Jeffers, Mann & Artman Pediatric & Adolescent Medicine, P.A.

Company is not properly billing insurance carriers as discussed with them numerous of times!!We have had 3 separate doctors visits for our daughters. 1 on 1/30/15, 2/11/15, 4/14/15. Our insurance has a primary insurance and a secondary insurance. The primary has been billed for all 3 but they did not bill the secondary properly. We provided a card at the initial visit, and 3 times by fax or email since then and at each visit even told them to file through both. Our medical card CLEARLY states that it must be filed between both carriers. My wife has spoken to them about a week ago in which the lady in billing seemed confused it didnt understand the secondary insurance. It states CLEARLY on our medical card to file through both carriers and provides information for both. We have had this conversation multiple times and still receive letters threatening going to collections. We received a bill in the mail today seeking payment for the initial visit in January which does not seem to be filed through the secondary insurance yet. They have a insurance pending of the other balance they were seeking but have not seemed to file the initial January visit. I have explained to them repeatedly they will not get a dime until a proper bill is sent to me after all visits have been properly filed with the insurance carriers. I am tired of receiving letters demanding payment or threatening collections due to incompetent people who cannot correctly do their job. Desired SettlementPlease properly bill the insurance carriers as instructed on the medical card that you have received a copy of over 3 times now. When this is done and I check with all carriers and verify the amounts, I will then pay whatever amount that is owed from me. Until this is done, please do not continue to waste my time sending bills because you will not get paid and sending me to collections for your failure to correctly do your job will only make matters worse for you.Business Response Contact Name and Title:[redacted], Billing MgrContact Phone:[redacted]Contact Email: [redacted]Thank you for taking time to contact Jeffers, Mann and Artman Pediatrics in regards to this complaint and for allowing us to explain our position in this matter. In reviewing this account, I do see that the insurance card was scanned in to our practice management system in January 2015. The primary insurance was promptly filed with the carrier for all three visits mentioned in the complaint. As per the complaint, the secondary insurance is clearly stated on the back of the card and should have been filed for these visits. However, typically the secondary insurance is on a separate card and not on the back of the primary card. Regrettably, this was totally missed by our staff. Therefore, after the primary insurance paid the balance was then billed to the patient. A second copy of the card was scanned in to our system on June 11, 2015. We received a call on June 19, 2015 from the patient's mother stating that she had faxed a copy of the card and explaining that there was secondary coverage and it was listed on the back of the card. To my knowledge that was the first fax and only call from the patient regarding the secondary coverage. We immediately filed the balance from all three visits with the secondary policy. However, the patient's secondary carrier is one our clearinghouse does not recognize so they were unable to process the claims electronically. Therefore, the clearinghouse rejected and sent the claims back. We did drop the claims to paper, mailed to the secondary insurance and those claims are now pending payment. We have added notes to the patient's account regarding the secondary coverage and have educated our staff. It was not our intent to cause any undo frustration and we regret any inconvenience caused by this issue. Our ultimate goal is to provide quality care to our patients. We make every effort to provide this quality service in every encounter with our office including billing. We apologize for this oversight on our part and are making every effort to rectify this situation. Consumer Response As you stated, this was missed by your staff. There were multiple phone calls about this issue and it was never taken care of. Yes, after a letter threatening to send to collections was sent then did we scan and send another copy. Completely unacceptable as the same scan and copy we sent is the exact scan and copy you admitted to not seeing. For it to go this far with the amount of time that we spent calling and trying to correct is ridiculous. As stated previously, I will not pay a single dime to you regarding any of the visits until I see that they have been billed properly and that a corrected amount will be billed to us. Apart from the frustration of this matter, we will no longer be attending your practice as this is completely ridiculous by a professional organization. Again, send me a statement when all insurance has been filed and paid with a corrected amount and then you will be paid. I do appreciate your response in this matter regardless of my feelings towards this issue.Final Business Response As stated in our first response, we do realize that this was an oversight on our part and are making every effort to assure that this does not happen again. Again, we regret any frustration and inconvenience this has caused the patient as that was certainly not our intention. That being said, we did file the secondary insurance for the visits in question and called to make sure that they were in receipt of our claims. We are following up with the insurance company weekly to make sure that claims are getting processed efficiently. We have received payment for two of the visits and are expecting the third one to be paid shortly. Again, we apologize for the frustration this has caused.