Health Care Resources

Complaint: [redacted] I am rejecting this response because: The response does not reflect the nature of my concernThere was never a question regarding the monies owed the the BusinessThe issue, which the Business failed to address, was with the manner in which the represnetative for the Business conducted herselfBeverly was rude, dismissive, intolerant, and the Business did not restore my access to the Patient Portal after the account was settledThese was the primary rationale for the compliantThe Business representative implied I was dishonest regarding my payment to the Collection Agency and restricted my direct access to my physician even after the debt was settledThe detailed account regarding the length of time it took me to resolve the account is not germaine to the reason for contacting the Revdex.comThe Business disallowed my direct access to my physician and acted as my representative with repect to services needed from my PCP, not at my request, but because of an internal policy that favored the Business and not the consumerWhen I filed this compliant my balance with the Business was zero, proven by my bank statement and the confirmation number I provided to the Business reflecting a "paid in full" status with the Collection AgencyThe Federal Fair Debt Collections Act of restricts a business or debt collector from abussive behavior in an attempt to collect a debtThe Collection Agency was professional, respectful, and engaged me in a manner that demonstrated dignityThe Business in question did not conduct themselves in this mannerThe Patient Portal is the tool utilized by the PCP's office to communicate directly with the Physician's officeIn the past, this tool has worked very wellMy PCP's office has responded in a timely manner whenever I accessed to Protal to request services, schedule appointments, and to review my medical recordsThe Business's response to the so called "limited" functionality of the Protal, again is not relevent to the primary issues prompting me to file this complaintThe Business's action to restrict my access to my Patient Portal account was just when the outstanding balance was active; however, the continuation of this access restriction for seven days (as per their policy) until the Business was paid by the Collection Agency was punitive and not consistent with the spirit of the Affordable Care Act and the FAir Debt Collections Act Regards, [redacted] [To assist us in bringing this matter to a close, the consumer must give a reason why they are rejecting the responseIf the consumer does not provide a reason the complaint will be closed Answered]

March 4, 2016Revdex.comJefferson St, NE, Ste A Albuquerque, NM 87109Re: Response to complaint ID # [redacted] Dear Revdex.com Complaint Department:First, it should be noted that with the patient confidentiality requirements of the HIPAA regulations, it makes it difficult for our office to respond to this complaint with all the specific detail we would likeAlso, we will not be able to use the patient's name or the name of the provider throughout this response and we also ask that the Revdex.com honor our requirement for patient confidentially based upon the HIPAA regulations that we are required to follow.Second, it should be noted that prior to Mr*'s account being turned over to theCollection Agency, we gave Mr [redacted] the required day notice, in writing, that we were "discontinuing care" and that he would not be able to access medical care including scheduling an appointment or refilling prescriptionsIt should also be noted that once an account makes it to the Collection Agency, there is no requirement for our office to Reactive a patient's account, reestablish care or extend them credit againMr [redacted] was seen on August 21, by DrSHe was sent a statement on September 4, 2015, showing that his insurance company had applied the total balance of the visit to his deductible ($135.65)Having not heard for Mr*, on October 5, 2015, we sent a letter with his second statement explaining his outstanding balance was past due, and that if it were not paid within days his account would be Inactived (with the explanation that he would not be able to access care, including scheduling an appointment or refilling prescriptions, if this were to happen)Having still not heard from Mr*, on November 6, 2015, we sent him a second letter with this statement confirming that his account was now Inactived and directing him to seek care from an urgent care or if his symptoms warrant it, go to the emergency roomHaving still not received a payment from Mr [redacted] on his outstanding balance, on December 7, 2015, we sent Mr [redacted] a third letter, with his fourth statement informing him that his account would be sent to the Collection Agency if the outstanding balance were not paid in days from the date of this final letterOn December 15, 2015, our office attempted to call Mr [redacted] to inform him of the impending Collection Agency action as a last ditch attempt to stop his account being turned over, but he did not answer, so a voicemail was left on his phoneHaving not heard from Mr*, on December 18, 2015, his account was turned over to the Collection Agency.It was not until February 22, 2016, (months after the services were provided to him) that Mr [redacted] paid the Collection Agency the amount dueOn February 22, 2016, Mr [redacted] called our office and informed Beverly that he did pay the balance dueOnce Beverly called to confirm with the Collection Agency that Mr [redacted] had made the payment, she tried to call Mr*, but his cell phone was not working properlyBeverly left a message at Mr*'s home phone to let him know that she was able to confirm the payment was made with the Collection Agency, and that his account would remain Inactive until we actually received the money from the Collection Agency for his payment on his accountShe also explained if he needed something, she would be able to schedule an appointment for Mr*, or refill prescriptions, until his account was officially Re-activatedIt should be noted that Beverly is our Operations Manager and is trained to perform these functions on a regular basis, and has direct access to DrS' appointment schedule and Medical Assistant (and has actually worked in DrS' office for many years).Mr [redacted] called the next day (February 23, 2016) and explained he needed help with a Prior Authorization for his medicationBeverly told him she could help him with this, but Mr [redacted] did not want to hear thisMr [redacted] insisted that we were preventing him from getting care, Beverly explained that his account has not been Re-actived yet per our office policy, but that she could help him if he needed somethingMr [redacted] insisted that the Affordable Care Act allowed him to directly contact DrS for anything he neededBeverly commented, that if Mr [redacted] can show us where in the Affordable Care Act it says that, we would modify our office policy to comply (as stated above, Mr [redacted] was given the proper prior day notice that care would be discontinued several months ago and there is no requirement for our office to Re-active a patient's account, re-establish care or extend them credit again).In the meantime, Beverly checked to see if a prescription request had come in from the pharmacy for Mr*, but no requests had arrivedShe sent an electronic message to DrS' Medical Assistant concerning the Prior AuthorizationOn February 24, the Prior Authorization had been approved by Mr*'s insurance and Mr [redacted] was informed by DrS' Medical Assistant by telephone message that same day (ironically, the same day that Mr [redacted] filed this complaint).Office Policy:Our office policy for accounts that are turned over for non-payment to the Collection Agency includes a Re-activation timelineThe policy of not Re-activating an account until the funds are actually received is a result of having learned that many patients' who let their account lapse into collections, many times have multiple collection accounts with the same Collection AgencyAs a result, the Collection Agency can take a payment from a particular patient and spread the amount paid over the other creditors that have also turned that patient over for non-paymentAdditionally, since a patient can dispute a charge on their credit card, any payment made to the Collection Agency by credit card can be reversed by the patient's credit card company while the dispute is being resolvedAs a result, we can only be assured that we are getting the full balance due to our office when the check arrives from the Collection Agency.Patient Portal:The patient portal is very limited in functionalityOf the few things that are accessible, they can for the most part, be done better by telephone.Closing:We feel everything was handled properly with Mr*Through our series of four statements and three collection letters sent to patients, and the personal phone call, we feel our collection policy is clearly presented to each patient in advanceWe give all patients, who refuse to pay their outstanding balance, the required day notice, in writing, that we are "discontinuing care" and that they will not be able to access medical care including scheduling an appointment or refilling prescriptionsAnd since there is no requirement for our office to Re-active a patient's account, reestablish care or extend them credit again, once the balance is paid off, we feel we have gone above and beyond what was necessary to help Mr*.Like other small practices, the ability to offer free care is not possibleOur creditors want to be paid on time, so therefore we ask patients to pay their outstanding balances on time as well.Sincerely,Peter R***Manager###-###-#### Ext **

March 4, 2016Revdex.com7007 Jefferson St, NE, Ste A Albuquerque, NM 87109Re: Response to complaint ID # [redacted] Dear Revdex.com Complaint Department:First, it should be noted that with the patient confidentiality requirements of the HIPAA regulations, it makes it difficult for our...

office to respond to this complaint with all the specific detail we would like. Also, we will not be able to use the patient's name or the name of the provider throughout this response and we also ask that the Revdex.com honor our requirement for patient confidentially based upon the HIPAA regulations that we are required to follow.Second, it should be noted that prior to Mr. *'s account being turned over to the. Collection Agency, we gave Mr. * the required 30 day notice, in writing, that we were "discontinuing care" and that he would not be able to access medical care including scheduling an appointment or refilling prescriptions. It should also be noted that once an account makes it to the Collection Agency, there is no requirement for our office to Reactive a patient's account, reestablish care or extend them credit again.Background:Mr. * was seen on August 21, 2015 by Dr. S. He was sent a statement on September 4, 2015, showing that his insurance company had applied the total balance of the visit to his deductible ($135.65). Having not heard for Mr. *, on October 5, 2015, we sent a letter with his second statement explaining his outstanding balance was past due, and that if it were not paid within 30 days his account would be Inactived (with the explanation that he would not be able to access care, including scheduling an appointment or refilling prescriptions, if this were to happen). Having still not heard from Mr. *, on November 6, 2015, we sent him a second letter with this statement confirming that his account was now Inactived and directing him to seek care from an urgent care or if his symptoms warrant it, go to the emergency room. Having still not received a payment from Mr. * on his outstanding balance, on December 7, 2015, we sent Mr. * a third letter, with his fourth statement informing him that his account would be sent to the Collection Agency if the outstanding balance were not paid in 10 days from the date of this final letter. On December 15, 2015, our office attempted to call Mr. * to inform him of the impending Collection Agency action as a last ditch attempt to stop his account being turned over, but he did not answer, so a voicemail was left on his phone. Having not heard from Mr. *, on December 18, 2015, his account was turned over to the Collection Agency.It was not until February 22, 2016, (6 months after the services were provided to him) that Mr. * paid the Collection Agency the amount due. On February 22, 2016, Mr. * called our office and informed Beverly that he did pay the balance due. Once Beverly called to confirm with the Collection Agency that Mr. * had made the payment, she tried to call Mr. *, but his cell phone was not working properly. Beverly left a message at Mr. *'s home phone to let him know that she was able to confirm the payment was made with the Collection Agency, and that his account would remain Inactive until we actually received the money from the Collection Agency for his payment on his account. She also explained if he needed something, she would be able to schedule an appointment for Mr. *, or refill prescriptions, until his account was officially Re-activated. It should be noted that Beverly is our Operations Manager and is trained to perform these functions on a regular basis, and has direct access to Dr. S' appointment schedule and Medical Assistant (and has actually worked in Dr. S' office for many years).Mr. * called the next day (February 23, 2016) and explained he needed help with a Prior Authorization for his medication. Beverly told him she could help him with this, but Mr. * did not want to hear this. Mr. * insisted that we were preventing him from getting care, Beverly explained that his account has not been Re-actived yet per our office policy, but that she could help him if he needed something. Mr. * insisted that the Affordable Care Act allowed him to directly contact Dr. S for anything he needed. Beverly commented, that if Mr. * can show us where in the Affordable Care Act it says that, we would modify our office policy to comply (as stated above, Mr. * was given the proper prior 30 day notice that care would be discontinued several months ago and there is no requirement for our office to Re-active a patient's account, re-establish care or extend them credit again).In the meantime, Beverly checked to see if a prescription request had come in from the pharmacy for Mr. *, but no requests had arrived. She sent an electronic message to Dr. S' Medical Assistant concerning the Prior Authorization. On February 24, the Prior Authorization had been approved by Mr. *'s insurance and Mr. * was informed by Dr. S' Medical Assistant by telephone message that same day (ironically, the same day that Mr. * filed this complaint).Office Policy:Our office policy for accounts that are turned over for non-payment to the Collection Agency includes a Re-activation timeline. The policy of not Re-activating an account until the funds are actually received is a result of having learned that many patients' who let their account lapse into collections, many times have multiple collection accounts with the same Collection Agency. As a result, the Collection Agency can take a payment from a particular patient and spread the amount paid over the other creditors that have also turned that patient over for non-payment. Additionally, since a patient can dispute a charge on their credit card, any payment made to the Collection Agency by credit card can be reversed by the patient's credit card company while the dispute is being resolved. As a result, we can only be assured that we are getting the full balance due to our office when the check arrives from the Collection Agency.Patient Portal:The patient portal is very limited in functionality. Of the few things that are accessible, they can for the most part, be done better by telephone.Closing:We feel everything was handled properly with Mr. *. Through our series of four statements and three collection letters sent to patients, and the personal phone call, we feel our collection policy is clearly presented to each patient in advance. We give all patients, who refuse to pay their outstanding balance, the required 30 day notice, in writing, that we are "discontinuing care" and that they will not be able to access medical care including scheduling an appointment or refilling prescriptions. And since there is no requirement for our office to Re-active a patient's account, reestablish care or extend them credit again, once the balance is paid off, we feel we have gone above and beyond what was necessary to help Mr. *.Like other small practices, the ability to offer free care is not possible. Our creditors want to be paid on time, so therefore we ask patients to pay their outstanding balances on time as well.Sincerely,Peter R[redacted]Manager###-###-#### Ext **

Complaint: [redacted]
I am rejecting this response because: The response does not reflect the nature of my concern. There was never a question regarding the monies owed the the Business. The issue, which the Business failed to address, was with the manner in which the represnetative for the Business conducted herself. Beverly was rude, dismissive, intolerant, and the Business did not restore my access to the Patient Portal after the account was settled. These was the primary rationale for the compliant. The Business representative implied I was dishonest regarding my payment to the Collection Agency and restricted my direct access to my physician even after the debt was settled. The detailed account regarding the length of time it took me to resolve the account is not germaine to the reason for contacting the Revdex.com. The Business disallowed my direct access to my physician and acted as my representative with repect to services needed from my PCP, not at my request, but because of an internal policy that favored the Business and not the consumer. When I filed this compliant my balance with the Business was zero, proven by my bank statement and the confirmation number I provided to the Business reflecting a "paid in full" status with the Collection Agency. The Federal Fair Debt Collections Act of 1996 restricts a business or debt collector from abussive behavior in an attempt to collect a debt. The Collection Agency was professional, respectful, and engaged me in a manner that demonstrated dignity. The Business in question did not conduct themselves in this manner. The Patient Portal is the tool utilized by the PCP's office to communicate directly with the Physician's office. In the past, this tool has worked very well. My PCP's office has responded in a timely manner whenever I accessed to Protal to request services, schedule appointments, and to review my medical records. The Business's response to the so called "limited" functionality of the Protal, again is not relevent to the primary issues prompting me to file this complaint. The Business's action to restrict my access to my Patient Portal account was just when the outstanding balance was active; however, the continuation of this access restriction for seven days (as per their policy) until the Business was paid by the Collection Agency was punitive and not consistent with the spirit of the Affordable Care Act and the FAir Debt Collections Act. 
Regards,
[redacted] [To assist us in bringing this matter to a close, the consumer must give a reason why they are rejecting the response. If the consumer does not provide a reason the complaint will be closed Answered]