Lewis-Gale Medical Center

We are in receipt of your correspondence dated April 3, 2017 from Amy [redacted] in reference to her two accounts from Lewis Gale Medical Center. In that correspondence, Ms. [redacted] expresses her concern for the charges on the account and the bills she is receiving from Lewis Gale Medical Center. We...

appreciate the opportunity to review and respond to Ms. [redacted]'s concerns. In her complaint, Ms. [redacted] advises she had the exact same services on two different dates and her accounts were billed differently. She paid in full $[redacted] for her April account and then received a new bill for different amount due. She feels she should not be responsible for the new balance. She was concerned that she was not able to meet face to face with the billing office to discuss this account and why it was billed incorrectly. Also, she feels the account for the July services are correct.Our records indicate Ms. [redacted] received Outpatient services on April 28, 2018 with charges totaling $[redacted]. We submitted those charges to the insurance company, [redacted]. They processed the claim making no payment, however they advised the patient was liable for $[redacted] which had been applied to the deductible. Ms. [redacted] contacted our billing office on November 3, 2016 asking if the account had been billed according to the physician order. The account was submitted to our Auditor where the charges were compared to the physician order and medical record. it was determined there were duplicate charges on the account. Ms. [redacted] was mailed a copy of the Audit results letter dated November 9, 2017 explaining the removal of duplicate charges. The account was re billed for the correct charges totaling $[redacted] processed the corrected claim making no payment however advising the patient would owe $[redacted] as applied to the deductible. her payment of $[redacted] was applied to the deductible owed. The current balance on the account is $[redacted].Further review of the account reveals on December 16,2016, Ms. [redacted] made an additional call to our billing office. She stated she had received another bill and it did not match her EOB from [redacted]. She acknowledged the insurance EOB showed her liability to be $[redacted] for the April 28, 2016 services and that closely matched the amount owed on her July account. The representative forwarded her account for review. The account was reviewed and adjusted per the EOB from [redacted]. An updated statement was sent to Ms. [redacted] on January 16, 2017 reflecting $[redacted] as the remaining balance. In consideration of Ms. [redacted]'s concerns, we have contacted [redacted], reference number [redacted], asking about the reprocessed claim and the deductible listed on the Explanation of Benefits (EOB). They have sent this claim for further review. They have requested to allow up to 30 days for the completion of their review of the claim. Additionally, [redacted] verified the claim for the services on July 15, 2016 was processed correctly.We are requesting additional time to have this account reviewed by [redacted] as they determine the patient liability for services. We have place the account [redacted] on a 30 day hold pending the review by [redacted]. We can understand the concerns from Ms. [redacted]. We apologize for any inconvenience she may have experienced. She is welcome to bisit our billing office located at [redacted]. Unfortunately, there is not a billing office located at the Lewis Gale Medical Center. Please do not hesitate to contact our offices at the number listed below should there be any further questions or concerns.Sincerely Marilyn R[redacted]