Lake Tahoe Pediatrics

Review: On July 31st, 2013 My son [redacted] was taken to the Barton Memorial Hospital for nasal congestion that was keeping him from being able to breastfeed. I have a HMO insurance plan that covers Emergency room visits. My wife and I knew he needed to go to the hospital since he was so young and not being able to eat.The emergency room contacted on call Doctor [redacted]. Dr [redacted] ordered a X-Ray. The X-ray was inconclusive and the Dr wanted a follow up at his private practice. Dr [redacted] made us a follow up appointment and advised us that our son needed a follow up and we should make it. On August 1, 2013 my wife and I took our son [redacted] to Lake Tahoe Pediatrics located at 2074 Lake Tahoe Blvd Suite 9, South Lake Tahoe Ca 96150. I spoke with the front desk office clerk in regards to payment. She advised me that they DO NOT accept HMO insurance and I would have to pay out of pocket. She stated, since we were going to pay out of pocket our cost would be 80.00. My wife and I asked if that would make this office visit paid in full. The office Clerk said "Yes, you will not owe us a penny more." The office clerk agreed to give me a copy of my receipt and doctors notes for what our son [redacted] was being seen for. She stated if I wanted to deal with my insurance it would be on me.When we returned home the next day I contacted my insurance and spent over an hour filling out the claim paperwork and receipts showing what I had paid. My insurance on August 16 mailed a check for 92.56 to Lake Tahoe Pediatrics. Lake Tahoe Pediatrics had refused to send me the check. Instead stating that is was for services rendered. After a month the office agreed to send me a refund of 65.00. I feel that since I put the time into processing the claim the office should have refunded me the 80.00 since we were paid in full. The practice of making us pay up front and then taking an insurance claim check cashing it, and holding it for a month is not a good practice. I live paycheck to paycheck and find what they did to be unreasonable

Desired Settlement: DesiredSettlementID: Refund

I feel that with the office getting the full 92.56 from the insurance after I had already paid in full of 80.00, that I should be refunded the full dollar amount. This Doctors office is being deceptive and fraudulent by taking funds in excess of what had already been settled. If they had not charged me at the time of my visit and billed my insurance there would never had been an issue. They were taking advantage of us when we were in a crisis situation with our sons health.

Business

Response:

Final Consumer Response

On August 20th, 2013 at 1515 hours, I was contacted by [redacted]. Mrs. [redacted] is the office manager for Lake Tahoe Pediatrics. Mrs. [redacted] has promised me the 15.00 refund in exchange for dropping my complaint to the Revdex.com. Please close out this case as resolved since Lake Tahoe Pediatrics is making it right by refunding me. Thank you for your assistance with this matter.