This is a response to Revdex.com case #***Our office is limited to the information we can discuss and release to the Revdex.com regarding this case, due to the HIPPA and patient privacy lawsOur office values our patients and we make every effort to inform/disclose to our patients regarding the
services they receive as well as their financial responsibility(attached is a copy of the paper work every patient fills out for our office) Every patient seen in our office must fill out this paper work and by signing they are acknowledging that they understand and agree to the policies/terms and conditions of our officeOur practice is that when a new patient arrives to our office they are given the new patient paper work to be filled out by the patient and a copy of their insurance card and picture ID is copiedOur front office then calls the insurance and verifies the insurance coverage, which was done on his visitOur office was told by Mr***'s insurance that he was responsible for a specialist copay which he was chargedThe patient saw the doctor and services were renderedAfter the patient's visit was complete, the patient was given a copy of his receipt( the receipt states what services were rendered and what he paid) A claim was then filed with the patients insurance and it was processed with part of his visit going towards his responsibility/deductibleOur office can only verify the insurance benefits with the insurance company and go off what we are told by the agent on the phone and that is what we didWe have limited access to the plan benefits since it is an agreement with the patient, his employer and his insurance companyOur office collected the amount we were told by his insurance representative at the time benefits were verifiedWe have no control over how his benefits are administered or how his claims are processed by his insurance once they receive the claimIt is his insurance that processed the claim to his responsibility and states that he owes that portion of his visit and it is also his insurance plan that did not place all services rendered under his copayAgain, we have no control over how his insurance processes his claims, all we can do is go off what is made available to us by his insurance company at the times his benefits were verified
The call on 2/29/the patient refers to was a courtesy call from our office because bills had been sent to the patient with no responseAgain, we take our work very seriously and we make every effort to work with our patients regarding their relationship with our officeOn 2/29/our office was reaching out the patient to touch base with him regarding his account, since we had not received any communication from the patient and statements had been sent and we had not received them back as undeliverableUpon further checking with his insurance company they also sent the patient EOBs(explanation of benefits), when the claims were processed stating what they paid and what he owed, so his statement about "his first time hearing of this" we cannot answer because our office sent our statements since September and according to his insurance they too sent the patient notification of his responsibilityI have to disagree with Mr***'s statement about he must pay or it would be turned over to collections, again as stated above this was just a courtesy call to him regarding his accountSandra also offered him to call his insurance company and discuss with them why they didn't pay his charges in full, since it is his insurance and they can tell him how it works
The statement Mr*** states services rendered "were not discussed with me or disclosed to me prior to being performed" and "extra procedures" being performed "without letting the client know" again I have to disagree withThe patient signed a separate consent in addition to the one in the original paper work giving consent for treatment by the DrHe was told what procedures were being performed on him as he was awake and aware of everything being done to himAgain, due to patient privacy laws, I cannot disclose what was done, but anyone would be aware of the procedures performed on them while awake and it is standard medical practice for the Drto explain what he/she is going to do to the patient and get a verbal consent before performing a procedure on a patientNot only was the procedure discussed with the patient prior to performing, a separate consent was also obtainedSo the "extra services rendered" the patient refers to were discussed, disclosed and consented to before being performed
Again, we try our very best to meet our patients needs/concerns and we have started an appeal to the patients insurance company to get the claim paid in full, because we were told one thing and the claims processed differentlyWe are more than willing to work with Mr*** to get this matter resolved and we encourage him to contact his insurance also to help with this matterOur office is at the mercy of the insurance company, because we depend on them to give us the coordination of benefits and we charge the patient based on that information and then the insurance processes the claim a separate way and they again tell us what the patient is to be charged
We would be glad to discuss this with Mr*** and his insurance on a three way call to resolve this issue with his accountAgain we encourage him to contact his insurance because when we discussed this situation with them, they stated that it is the patients responsibility to know his coverage and benefits
This is a response to Revdex.com case #***Our office is limited to the information we can discuss and release to the Revdex.com regarding this case, due to the HIPPA and patient privacy lawsOur office values our patients and we make every effort to inform/disclose to our patients regarding the
services they receive as well as their financial responsibility(attached is a copy of the paper work every patient fills out for our office) Every patient seen in our office must fill out this paper work and by signing they are acknowledging that they understand and agree to the policies/terms and conditions of our officeOur practice is that when a new patient arrives to our office they are given the new patient paper work to be filled out by the patient and a copy of their insurance card and picture ID is copiedOur front office then calls the insurance and verifies the insurance coverage, which was done on his visitOur office was told by Mr***'s insurance that he was responsible for a specialist copay which he was chargedThe patient saw the doctor and services were renderedAfter the patient's visit was complete, the patient was given a copy of his receipt( the receipt states what services were rendered and what he paid) A claim was then filed with the patients insurance and it was processed with part of his visit going towards his responsibility/deductibleOur office can only verify the insurance benefits with the insurance company and go off what we are told by the agent on the phone and that is what we didWe have limited access to the plan benefits since it is an agreement with the patient, his employer and his insurance companyOur office collected the amount we were told by his insurance representative at the time benefits were verifiedWe have no control over how his benefits are administered or how his claims are processed by his insurance once they receive the claimIt is his insurance that processed the claim to his responsibility and states that he owes that portion of his visit and it is also his insurance plan that did not place all services rendered under his copayAgain, we have no control over how his insurance processes his claims, all we can do is go off what is made available to us by his insurance company at the times his benefits were verified
The call on 2/29/the patient refers to was a courtesy call from our office because bills had been sent to the patient with no responseAgain, we take our work very seriously and we make every effort to work with our patients regarding their relationship with our officeOn 2/29/our office was reaching out the patient to touch base with him regarding his account, since we had not received any communication from the patient and statements had been sent and we had not received them back as undeliverableUpon further checking with his insurance company they also sent the patient EOBs(explanation of benefits), when the claims were processed stating what they paid and what he owed, so his statement about "his first time hearing of this" we cannot answer because our office sent our statements since September and according to his insurance they too sent the patient notification of his responsibilityI have to disagree with Mr***'s statement about he must pay or it would be turned over to collections, again as stated above this was just a courtesy call to him regarding his accountSandra also offered him to call his insurance company and discuss with them why they didn't pay his charges in full, since it is his insurance and they can tell him how it works
The statement Mr*** states services rendered "were not discussed with me or disclosed to me prior to being performed" and "extra procedures" being performed "without letting the client know" again I have to disagree withThe patient signed a separate consent in addition to the one in the original paper work giving consent for treatment by the DrHe was told what procedures were being performed on him as he was awake and aware of everything being done to himAgain, due to patient privacy laws, I cannot disclose what was done, but anyone would be aware of the procedures performed on them while awake and it is standard medical practice for the Drto explain what he/she is going to do to the patient and get a verbal consent before performing a procedure on a patientNot only was the procedure discussed with the patient prior to performing, a separate consent was also obtainedSo the "extra services rendered" the patient refers to were discussed, disclosed and consented to before being performed
Again, we try our very best to meet our patients needs/concerns and we have started an appeal to the patients insurance company to get the claim paid in full, because we were told one thing and the claims processed differentlyWe are more than willing to work with Mr*** to get this matter resolved and we encourage him to contact his insurance also to help with this matterOur office is at the mercy of the insurance company, because we depend on them to give us the coordination of benefits and we charge the patient based on that information and then the insurance processes the claim a separate way and they again tell us what the patient is to be charged
We would be glad to discuss this with Mr*** and his insurance on a three way call to resolve this issue with his accountAgain we encourage him to contact his insurance because when we discussed this situation with them, they stated that it is the patients responsibility to know his coverage and benefits
Did not incude important items in divorce decree, hired him to protect my rights according to the law, it was a farce