Kelly Family Clinic

Complaint: [redacted] I am rejecting this response because: [redacted] , which are the experts at handling their claims as my secondary insurance, has already called and attempted to explain to the Kelly Family Clinic, Austin in particular, on what myself, as the patient, and what the clinic has to write off per the contract they have with them I feel after numerous attempts by me, [redacted] customer service reps and a manager for [redacted] and now the Revdex.com that I have to move on to the next step in reporting this billing inconsistency I take solace in knowing I have two letters sent to me by [redacted] advising that I am in no way responsible for any more charges other than what has been paid in early May, to bring my responsibility to a zero balance Regards, Brenda Graves

Complaint: [redacted]
I am rejecting this response because: [redacted], which are the experts at handling their claims as my secondary insurance, has already called and attempted to explain to the Kelly Family Clinic, Austin in particular, on what myself, as the patient, and what the clinic has to write off per the contract they have with them.   I feel after numerous attempts by me, [redacted] customer service reps and a manager for [redacted] and now the Revdex.com that I have to move on to the next step in reporting this billing inconsistency.  I take solace in knowing I have two letters sent to me by [redacted] advising that I am in no way responsible for any more charges other than what has been paid in early May, 2016 to bring my responsibility to a zero balance. 
Regards,
Brenda Graves

Unfortunately, medical billing and dealing with insurance companies can be very complicated and difficult to understand.  Because we know the whole process can be frustrating and confusing, we are dedicated to making sure that claims are billed correctly, filed correctly, and that our patients...

understand their bills.  When patients have questions about their bills, we encourage them to call us so we can explain them.  This patient did call our clinic before her claims were processed by her insurance company to inquire about how her claims would be filed and processed.  We explained to her how the process would likely work.  In her case, the process is more complicated than usual because she has a primary and secondary insurance, but we explained to her what we estimated both insurance companies would pay.  She acknowledged the estimate and expressed understanding of how the claims would likely be processed by both insurance companies.  When the claims were processed exactly as estimated, a bill was sent to the patient.  She then called our office and indicated that we had made a mistake.  We do occasionally make clerical errors, but because we are so dedicated to making sure we handle our billing correctly, when a patient brings a possible mistake to our attention, we respond immediately, usually on the same phone call.  We researched the account with her on that phone call and verified that there were no mistakes made.  When we attempted to explain the bill to her again, she indicated that she did not want to hear the explanation.  Her secondary insurance company has contacted our office several times at her request, but each time, they have called not realizing that they were the second payer.  The information they provide the patient each time she calls them would be correct if they were the primary payer, but since they are the secondary payer, the amount owed by the patient is different.  We have attempted to explain this to the patient, but unfortunately, she did not want to hear the explanation.It is always our goal to work with our patients to make sure they understand their insurance benefits and to estimate their costs.  We make every effort to provide the lowest cost medical care possible, and help patients make financial choices along with their healthcare choices.  We also work closely with patients who may be struggling with their bills by setting up monthly payment plans.  However, like any other business, when we have patients who choose not to pay their bill after a reasonable amount of time, the account must be sent to a collections agency.  We make every effort to avoid the use of an agency by making several calls and sending several statements before the account is released to the agency.  We would be glad for the patient to call so we can explain how her secondary insurance works, and will make every effort to ensure she understands her insurance benefits in the future.