INOVA HealthPlex

June 9, 2014Dear *** ***:We are in receipt of the complaint filed with the Revdex.com with ID number ***.We have investigated the issue raised, and have provided the stated desired outcome by the complainantAdditionally, we have reached out to the individual; and they have stated
they are now satisfied with the result.We pride ourselves on efficiency and the ability to attend to matters and concerns immediatelyWe appreciate the Revdex.com facilitating this discussion to allow for the raising of a concern in this forum.We send you kind regards always.Sincerely,

September 16, Dear *** ***:This letter is in regard to the collection notices and bills erroneously sent to you by ***Please accept our apology for the difficulties you have encountered in trying to resolve the errorsIn reviewing your account we noted that there was
an error of omission in not including your FEP BCBS insurance at the time of service which resulted in your account being set up as a self-pay for date of service April 9, This oversight resulted in statements being released and subsequently having your account transferred to *** bad debt.In reviewing the handling of your account, we recognized the frustrations you must have experienced with our billing proceduresYour feedback, however, has given us an opportunity to improve our billing and customer service processes and to avoid this situation in the future for all of our patientsThe total charge on your account was originally $which was later reduced to reflect a discount which we apply to self pay accountsWe have written off the remaining $and your account now shows a zero balancePlease accept my apologies for the length of time it has taken to resolve this matterAt Inova, we remain committed to providing our community with excellent health care services and we thank you for choosing us for your medical needsIf you should have any questions or concerns, please feel free to contact me at ###-###-####.Sincerely,
Dolly DDirector

Dear Revdex.com,We have looked into this claim and take this very serious. We strive to do everything possible to make sure our patients (customers) have the best experience possible while at our Centers. We believe that we have an exceptional reputation of providing great service in...

this community and we try our hardestto make sure this continues in the future.Although, we feel the claim filed is directed at the wrong entity, we have taken this on to resolve the matter. Prior to the Date of Service, our Center was told that no pre-authorization was needed from the patient's (customer's) insurance company for their procedure(s). After the claim was filed and processed from their insurance company, they deemed that the procedure(s) needed pre-authorization. We billed the patient (customer) according to the Explanation of Benefits their insurance carrier sent back to us.We contacted the collection agency directly to ask them to take this outstanding claim off and they agreed. Hopefully the patient (customer) will see we have taken extra steps to help resolve this issue.Thank you

Review: After multiple communications and attempts at resolution, it is my understanding that a fee in the total of $4,843.19 has been reported to a collection agency with a negative impact on my credit score. No response to my April 2014 letter was received and my credit score has been lowered by over 100 points due to their inaction. The fee of $4,843.19 was generated due to Inova Surgery Center and [redacted] ENTs failure to secure pre-certification clearance and due to this failure, [redacted] Services Inc. consequently deeming the surgery as not medically necessary. When I inquired on the amount, Bryon of Inova Surgery Center informed me that the $5000 amount was due to a failure on [redacted] ENT to obtain pre-certification clearance, and that $156.81 had been previously collected in payment, reducing the final amount to $4,843.19. I challenge this claim on three grounds: 1) The fee in $4,843.19 generated on billing documents three months (July 2014) after the completion of the surgery without explanation to either party. It was only after making a direct inquiry that I received confirmation that it was due to a lack of pre-certification clearance. 2) There is no explanation as to why the code corresponding with the surgery (code [redacted]) had two billing codes: one confirming that the patient cannot be held responsible due to billing obligations ([redacted]) and another confirming that the patient is held responsible ([redacted]). Why are there two billing codes for the same medical procedure? 3) Finally, [redacted] ENT documented that no pre-certification clearance was needed (per [redacted] of [redacted] Services Inc.) Specifically, please see the highlighted portion of Exhibit C confirming that no pre-certification was required for code [redacted]. This information was communicated to Inova Surgery Center prior to the surgery.Desired Settlement: To resolve this matter, I request that this charge be removed from my credit report, as this is obviously a miscommunication between the billing departments of [redacted] ENT and Inova Surgery Center.

Business

Response:

Dear Revdex.com,We have looked into this claim and take this very serious. We strive to do everything possible to make sure our patients (customers) have the best experience possible while at our Centers. We believe that we have an exceptional reputation of providing great service in this community and we try our hardestto make sure this continues in the future.Although, we feel the claim filed is directed at the wrong entity, we have taken this on to resolve the matter. Prior to the Date of Service, our Center was told that no pre-authorization was needed from the patient's (customer's) insurance company for their procedure(s). After the claim was filed and processed from their insurance company, they deemed that the procedure(s) needed pre-authorization. We billed the patient (customer) according to the Explanation of Benefits their insurance carrier sent back to us.We contacted the collection agency directly to ask them to take this outstanding claim off and they agreed. Hopefully the patient (customer) will see we have taken extra steps to help resolve this issue.Thank you

Review: COMPANY FAILED TO PROCESS MY INSURANCE AFTER IT WAS PRESENTED NUMEROUS TIMES. I AM SUBMITTING THIS COMPLIANT ONLINE AND MAILING IT ON FOR INOVA & [redacted]. I am writing regarding a collection statement I received on 8/27/2014 regarding a date of service of 4/9/2012. When I called the provided number (###-###-####) I was told they received my proof of insurance in 2013 but it was too late to file. I informed the representative that I had faxed in and mailed in my proof of insurance and documents various times. She still stated it was still too late to file the insurance and I would need to make the payment. I am now writing as I do not feel I should be held liable for the balance since I have provided my information. In order to show that I have provided the proper documentation in a timely manner, please see below my timeline of events: 1. 6/18/12- Received a statement from INOVA dated 6/5/12 in the amount of $94.40. a. Contacted INOVA at ###-###-####. b. Spoke with Emilio and was told that my insurance information was not file on. On this date I faxed a copy of my insurance card to Emilio at ###-###-####. I. Please see the enclosed statement and fax transmission report. 2. 8/16/12- Received a statement from INOVA dated 8/8/12 in the amount of $94.40 a. Contacted INOVA at ###-###-####. b. Spoke with Emilio was told that my insurance information was not in the Epic System and I need to fax a copy of my insurance card again to ###-###-####. I. Please see the enclosed statement and fax transmission report. 3. 9/17/12- Received a statement from INOVA dated 9/6/12 in the amount of $94.40 a. Contacted INOVA at ###-###-####. b. Was told my insurance information was on file and they would re-file the claim. I. Please see the enclosed statement. 4. Received statements from [redacted] dated 4/22/13 and 3/21/13 in the amount of $94.40. a. 3/28/13: I faxed a letter, copy of previous faxes, explanation of benefits, proof of coverage, benefits at a glance and verification of eligibility to Lily J[redacted] at ###-###-####. I. Please see the enclosed fax transmission report/transmission verification report. b. 3/29/13: I mailed a letter to [redacted] PO Box [redacted] MD [redacted] regarding this balance and included the faxes, explanation of benefits, proof of coverage, benefits at a glance and verification of eligibility. I. Please see the enclosed letter and documents sent. c. 7/10/13: I faxed the statement dated 3/21/13 and copy of insurance card to Lily J[redacted] at ###-###-####. I. Please see the enclosed fax transmission report/transmission verification reports. One is time stamped at 7:26 and other is time stamped at 7:28 5. 8/27/14 - Received a statement from [redacted] in the amount of $69.40. a. Please the enclosed statement. Based on the information above and enclosed documentation, I request that INOVA/[redacted] resubmit the claim to the insurance company and/or write off the balance as I have provided the proper documentation in a timely manner. In addition, I would like INOVA/[redacted] to advise why in 2013 I owed $94.40 and in 2014 I owe $69.40.Desired Settlement: Write off the balance or resubmit claim to insurance company.

Business

Response:

September 16, 2014Dear [redacted]:This letter is in regard to the collection notices and bills erroneously sent to you by [redacted]. Please accept our apology for the difficulties you have encountered in trying to resolve the errors.In reviewing your account we noted that there was an error of omission in not including your FEP BCBS insurance at the time of service which resulted in your account being set up as a self-pay for date of service April 9, 2012. This oversight resulted in statements being released and subsequently having your account transferred to [redacted] bad debt.In reviewing the handling of your account, we recognized the frustrations you must have experienced with our billing procedures. Your feedback, however, has given us an opportunity to improve our billing and customer service processes and to avoid this situation in the future for all of our patients.The total charge on your account was originally $176.00 which was later reduced to reflect a discount which we apply to self pay accounts. We have written off the remaining $69.40 and your account now shows a zero balance.Please accept my apologies for the length of time it has taken to resolve this matter. At Inova, we remain committed to providing our community with excellent health care services and we thank you for choosing us for your medical needs. If you should have any questions or concerns, please feel free to contact me at ###-###-####.Sincerely,Dolly DDirector

Review: I had a medical test done in February and paid what portion Inova said was my portion of the bill up front. I informed them that I thought that it was too high as I had already met my deductable for the year. I was assured that they had spoken to my insurance and this was the correct amount. I received notice from my insurance company in March that I had overpaid $148.11. My insurance company notified Inova on 24 February 2014 that I had overpaid but Inova did not start to process my refund until 24 March 2014 when I called after receiving notification from my insurance company. I was informed it would take 30 days. I called after 24 April and was again informed it was "in process". I called again on 6 May 2014 and was told by another employee that nothing had been processed so she had put a "rush" on it. I was informed I should receive payment within 72 DAYS, not hours but DAYS. That would make it almost 6 months from the time they received a payment from my insurance company and were informed that I had overpaid by $148.11. The fact that a refund had not been processed when they were notified by my insurance is unacceptable, more so after I called in March.Desired Settlement: I would like either a check cut immediatly or the money refunded to the credit card I used to pay the bill - WITH an additional interest of 15.24% - the current interest rate on my [redacted] Card--if the refund is not completed in 14 days.

Furthermore, I would like Inova to institute a process that when they receive payment from Insurance companies and it is determed the patient overpaid - refunds are automatically processed rather than waiting to see if the patient notifies them and demands payment. I believe it borders on fraud that they did not start to process my refund until I called them--1 month after they received notification and payment from my insurance company.

Business

Response:

June 9, 2014Dear [redacted]:We are in receipt of the complaint filed with the Revdex.com with ID number [redacted].We have investigated the issue raised, and have provided the stated desired outcome by the complainant. Additionally, we have reached out to the individual; and they have stated they are now satisfied with the result.We pride ourselves on efficiency and the ability to attend to matters and concerns immediately. We appreciate the Revdex.com facilitating this discussion to allow for the raising of a concern in this forum.We send you kind regards always.Sincerely,