Institute of Advanced Gastroenterology

To Whom It May Concern: I am writing you regarding a complaint I received on a 'Billing or Collection Issues". First and foremost, we do not do procedures at Dr. [redacted]'s office (Institute of Advanced Gastroenterology), procedures are performed at Advanced Endoscopy Center; which is an Ambulatory...

Surgical Center. This is an outpatient facility for endoscopic procedures only. Our office has tried to communicate with you multiple times as mentioned below regarding your bills, most importantly this is your insurance benefits and has nothing to do with our office or Advanced Endoscopy Center. We have tried to explain to you before and I don't think you understand that the two bills are for two separate entities as mentioned below. We DO NOT promise or tell anyone that their insurance will pay for everything because everyone's insurance coverage is different depending on their plans and that is why you have signed a financial policy. You can review your financial policy and it clearly defines all the details you need to know and it does not state "your health insurance would pay for everything". Our office gives an 'estimated" cost, we cannot make determination before services are rendered, the outcome depends on findings of the procedure. Our office billed your health insurance according to your health insurance guidelines. If you have any concerns, please call your health insurance for clarification on any questions you may have. Our number one goal is to provide the best med Cal care first to make sure our patients are well taken care of. The patient's medical health is our number one priority and we try our very best to accommodate to all of our patients. Before financial involvement is addressed with the patient, our office verifies the patient's eligibility and benefits. The patient is also responsible to contact his/her insurance company to talk to them in depth of what services are covered since they would know their benefits/coverage the best. Before anyone signs up with any insurance and chooses their plan, they are provided a pamphlet or given a website to view their coverage and benefits before choosing what is right for them. Once the patient chooses their plan, it Is the patients responsibility to understand what plan they chose and if they do not understand their plan or benefits then they are encouraged to call their insurance for details. Our office cannot go into details about the patients plan and benefits because we are not the patient's insurance company as mentioned before. As a courtesy and as a participating provider with the patient's insurance we bill their health insurance for reimbursement of services provided to the patient and we verify eligibility and benefits to help our patients. Mr. Mamaradlo, we received your letter you wrote us doted 11/30/16 with your concern on the bills you received, so our office contacted you on 12/19/16, our office left a voicemail message and you did not answer our call. Again, we tried to contact you on 12/21/16 and still no answer. The two bills you are have received are NOT from the SAME office. The two bills you received are from • Institute of Advanced Gastroenterology o Amount due: $332.35 o This amount was applied to your annual deductible by your insurance company. Your insurance company stated you have cm annual deductible that needs to be met before they can pay for services rendered. • Advanced Endoscopy Center o Amount dues 5136.10 o This amount was applied to your annual deductible and your co-insurance by your insurance company. Your insurance company stated you have an annual deductible and out-of-pocket that needs to be met before they con pay for services rendered. Your insurance company is available to give you full explanation of how your claim(s) were processed. Please contact GEHA or Aetna to discuss your plan and benefits. On behalf of our company, we would like to apologize for any misunderstanding and hope this information helps you understand the difference between the two bills.