12:01 PMsubject: Fwd: [redacted] Date of Service: 11/02/2016 Member ID: [redacted]Complaint #[redacted] & A Step Ahead, Fort Collins---------- Forwarded message ----------From: [redacted]>Date: Fri, Mar 3, 2017 at 11:55 AMSubject: RE: [redacted] Date of Service: 11/02/2016 Member ID: [redacted]To: [redacted] <[redacted]@gmail.com>Thank you for reaching out to [redacted]! I'm Paul!Firstly, we are so sorry for the delay in getting back to you! We are excited that [redacted] is growing fast but due to our growth we've had a sudden surge in communication with Members! We are working to get on top of this and resolve to be much more prompt in our responses in the future!I understand that you're wondering about your response from Claims. I'm happy to help you with that!I have forwarded you e-mail to the Claims Supervisor requesting the Statement of Sharing be forwarded to Step Ahead and to you, I also requested that they send the Estimate of Sharing to Dr. B[redacted] office and notify you as soon as these documents are sent, if they have been sent already, to send you a copy, so you can submit your complain to the Revdex.com.Please feel free to reach out to us anytime via email or at the number below if we can answer more questions!Thanks for choosing [redacted]!Paul M. LotzeMember Services[redacted]!-----Original Message-----From: "[redacted]" <a[redacted]@gmail.com>Sent: Saturday, February 25, 2017 6:54pmTo: "[redacted]" <memberservices@[redacted].org>Subject: [redacted] Date of Service: 11/02/2016 Member ID: [redacted]Attention: Claims DepartmentOn 11/2/2016, I Went to A Step Ahead Foot and Ankle Center/Dr. B[redacted] foringrown toenail surgery. I presented my card and asked the lady at thefront desk to call [redacted] to check about billing for the surgery. She hadnever heard of [redacted] or [redacted] and told me that she wasn't goingto call. She would charge me $300 for the visit and their billingdepartment would work out the rest. I asked her again to call [redacted] andshe refused. It was the end of her day and I think she wanted to go home.I paid $300 for the surgery that day. The next morning I spoke with A StepAhead's billing department about the front desk lady's unwillingness tocall [redacted]. The lady in the billing department offered to bill [redacted]directly. When I asked her more about this, it sounded like she would bill[redacted] - then if [redacted] paid her - she would reimburse me. Instead I choseto submit my paid invoice to [redacted] myself, therefore avoiding a middle man(if A Step Ahead billed [redacted] after I had already paid, the check would gofrom [redacted] - *to* - A Step Ahead - *and finally to* - Me).*Side note: This same office billed me for my daughter's visit when theyshould not have. When they finally issued the reimbursement check, theymade it out to my daughter - who is 13 years old and didn't pay the bill. Ihad to take the check back to them, wait for them to reissue it, then mailit back to me. All this for a service I should not have been charged for inthe first place. I don't have a lot of confidence in their billing or frontoffice staff.*Last week I got the [redacted] estimate of sharing for my 11/2/16 visit. Itsaid that services for a pre-existing condition are not eligible forsharing. So I won't be reimbursed by [redacted]. It also said that $224.80 isthe [redacted] contract rate and my responsibility. I paid Dr. B[redacted]'s office$300.00 on the day of the service. I would like them to reimburse me thedifference between the $224.80 contracted rate and the $300.00 that I paidwhich = $75.20.I spoke with Sherry, the office manager at A Step Ahead. She told me thatshe had never heard of [redacted]. I offered to bring a copy of my explanation ofsharing to the office. She refused saying she would only accept an EOB from[redacted]. I asked a lady at [redacted] to fax a copy of the estimate of sharingto A Step Ahead at (970)493-6710. On February 3, 2017, I called to verifythat Sherry had received the fax. She said that she did not.On February 24, 2017, I spoke with Derek Morales at [redacted]. I explained allof the above. He said that he would forward my information to the claimsdepartment. He assured me that the claims department would fax the estimateof sharing to Dr. B[redacted]'s office *and then verify* that their officeactually received it. Additionally he asked the claims department to notifyme when all of this was done.I'm sure that Mr. Morales will do as he said he would; but now I'verealized that I may need to complain to the Revdex.com to getthe money I am owed. I am sending this email to ask that [redacted] claimswill *confirmin writing (via email is fine) dates/times that A Step Ahead receives andconfirms receipt of the estimate of sharing*. Once this happens, I can moveforward with my complaint submission for Dr. B[redacted] and his office.Thank you for your help with this matter![redacted]Member ID: 204576000844 N Jefferson Ave.Loveland, Colorado 80537970-690-6341a[redacted]@gmail.com
Complaint: [redacted]
I am rejecting this response because:
What is the point of negotiated rates and going to a [redacted] Multiplan provider if A Step Ahead does not honor the rates they agreed to? It sounds like those negotiated rates are only for the benefit of the insurance provider (or health share) and A Step Ahead.
Regards,
[redacted]
Dear Revdex.com,Attached please find my response to your complaint. Please let us know if you have any questions. Thanks in advance for you help.August 11, 2017 RE: Response to complaint ID: [redacted] We received complaint from Revdex.com on 8-8-17 through email and our response/dispute is...
below: Patient was seen in our Fort Collins office on 11/02/2016. Patient made this appointment on 11/02/2016 stating she had no insurance. During patients visit, she presented our office with her new insurance information through [redacted]. She was informed that our office does not accept this insurance. Patient was informed that day that if she still wanted to be seen, she would have to pay at time of service. Patient opted to still be seen and pay on her own accord. Per our physician, the billing office was directed to bill her insurance as a customer service effort. However, patient opted out of this option and chose to bill her insurance herself which would allow her to get reimbursed by her insurance directly if any reimbursement was due. Patient was advised repeatedly that if she provided her explanation of benefits from her insurance, she may receive a refund if one was due per her non contracted insurance carrier. Patient states in her complaint that her insurance informed her that "services for pre-existing condition are not eligible for sharing." This is considered non-covered charges. We do not reimburse or provide discounts for insurance allotted non-covered charges. To date, we have yet to receive an explanation of benefits regarding date of service 11/02/2016. We have call logs and further documentation of in office communication to reflect the extent of customer service that we provided in hopes to help patient with her situation, to no avail. A Step Ahead Foot and Ankle Centers prides ourselves on our quality patient care and customer service. Our Podiatrists have been providing foot and ankle care to this community for over 44 years combined and have been accredited with the Revdex.com since 1991. Sincerely, A Step Ahead Foot & Ankle Centers Sue S[redacted]A STEP AHEAD FOOT & ANKLE CENTER2001 S SHIELDS ST, #FFT COLLINS, CO 80526[redacted]
Complaint: [redacted]
I am rejecting this response because:I called and spoke to Sherry at the Shields office. I offered to hand deliver the Explanation of Sharing (EOS) from [redacted]. At that time, she refused to take the EOS from me, stating she would only accept it from [redacted]. So I verified the fax number she wanted it sent to and called [redacted]. They said they would fax the EOS to Sherry and read back the fax number for verification. They told me she would get it by the next day. So the day after, I called Sherry to verify that she got [redacted]'s fax. She said she did not. Next, I called [redacted] and they confirmed that they did fax the EOS to Sherry. Unfortunately, this happened several times. I would like to point out that [redacted] contracts with [redacted]. According to the [redacted] website, A Step Ahead is part of Multiplan (which is a part of [redacted]). Providers who are part of [redacted] agree to charge a fixed rate for a given service with [redacted] insurers and [redacted]s. Please see the attached screenshot showing Dr. B[redacted] as a [redacted] provider.I have provided a copy of my Estimate of Sharing for A Step Ahead. Please see the attached. As mentioned above, I offered to bring it to their Shields office personally months ago. However, from the response to my complaint, it does not sound like A Step Ahead honors contracted [redacted] rates.
Regards,
[redacted]from: [redacted] <[redacted]@gmail.com>to: [email protected]: Sat, Aug 12, 2017 at 11:57 AMsubject: Complaint ID [redacted]Hi,I just want to let you know that I am forwarding emails between myself and [redacted]. They go back as far as February of 2017 and show that I tried to get [redacted] to send an Estimate of Sharing to A Step Ahead. They discuss the difficulty I was having and the resolution I was asking for. I also can ask [redacted] for my call record. I made lots of calls regarding this problem.Thank you![redacted]from: [redacted] <[redacted]@gmail.com>to: [email protected]: Sat, Aug 12, 2017 at 12:01 PMsubject: Fwd: [redacted] Date of Service: 11/02/2016 Member ID: [redacted]Complaint #[redacted] & A Step Ahead, Fort Collins---------- Forwarded message ----------From: [redacted]>Date: Fri, Mar 3, 2017 at 11:55 AMSubject: RE: [redacted] Date of Service: 11/02/2016 Member ID: [redacted]To: [redacted] <[redacted]@gmail.com>Thank you for reaching out to [redacted]! I'm Paul!Firstly, we are so sorry for the delay in getting back to you! We are excited that [redacted] is growing fast but due to our growth we've had a sudden surge in communication with Members! We are working to get on top of this and resolve to be much more prompt in our responses in the future!I understand that you're wondering about your response from Claims. I'm happy to help you with that!I have forwarded you e-mail to the Claims Supervisor requesting the Statement of Sharing be forwarded to Step Ahead and to you, I also requested that they send the Estimate of Sharing to Dr. B[redacted] office and notify you as soon as these documents are sent, if they have been sent already, to send you a copy, so you can submit your complain to the Revdex.com.Please feel free to reach out to us anytime via email or at the number below if we can answer more questions!Thanks for choosing [redacted]!Paul M. LotzeMember Services[redacted]!-----Original Message-----From: "[redacted]" <a[redacted]@gmail.com>Sent: Saturday, February 25, 2017 6:54pmTo: "[redacted]" <memberservices@[redacted].org>Subject: [redacted] Date of Service: 11/02/2016 Member ID: [redacted]Attention: Claims DepartmentOn 11/2/2016, I Went to A Step Ahead Foot and Ankle Center/Dr. B[redacted] foringrown toenail surgery. I presented my card and asked the lady at thefront desk to call [redacted] to check about billing for the surgery. She hadnever heard of [redacted] or [redacted] and told me that she wasn't goingto call. She would charge me $300 for the visit and their billingdepartment would work out the rest. I asked her again to call [redacted] andshe refused. It was the end of her day and I think she wanted to go home.I paid $300 for the surgery that day. The next morning I spoke with A StepAhead's billing department about the front desk lady's unwillingness tocall [redacted]. The lady in the billing department offered to bill [redacted]directly. When I asked her more about this, it sounded like she would bill[redacted] - then if [redacted] paid her - she would reimburse me. Instead I choseto submit my paid invoice to [redacted] myself, therefore avoiding a middle man(if A Step Ahead billed [redacted] after I had already paid, the check would gofrom [redacted] - *to* - A Step Ahead - *and finally to* - Me).*Side note: This same office billed me for my daughter's visit when theyshould not have. When they finally issued the reimbursement check, theymade it out to my daughter - who is 13 years old and didn't pay the bill. Ihad to take the check back to them, wait for them to reissue it, then mailit back to me. All this for a service I should not have been charged for inthe first place. I don't have a lot of confidence in their billing or frontoffice staff.*Last week I got the [redacted] estimate of sharing for my 11/2/16 visit. Itsaid that services for a pre-existing condition are not eligible forsharing. So I won't be reimbursed by [redacted]. It also said that $224.80 isthe [redacted] contract rate and my responsibility. I paid Dr. B[redacted]'s office$300.00 on the day of the service. I would like them to reimburse me thedifference between the $224.80 contracted rate and the $300.00 that I paidwhich = $75.20.I spoke with Sherry, the office manager at A Step Ahead. She told me thatshe had never heard of [redacted]. I offered to bring a copy of my explanation ofsharing to the office. She refused saying she would only accept an EOB from[redacted]. I asked a lady at [redacted] to fax a copy of the estimate of sharingto A Step Ahead at (970)493-6710. On February 3, 2017, I called to verifythat Sherry had received the fax. She said that she did not.On February 24, 2017, I spoke with Derek Morales at [redacted]. I explained allof the above. He said that he would forward my information to the claimsdepartment. He assured me that the claims department would fax the estimateof sharing to Dr. B[redacted]'s office *and then verify* that their officeactually received it. Additionally he asked the claims department to notifyme when all of this was done.I'm sure that Mr. Morales will do as he said he would; but now I'verealized that I may need to complain to the Revdex.com to getthe money I am owed. I am sending this email to ask that [redacted] claimswill *confirmin writing (via email is fine) dates/times that A Step Ahead receives andconfirms receipt of the estimate of sharing*. Once this happens, I can moveforward with my complaint submission for Dr. B[redacted] and his office.Thank you for your help with this matter![redacted]Member ID: 204576000844 N Jefferson Ave.Loveland, Colorado 80537970-690-6341a[redacted]@gmail.com
Complaint: [redacted]
I am rejecting this response because:
What is the point of negotiated rates and going to a [redacted] Multiplan provider if A Step Ahead does not honor the rates they agreed to? It sounds like those negotiated rates are only for the benefit of the insurance provider (or health share) and A Step Ahead.
Regards,
[redacted]
Dear Revdex.com,Attached please find my response to your complaint. Please let us know if you have any questions. Thanks in advance for you help.August 11, 2017 RE: Response to complaint ID: [redacted] We received complaint from Revdex.com on 8-8-17 through email and our response/dispute is...
below: Patient was seen in our Fort Collins office on 11/02/2016. Patient made this appointment on 11/02/2016 stating she had no insurance. During patients visit, she presented our office with her new insurance information through [redacted]. She was informed that our office does not accept this insurance. Patient was informed that day that if she still wanted to be seen, she would have to pay at time of service. Patient opted to still be seen and pay on her own accord. Per our physician, the billing office was directed to bill her insurance as a customer service effort. However, patient opted out of this option and chose to bill her insurance herself which would allow her to get reimbursed by her insurance directly if any reimbursement was due. Patient was advised repeatedly that if she provided her explanation of benefits from her insurance, she may receive a refund if one was due per her non contracted insurance carrier. Patient states in her complaint that her insurance informed her that "services for pre-existing condition are not eligible for sharing." This is considered non-covered charges. We do not reimburse or provide discounts for insurance allotted non-covered charges. To date, we have yet to receive an explanation of benefits regarding date of service 11/02/2016. We have call logs and further documentation of in office communication to reflect the extent of customer service that we provided in hopes to help patient with her situation, to no avail. A Step Ahead Foot and Ankle Centers prides ourselves on our quality patient care and customer service. Our Podiatrists have been providing foot and ankle care to this community for over 44 years combined and have been accredited with the Revdex.com since 1991. Sincerely, A Step Ahead Foot & Ankle Centers Sue S[redacted]A STEP AHEAD FOOT & ANKLE CENTER2001 S SHIELDS ST, #FFT COLLINS, CO 80526[redacted]