Lewis Gale Physicians

Lewis Gale Physicians sent our bills to the wrong address. Then sent some of the bills to a collection company. I called and corrected the address and LGP employee told me nothing would be sent to collections. My insurance paid the bills but the collection company is still trying to get payment for the bills that the insurance paid. The collection company lied about the insurance company denying coverage. The collection company also said they would not call or harass me for 21 days. They started calling again after 10 days. Everything has been paid except for $40 in copays. However I am still getting harassed for bills over $3000 for collections of payments my insurance paid. Do not trust anything LGP employees say! On top of all this when I called to correct the billing in one day during multiple calls the company put me on hold for a total of 1hour and 54 minutes. Most people would get frustrated hang up and just pay the money even though it is not due. I asked multiple times for a number or email for a manager or supervisor. I never got an email, phone number or even a name? What are they trying to hide?

November of 2020 orthopedic doctor Hakanson did a quadricep tendon repair surgery on my left knee. They put in a cadaver part and some other material to hold the need together . After the surgery I visited Hakanson or Orthopedic Doctor Conrad for check up appointments to see how the knee was doing just about monthly. After a couple months after the first surgery I started to do physical therapy as well. While going to physical therapy the surgical area in my knee always stayed swollen and very red with severe pain with hardly any relief. When I would go to my monthly visits to the orthopedic doctor they told me this was normal. After a few months the pain was more intense and had seemed to spread from my foot all the way up to my hip radiating out of the knee area. There was a couple of instances where I had to go to ER because the pain was so severe. They would cut my cast to relieve the area around my foot where the cast was pushing and cutting into my ankle area and top of my foot. Disorder relieve some of the pain but only in that direct area of pain . The rest of my leg and hip and even lower back area still had intense pain . Over these months I was getting very dizzy and sickly. There were times when I felt like I was going to fall out of the chair. After around 5 to 6 months of physical therapy and the only thing that was happening was me having more pain and the quadricep repair not seeming to be functioning correctly or healing. They decided to do a MRI and found that the surgery had come apart. The only reason being they said this sometimes happens. At that point they decided to do another surgery without checking for any signs of infection or anything that could have made the surgical area not heal and come apart. So in July 2021 they did another surgery duplicating the first. After my first follow-up visit with Hakanson I scheduled an appointment to come in and see her because I was running a fever feeling very sick and my knee was swollen even more than usual this time being more than red but purplish. I believe that this point the knee was infected again. I saw Hakanson and she told me it was probably not infected but gave me some antibiotics anyways? After a couple of weeks I started going back to therapy and following the same routine of check-up appointments. My next visit with the ortho doctors were mainly with Doctor Conrad after that engagement with Hakanson. I was put on sedentary work restrictions and supposedly I was good to go. I repeatedly told the doctors that my knee was worse off than it was after the first surgery. They told me everything look normal and the pain and swelling was normal as well. My physical therapy was not going well at all at this point. I was constantly in more pain each week after that second surgery. I was dizzy all the time with pain radiating all the way up into my neck. I was getting ringing in my ears. I also had a lot of dizzy spells where I would almost fall down if I did not catch myself. Finally one day the physical therapist was looking at my leg and told me something was not right. They told me they will not do any more therapy on me until I see the ortho doctor. I made an appointment that day and was able to see Doctor Conrad the very next day. When I went to see Conrad he examined my knee with his hands and said yeah something doesn't feel right "I'm going to schedule an MRI but you will not receive the MRI until your insurance authorizes it". A few days past and the pain got even more intense and I was very sick at this point running a fever. So I decide to go to the ER. When I get to the ER they ran an ultrasound to check for blood clots and look for infection. After about 10 minutes of running the ultrasound around my growing and leg area the doctor told me I definitely had an infection in my surgical Site Area. She said she could tell because of the obvious signs of the swelling and redness but mostly my lymph nodes were swollen, my he was fighting an infection for sure . She sent me home with antibiotics. A few days later I received my MRI. I did feel a little better from the antibiotics but not much. About five days after I did the MRI the orthopedic office called me in to see doctor Conrad. I came into Conrad's office and he told me "I messed up my knee again". I've then told him, well, I got to tell you something. A few days after I saw you at our last visit. The pain got so bad I went to the ER right here at the Lewis Gale Hospital. I told him they found out that I had an infection and before I could finish. He said " not a surgical site infection!" I told him where that's where the infection was found. He immediately got up and called for one of his assistants. He left the room. He came back in and said he was going to take fluid and send me to get my labs done. He took fluid out of my knee and then sent me to do my blood work. A few days later they called me in for an appointment immediately. I went and Conrad told me I had a long-standing infection. From the first surgery. My body was not accepting the material and parts that they put in to put the knee back together. The infection was what was stopping the healing. So they wanted to do another surgery this time just to basically clear out the infection. So they wanted to schedule a surgery as soon as possible. I said so this is why both surgeries failed? It was because of infection after the first surgery and second. He told me yes it was from the infections. I said at least we know why now. He agreed. I told him I might need a couple of days I had some things I needed to take care of. He said he'll leave the room for 5 minutes I need to make phone calls and take care of whatever it is I have to take care of but he needs me in the surgery room Monday. I then called my lawyer Mr. Miller. I explain to him what was going on. When I went to have surgery on Monday they first sent me into an operating room to put a IV Port into my arm that went down into my heart. This was for me to be able to take antibiotics for six weeks daily due to having the infection from the prior surgeries. When I went in for knee surgery prep I finally saw Hakanson for the first time in months. She explained to me that they were going to take out everything they put in from the first surgery and second surgery and then insert antibiotic beads that will fight the infection that was in my knee area. She told me that more than likely I will have to have another surgery because they were going to put in sutures that they do not usually use and are not that strong to hold the quadricep tendon in knee area together. This was the third surgery at the end of January or mid February I believe of 2022. I was in the hospital for a few days after surgery. A infectious disease doctor came in and explained to me that I would have a nurse that will be coming out to my house to tend to my port area once a week. I would have to inject antibiotics into the port area for 6 weeks daily. I would have two different types of antibiotics as well and sailing and heparin to inject with the antibiotics everyday. After a few days of injecting the antibiotics I started to get a rash Breakout and was sick all of a Time. This was nothing new since I was sick all the time anyways from the infections from the previous surgeries but the rash was definitely new it was all over my face and neck area and the top of my head. The nurse came out on her weekly visit which was the second Wednesday I believe and took blood as she would do every week. After she drew the blood she left I said I would be getting a phone call in a couple of days about the rash and sickness I was getting. I got a phone call from biotech and they told me to stop taking one of the antibiotics immediately which I did but too continue the other antibiotic. After a couple weeks the rash seem to subside a little bit but did not go away completely. I had a couple conversations with the nurse about the antibiotics that I was taking and she told me they were super strong antibiotics for severe serious infections that would usually kill a person. She told me these types of antibiotics are for infections that are throughout the body a lot of the time. I asked her is that what is going on with me. She said with the long-standing infection that you have the infection had spread throughout my body. She also said she had seen many not make it through the process of recovery from these types of infections. He also said that the infection that I have would have killed me if they would not have found out about it. So I asked her so I was dying this whole time and had no idea? She said yes. When I asked her what type of infection it was she did not know but she would try to find out. She never could with no explanation . She said she asked but no one would ever give her any information . I also around this time went to my regular doctor and he told me the only people he's seen take these antibiotics are people that are staying in that hospital never at home. He said these are very powerful antibiotics for severe cases . After the six weeks of taking the antibiotics I went to infectious disease doctor at Lewis Gale Hospital. On this day I was to see the Infectious Disease doctor first and then go to the ortho doctor and get my cast taken off that I had been wearing since the day of the third surgery. When I went to the Infectious Disease doctor he asked me if I could show him the infected area. I pointed at my cast. He said I need to see the infected area I said well they're going to take the cast off here at Lewis Gale orthopedic in a few hours. He Shrugged his shoulders and he said I'll just take out the port right now. He then proceeded to pull out my medication port. After he pulled it out I said how do you know the infection is gone . He paused for a second and said well your blood work looks okay from last week. I didn't ask him what kind of infection was it. He said they did not know. I said what do you mean? I then said did I invent a new infection or something. He said no. I said but I did have an infection right? He said yes. I said well that's kind of weird that you don't know what kind of infection I had . He didn't reply clean me up and sent me on my way. Later that day I went and had my cast taken off. Conrad looked at my leg and said oh it's all together without really doing anything but telling me to lift my leg. A few minutes later the woman that took my cast-off went out to ask Doctor Conrad if I needed to do any x-rays to see if the surgery was still together. He told her no. She came in and said that's kind of weird. When they take off a cast they usually want to do x-rays to make sure everything is still in the right place she said. They then put me in a straight leg brace. I started doing therapy a couple weeks later. When I went into physical therapy the therapist told me they did not receive any type of physical therapy plan that they could follow from the orthopedic Department. After my first visit I went home with a scheduled to come back a couple days later. While I was gone the physical therapist that saw me for my first visit called Lewis Gale Orthopedic to try to get a Physical Therapy plan. When the physical therapist First Called she said she was hung up on when she mentioned my name. She called back and someone else got on the phone and said they could not give her a physical therapy plan for me she would have to talk to the Head Nurse. She never did talk to the head nurse but they did get a fax from the orthopedic office a couple days later with nothing but the very first paperwork they got from the first surgery that I had 2020. When I went in the second physical therapy appointment they told me all about this. That anything that has to do with me regarding that orthopedic office is very hush-hush. They had never seen this type of behavior from my Ortho office ever before. The people working at Cora Physical Therapy say they will testify for the negligence of the Lewis Gale Orthopedic regarding my treatment plan. My most recent visit at Lewis Gale Orthopedic was with hakanson. When she came into the room that I had been waiting in she asked me how I was doing. I told her I was here. She looked at the leg and asked how is it going. I said it's not functioning at all like I would think it should. I said it's not red and swollen like after the first two surgeries from the infections that I had. I asked her so as long as the infection is clear it should not separate again like the first two times correct. I said the first two surgeries did not heal because of the infections correct. She said yes that is why the first two surgeries did not heal and fell apart She said it should stay together hopefully this time but this surgery was not to really repair it but to clear out the infection. She said we want to give it a chance with physical therapy but more than likely I will have to have another repair surgery. She then said but if it holds together and even if you have some pain and stiffness "we will be good with that" I didn't say anything but I thought "No we aren't good with that". I also told her since I stopped taking the antibiotics I had started to get the pain that would start in my knee and radiates down to my foot and up my leg all the way up into my trapezoid neck area. She said she doesn't know anything about that it wouldn't be from the knee surgery. I also mentioned I was feeling ill again and I am getting the ringing in my ears that I once had before I was taking the antibiotics. She pretty much blew me off.

The malpractice negligence I see here from research is a mistake that resulted in causing a patient unintended harm. The mistake here was not investigating why the first surgery failed. Instead just went ahead and redid the entire surgery with not knowing why it failed in the first place at all. After the first surgery failed the orthopedic doctors could have done the labs and taking the fluid out of my knee to see if I had any infection or what was going on at that time. It was obvious to me and everybody else that looked at my knee area that I had an infection there it was red swollen and I was constantly getting fevers and I was very ill all the time after the first surgery. This continued after the second surgery but much worse. The infection had been there for a year plus. It was not until after I went to E.R even after talking to Conrad first days before on how I was feeling. It was the ER Department that found that I had the long-standing infection. After my visit with Conrad and him obtaining the medical records of the ER visit he then followed the correct procedure and took fluids out of my knee and did lab work to see what was going on in my infected surgical Site Area. At that time he was very Swift and took a defensive stance pertaining to my infection. After they found that I did have a long-standing infection they did everything they could to get me in that surgery room to take out whatever it was that was causing the infection. My guess which does not really matter was that they left some material that was not supposed to be in there or something to that effect. But the third surgery never should have happened. After the first surgery failed they should have drawn the fluid from the knee and did the blood work. If they would have done that at that time it they would have found that there was an infection and would have tried to clear it before they even did the second surgery. Instead they went ahead and did the second surgery while the infection stayed in the surgical Site Area. I do not want to visit this Orthopedic Department again. They definitely are not going to do surgery on me. Please help me get some real help.
Now I am in more pain than ever. I feel ill most of the time. I have no energy. My life is not my life anymore. It is filled with anxiety and depression. A feeling of no hope.

The sooner we as former lewis gale customers' realize that they don't care what we go through just to make the appointments they schedule, then change over & over have finally reached the end of this road. So long l. G.

Review: I had a visit scheduled with my primary care MD, Dr. [redacted] for a minor health problem on April 16, 2014. Upon arrival, I was informed that Dr. [redacted] would see me instead. Dr. [redacted] did see me and spent a generous amount of time, as often Dr. [redacted] does. However, I was billed for $260, the cost of a physical exam although I was not due for that nor scheduled nor wanted a physical. Also, my health plan had already paid the office for my physical earlier that year with [redacted].

Medicare completely denied the claim. I called Lewis Gale Physicians (LGP) billing office with that information. My calls were as follows: [redacted] on 05/12/14, 06/22/14, 07/21/14., and 08/18/14 to I spoke to [redacted] , and I made two attempts today. Each time I requested that the billing office seek clarification from the clinic's staff about actual time and services performed so that it could be billed correctly to Medicare and my secondary. Agents have been polite and agreed to do that. One of them also confirmed that Dr. [redacted] is a participating provider with Medicare and [redacted]. This means he agrees to accept a "usual and customary" amount on his bills and will write off any difference between what he gets offered as a total from MC and patient.

For example: MD charges $100; Medicare pays $50; [redacted] pays $1, Patient pays $14. Participating provider writes off the difference: $35.

To make a long story short, from May until now I have been dunned to pay the entire $260 even though I have called multiple times to explain the error and request it be re-billed as a regular office visit .Under my plan, I am responsible to pay between $10 and $20 copay for doctor visits. Thus far, the billing office shows receipt of four checks from me which have been disbursed to this bill for : 22.43 + 17.57+ 1.00+ 13.73 = $55.73. Medicare has paid $132.80 it seems from the most recent bill. If my math is right, the 04/16/14 the Dr. [redacted] bill has been paid at $198.53 and my most current bill threatens to send me to collections if I do not pay $72.07 immediately.

The office has also failed to write off an appropriate amount to bring my bill into a reasonable copay charge under my drug plan. If possible, I will include a copy of the most recent bill.

About a month ago I wrote a query on the LGH webpage requesting to be in contact with a supervisor. I received no response. Also, as I have done approximately monthly on this matter, today I called the billing office to make a last attempt to reason with them. On a Thursday afternoon at 3:05 PM and 3:10 PM, the auto-answer refused to connect me with either a person or an answering machine to take a message. Instead, it asked me to "call back after 2:00 PM. I feel quite poorly treated by the entire LGH community in this matter, and it is not the first time I have had an intractable billing matter.Desired Settlement: Most important I wish the LGP Group to redesign it's accountability so that people are expected to bill and/or adjust bills accurately the first time, and to correct any problems promptly and effectively.

I want my payments to be credited to the charge I've been billed for. not placed into a pool from which LGH can disburse the payment to any charge they choose. I want a refund and an explanation of how they will prevent such errors from occurring in the future, especially for me and all other disabled, very young or elders like me. Last I would ALWAYS like to be issued a refund promptly on any bill that my insurers and I have paid for at the agreed upon rate.

Business

Response:

This letter is to respond to the above complaint. While the complaint is indicated as being sent on 10/23/14, we could not

locate the original request. Please excuse the tardiness of this response.

Ms. [redacted] was seen on April 16, 2014, by Dr. [redacted] as stated in her complaint. However, Dr [redacted] did not bill

her for a "physical exam" rather for a detailed office visit. The diagnosis code he billed for the visit was "encounter for

prescriptions" which is code V68.1 . Medicare considers many "V" codes to be routine and many routine services are not

covered. Medicare denied this claim, as preventive or routine, due to the diagnosis code submitted, On May 12, 2014,

Ms. [redacted] called and the customer service representative sent the claim for coding review which, unfortunately, did

not get completed. Ms. [redacted] called again on July 21, 2014, and the claim was then reviewed by a coder and, on July

31, 2014, corrected the order of diagnosis codes. The claim was sent to the central billing office requesting a correcting/

appealing the claim to Medicare. However, Medicare would not reopen the claim. To further confuse the issue, Ms.

[redacted] secondary insurance, [redacted], paid the claim as primary and needed to be refunded. With the above activity on

this claim showing processed from both Medicare and [redacted], the billing system moved the balance on the claim to

patient responsibility. On November 12, 2014, a new claim was resubmitted to Medicare and the balance moved from

patient responsibility and is now showing as pending insurance. Medicare typically takes 14 days to process new claims.

I apologize on behalf of LewisGale Physicians for the confusion in resolving this complaint and getting Ms. [redacted]'

claim billed correctly and processed by insurance.

Should you need additional information, please don't hesitate to contact me.

Respectfully,

Consumer

Response:

Dear Ms. [redacted] at Revdex.com, and Ms. [redacted], Coding and Compliance

at LewisGale Physicians,

Thank you for replying to my concerns about improper handling

of charges to my LewisGale account. I

understand that a new bill has been sent to Medicare, that LGP recognized that

[redacted] needed to be refunded for overpayment, and that the balance on the

account has been temporarily removed from my responsibility pending responses

to proper billing of my insurers. Also, Ms.

[redacted], I appreciate your apology on behalf of LGP.

This is a start toward resolution of my concerns, but only a

start. I have reviewed the response offer 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.

Please recall my requested

outcomes: “Most important I wish the LGP

Group to redesign it's accountability so that people are expected to bill

and/or adjust bills accurately the first time, and to correct any problems

promptly and effectively. I want my payments to be credited to the charge I've

been billed for, not placed into a pool from which LGP can disburse the payment

to any charge they choose. I want a refund and an explanation of how they will

prevent such errors from occurring in the future, especially for me and all

other disabled, very young or elders like me. Last I would ALWAYS like to be

issued a refund promptly on any bill that my insurers and I have paid for at

the agreed upon rate.”

Certainly some time must pass for Ms. [redacted] to complete

the corrected billings to Medicare and [redacted] and to obtain their responses. I suggest that that on behalf of myself and

the Revdex.com, you, Ms. [redacted], plan to re-contact LGPhysicians in 60 days to obtain

an update about that.

So far, so good. Now,

what steps has Ms. [redacted] taken to address the systemic problems that my

case has uncovered? Is not her own

inability to acknowledge the initial notification sent on 10/23/14 an

indication of lapses in the company’s handling of correspondence and

information?

I expect any needed

refunds to go promptly to the agent who overpaid. I trust that Ms. [redacted] can see that I

have already overpaid on this bill, yet I received a collection letter from the

corporation‘s collection arm last week.

While I do expect she will cancel that collection order, it is another

example of “the billing system” acting in a way that is unsatisfactory. “The

billing system” needs to be ably monitored and controlled by humans who can

discern commonsense responses to information that a machine cannot. Without that, in the future, how can I be assured

that billing to insurers and to me will be accurate?

Sincerely,

[redacted]

Business

Response:

Ms. [redacted]' visit of April 16, 2014, with Dr. [redacted] has been refiled and paid by Medicare on 12/2/2014. Her[redacted] insurance has been refunded appropriately for having paid as primary on this claim however has yet to reprocessas secondary. Additionally, we received a call from her [redacted] insurance on 12/16/2014 indicating they were in theprocess of reviewing her claims see if other payments needed to be reprocessed as secondary. Patient payments havebeen appropriately moved to other open patient balance charges, and until a patient overpayment/credit on the account isshowing, a system refund cannot be generated. All of this is part of our standard processes. Ms. [redacted] currently hasa -0- patient balance with several newer charges pending insurance.Ms. [redacted] expressed her expectations on the billing system. Since the billing system is handled at our CorporateCentral Billing Office (CBO), this concern was forwarded to the CBO Practice Support team for review and we are unableto fully meet the expectations outlined her letter at this time. Ms. [redacted] is always welcome to call our customer serviceline for questions regarding her account.Respectfully,LewisGale Physicians[redacted], CPC, CCP-P, CRSDirector, Goding, Compliance & EducationLewisGale Physicians, LLC

Consumer

Response:

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

Thank you

for looking further into the inconsistencies in billing practices, and also

Lewis Gale Physician's inappropriate dunning of me over this bill for 04/16/14

with Dr. [redacted].

This week, I

contacted my secondary insurer in regard to a different Lewis Gale Physicians bill. I

triggered the company's discovery that

they, [redacted], has processed nearly all of my medical bills since 10/01/13

under a previous policy number inappropriately and incorrectly. Probably it will be many weeks until we know

what total amount I truly am responsible

for down to the penny. The insurer did

contact the hospital to advise them of this, per my request. Thus, they share

responsibility for mixed up claims processing of my bills.

As regards

the flawed structure of the billing process itself, why am I not surprised that

the hospital's spokesperson states that she must refer me to another department

out of the area? I'm also unsurprised

that the name and contact information for the supposed responsible party has

not been offered.

What do I

request now?

1.) A full reevaluation of current billing

practices. I would much appreciate

learning that there has been the program's redesign, so that bills are created

correctly the first time. I would like

to learn that there is then a new staff training which also empowers them to

make reasonable patient accommodation when errors occur. Any reasonable person looking at this bill's history can see

that far too many payments I've made have been credited to this overcharged

bill. Would it be too much to ask for

LGMC to refund all but the expected amount of patient responsibility after both

insurers have reprocessed the claim?

2.) The

name, address, email address, and phone number of the department head for the CBO Practice Support Team.

3.) That refund originally requested.

I appreciate

the medical care I receive through LGP.

I hope the billing issues get resolved in skilled and thoughtful ways.

Regards,

[redacted],

###-###-####

Review: Urologic Surgery PC has sent 3 bills in 2015 for services rendered in November 2013 and January 2014. The bills did not look typical as they did not break down the services provided for any given day. The bill itself was a single piece of somewhat yellowed paper with my portion to be paid at the bottom. Each bill had a service period and a bill amount only. When I requested an itemized bill from the number listed she said it was not available, but sent another version of the same bill. I paid each.In October 2015 I received yet another bill for $213.66 which was already marked as past due. This is the first time seeing this bill. Once again I paid the bill.I was treated for Kidney Stones by Dr. [redacted] during that period. In the short period after my treatment I received bills for treatment that were paid. This seems to be some scheme to overcharge me, or double dip on payments they have not properly posted.Desired Settlement: Not just a billing adjustment. Not only is this fraudulent billing, but mail fraud as well. This needs to be investigated and resolved. Is this just Urologic PC or the Lewis Gale Hospital on a whole.

Consumer

Response:

I do understand the Urological Services were provided by a private doctor from within the [redacted]. My claim should be directed to the doctors office.Unfortunately the bill from the Urologist and the Collection Agency were a single sheet of paper that was returned with the check.[redacted]

Review: Billing department for Lewis Gale Physicians continuously lied to me about their billing practices and/or the status of a refund due me for overpayment. Insurance claims filed incorrectly and even though they are contracted to file claims accurately and in a timely manner, they do not follow up on incorrectly filed claims and bill the patients in full. After tracking down the information myself and contacting my insurance provider, the claim was paid resulting in a refund of over $200 due. After being told that a refund request had been initiated and would be received in 6-8 weeks, no such request was ever initiated. Called again and was told that an "expedited request" was initiated and a supervisor had been notified of my concerns. Actually, the refund had already been applied to a new claim, but the representative lied and said she would be sure that did not happen. I have already cancelled my next appointment with my doctor so I can avoid these insurance mistakes and mishandling of my patient account in future. We pay our bills on time and make timely payments, but are continuously treated as if we are delinquent and/or negligent in our responsibilities which could not be further from the truth. Lewis Gale Physicians should reconsider using this billing company and either bring billing back in-house or go back to the company they used a few years back that was, I believe, based in Richmond, VA or the state of Georgia. Please help with getting this situation cleared up with some amount of transparency and/or honesty on the part of Lewis Gale Physicians' billing department located in Ohio.Desired Settlement: I want to be contacted by an actual manager/supervisor in the finance department of the local (Salem, VA) billing department and assured that in future, there will be a better handling of any future insurance claims and billing. I wish to never be contacted again by local third party company Cash Flow Management who called my husband, a tractor trailer driver, while he was driving his truck even though I always am prompt to answer my phone and am home all day.

Business

Response:

Ms. [redacted], Thank you for taking the time to speak to me this morning. I have researched the account associated with this query and have learnt from our Central Billing Office that an expedited check has been requested and will be released on Monday June 3rd by our accounts payable department in California. I understand that Ms. [redacted] should receive it within 10 business days thereafter. I have called Ms. [redacted] and left a voicemail regards the same and have also left my name and phone number should she have any additional questions. Thank you for your time and patience. [redacted]Business ManagerLewisGale PhysiciansHCA Virginia Health System1802 Braeburn DriveSalem, VA 24153T: ###-###-####F: ###-###-####[redacted]com

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.Regards,[redacted]

Review: I was in the process of refinancing my home when I found out that I had collection action against me dating back to July 10, 2008 for $291.00. I contacted Lewis Gale Physicians and they said that they did not have the correct insurance information, phone number or home address when they filed for insurance payment. At no time was I contacted about this bill or even notified by CAC Debt Collection. I only just found out about this bill during the process of applying form my new home loan. When I contacted Lewis Gale Physicians and asked why they did not file with my Primary Insurance or my Secondary Insurance they stated, it was to late to try and file it could not be over a year old. I had to pay this bill out of my pocket, even though I have 2 insurances and feel this was handled unfairly on their part.Desired Settlement: I would like to be paid back for this amount that I had to pay. I pay for two insurances so I don't have to pay out of my pocket. The whole situation with this bill was not handled in a professional or ethical manner. I was not notified of this in a timely manner and have always paid my debts. The way I was treated over the phone by CAC Debt Collection was totally disrespectful to me. I would hope that I am the only person this has happened too and not a way of doing business with this community.

Business

Response:

This letter is to respond to the above complaint. While the complaint is indicated as being sent on October 2 2013, we could not locate the original request. Please excuse the tardiness of this response. Mr. [redacted] states he was never notified he had a balance due with LewisGale Physicians (LGP) from July 2008. Our records show he had four charges in July 2008. These charges were filed with the [redacted] insurance based on the information Mr. [redacted] had provided to us. [redacted] denied these charges stating the patient had other insurance. The patient should have received the same information from the insurance prompting him to clear up the confusion with [redacted] or provide other primary insurance information to LGP. These charges were then billed to the patient. Mr. [redacted] was sent four statements between August and November of2008. Additional letters of correspondence were sent advising his balance would be turned over to collections. When a patient requests medical treatment, either in the hospital or office setting, the patient signs an acknowledgement which state she or she will be financially responsible for services rendered, regardless of insurance status. The address and phone number showing on the Revdex.com complaint matches our records from 2008, which is where the statements and correspondence were mailed. Mr. [redacted] did not provide the name of the representative he spoke to at CAC so we cannot contact CAC to inquire on their staff or the conversation. We respectfully submit that LGP has not deviated from fair collection practices. Without proper insurance information to refile claims ,Mr. [redacted] is solely responsible for the full balance of the charges. The professional services were rendered in good faith that the physician would receive payment for said services. Therefore, we must deny his request for are fund. Should you need additional information, please don' thesitate to contact me. Respectfully, [redacted], CPC, CCP-P, CRS Director, Coding, Compliance & Education LewisGale Physicians, LLCTel: [redacted]Fax:[redacted]

Consumer

Response:

I have reviewed the response offer 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. When I contacted Lewis Gale Physicians about this issue a couple of weeks ago they stated that they had the wrong information to file with my [redacted] and that they did not have a correct phone number for me. In the past when other doctors offices file with my insurance I would get a bill from them and I would wait until my primary insurance would take care of it and then [redacted] would do their part. Five years have past and they are telling me that I have not used their office for any other medical issues and filed against my insurance? I do not accept this answer from them. If they did not file it correctly the first time and then just keep sending a bill to me then who's fault is that? When I fill out information at a doctors office they make copies of my insurance cards as well as my Retired Military I.D.. So now I'm out $290.00 when I pay two separate types of medical insurance? Why? Can they tell me if I have not used their office over the past five years? Did they file against my insurance for any of those visits? When I talked to them a couple of weeks ago they said if they don't get it filed correctly within a year then it becomes my problem. Is that fair to me? If I'm not mistaken I believe this bill came from an overnight stay at Lewis Gale hospital for a cardiac stress test, I didn't get a bill from Lewis Gale Hospital, but the doctors that read the test couldn't file the insurance correctly? Don't you think that if the hospital received payment then the doctors should of? Your inability to file the insurance claim now becomes my problem? This is not fair to me. Regards,[redacted]