Irvine Walk-In

December 11, 2014Revdex.comViewridge Ave #200San Diego, CA 92133-6199Re: ID # ***
This is in response to your letter of 12-5-regarding *** ***On 9-28-we took care of Mr*** ***'s health problemAfter hisinsurer
denied the claim, we submitted a bill to him for paymentIt is then that heinformed us that he had another Insurer, which is an *** planHe had failed to tell usthis important detail at the time of serviceHe knew that we do not participate in any*** plan, as he read and signed our financial policy prior to being seenIn essence hemisrepresented his insurance coverage for the service we provided himHad we knownhe was insured by an *** plan, we would have told him we were not a member of his*** and would have directed him to nearby health clinics.I have enclosed a copy of the policy he read and signed here at our office.Thank you
*** ***Administrator

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.]
Regards,
[redacted]
The receptionist is responsible to check my eligibility. This is not my first time going to doctor's office or even an regent care. They always take my social security number and policy number and check in their system before letting me be seen by the doctor. I never misrepresented my insurance coverage. I had [redacted] and I still do have [redacted]. I did not know the policy name which is [redacted] it is the office responsibility to check that before accepting a patient. I am not an insurance expert but it is obvious that they did not do their part right and now I have to pay for it.
[redacted]

Review: On 0928/2014 I went to Irvine Walk in clinic in Irvine. I asked them that if they do take [redacted] insurance and the receptionist said yes. she took my information and without calling my insurance to confirm anything told me that have a sit and the doctor will see you in a few minutes. I have [redacted] under [redacted] and I only knew that I have medicare. As patient I don't know [redacted] is under [redacted]. They are the providing clinic and they know the insurance better. I am [redacted] and I don't know the details about [redacted] is under [redacted]. They sent me bil for $[redacted] and I don't have the money to pay. I tried to talk to them and they said they can not help me. A doctor told me by medical law it is illegal for urgent care to bill patients over ** under [redacted] because they are covered by the government. Please help me resolve the issue. Thank you My [redacted] plan #8xxx-xx-xxxxDesired Settlement: Bill that they sent me I can not pay.

Business

Response:

December 11, 2014Revdex.com4747 Viewridge Ave #200San Diego, CA 92133-6199Re: ID # [redacted]This is in response to your letter of 12-5-2014 regarding [redacted]On 9-28-2014 we took care of Mr. [redacted]'s health problem. After hisinsurer denied the claim, we submitted a bill to him for payment. It is then that heinformed us that he had another Insurer, which is an [redacted] plan. He had failed to tell usthis important detail at the time of service. He knew that we do not participate in any[redacted] plan, as he read and signed our financial policy prior to being seen. In essence hemisrepresented his insurance coverage for the service we provided him. Had we knownhe was insured by an [redacted] plan, we would have told him we were not a member of his[redacted] and would have directed him to nearby health clinics.I have enclosed a copy of the policy he read and signed here at our office.Thank you[redacted]Administrator

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.]

Regards,

The receptionist is responsible to check my eligibility. This is not my first time going to doctor's office or even an regent care. They always take my social security number and policy number and check in their system before letting me be seen by the doctor. I never misrepresented my insurance coverage. I had [redacted] and I still do have [redacted]. I did not know the policy name which is [redacted] it is the office responsibility to check that before accepting a patient. I am not an insurance expert but it is obvious that they did not do their part right and now I have to pay for it.