Initial Business Response /* (1000, 7, 2017/08/18) */
RE: Case # [redacted] Dear Ms. [redacted]
We investigated the above complaint. We apologize that the issue was not resolved prior to the patient submitting a complaint to the Revdex.com. Saint Joseph Physician Network...
("SJPN") is committed to providing quality patient care as well as excellent customer service. We have addressed all of the concerns from the patient in our response below.
Customer Complaint: Failed to credit account [redacted] after providing canceled check, we provided canceled check, and they say they don't know where our money went and are blaming the bank.
The customer's check is dated 7/7/17. Payments are mailed directly to our financial institution's lockbox which is a standard process, then converted to an electronic file and provided to SJPN for posting. The bank processed the payment on 7/11/17. Ms. [redacted] first contacted our office on 7/24/17, a copy of the deposited check was provided on 7/25/17, and the payment was applied to the account by end of business on 7/25/17. An operator was actively working several payment batches; one that included the [redacted] payment in question which explains why the payment was not visible yet in our system when Ms. [redacted] first contacted us on 7/24/17. The operator reconciled and closed the batch on 7/25/17. The payment inquiry was resolved within 24 hours.
Customer Complaint: On 7/18, they sent a billing statement that did not reflect the payment.
As stated above the payment was in transit and crossed with a new billing statement being generated (Exhibit A). Customer Complaint: Brought to their attention three times.
The first contact from Ms. [redacted] regarding the [redacted] payment was on 7/24/17. A copy of the deposited check was provided on 7/25/17 (Exhibit B). [redacted] patient, followed up with several phone calls also all on 7/25/17; he was informed the canceled check would be researched and he would receive a response in 24-48 hours. Prior to business hours on 7/26/17, Ms. [redacted] emailed a Notice of Legal Claim; an acknowledgement of receipt was sent on 7/26/17. There were further email communication with Ms. [redacted] on 7/27/17 & 7/28/17 (Exhibit C). A return call was also placed to Mr. [redacted] on 7/27/17.
Customer Complaint: We noticed the entity double billed certain charges to insurance and failed to bill others.
SJPN billed appropriately for services rendered to [redacted] no double billing occurred. Ms. [redacted] emailed stating the balance on account XXXXXXX is not a true balance. Account XXXXXXX is not a SJPN account and is possibly from a different organization. This was communicated to Ms. [redacted]. Ms. [redacted] also stated charges for DOS 2/14/17 were never filed to her insurance. You will find in the attachments; Electronic Provider Remittance Advice (explanation of benefits) from her insurance company
that support they did received and process a claim for DOS 2/14/17 (Exhibit D).
After our investigation, it was determined that the customer's inquiry was addressed in a timely manner and fraudulent/double billing did not occur. For these reasons we are unable to satisfy the customer's desired resolution of paying back the [redacted] There is still an outstanding balance due on the account of [redacted] as of August 16, 2017 (Exhibit E).
Sincerely,
[redacted], Paralegal
Legal Services Manager
Organizational Privacy Officer (XXX) XXX-XXXX
Initial Consumer Rebuttal /* (3000, 9, 2017/08/22) */
(The consumer indicated he/she DID NOT accept the response from the business.)
There absolutely WAS an improper billing made on the account with respect to a February charge, which has been acknowledged by SJMC in writing. Additionally, the [redacted] payment issue was not resolved within 24 hours contradictory to what is stated in the Company's response. Additionally, I was supposed to received a revised bill reflecting the actual balance on the account 2 weeks ago and I am still waiting for SJMC's written response.
Initial Business Response /* (1000, 7, 2017/08/18) */
RE: Case # [redacted] Dear Ms. [redacted]
We investigated the above complaint. We apologize that the issue was not resolved prior to the patient submitting a complaint to the Revdex.com. Saint Joseph Physician Network...
("SJPN") is committed to providing quality patient care as well as excellent customer service. We have addressed all of the concerns from the patient in our response below.
Customer Complaint: Failed to credit account [redacted] after providing canceled check, we provided canceled check, and they say they don't know where our money went and are blaming the bank.
The customer's check is dated 7/7/17. Payments are mailed directly to our financial institution's lockbox which is a standard process, then converted to an electronic file and provided to SJPN for posting. The bank processed the payment on 7/11/17. Ms. [redacted] first contacted our office on 7/24/17, a copy of the deposited check was provided on 7/25/17, and the payment was applied to the account by end of business on 7/25/17. An operator was actively working several payment batches; one that included the [redacted] payment in question which explains why the payment was not visible yet in our system when Ms. [redacted] first contacted us on 7/24/17. The operator reconciled and closed the batch on 7/25/17. The payment inquiry was resolved within 24 hours.
Customer Complaint: On 7/18, they sent a billing statement that did not reflect the payment.
As stated above the payment was in transit and crossed with a new billing statement being generated (Exhibit A). Customer Complaint: Brought to their attention three times.
The first contact from Ms. [redacted] regarding the [redacted] payment was on 7/24/17. A copy of the deposited check was provided on 7/25/17 (Exhibit B). [redacted] patient, followed up with several phone calls also all on 7/25/17; he was informed the canceled check would be researched and he would receive a response in 24-48 hours. Prior to business hours on 7/26/17, Ms. [redacted] emailed a Notice of Legal Claim; an acknowledgement of receipt was sent on 7/26/17. There were further email communication with Ms. [redacted] on 7/27/17 & 7/28/17 (Exhibit C). A return call was also placed to Mr. [redacted] on 7/27/17.
Customer Complaint: We noticed the entity double billed certain charges to insurance and failed to bill others.
SJPN billed appropriately for services rendered to [redacted] no double billing occurred. Ms. [redacted] emailed stating the balance on account XXXXXXX is not a true balance. Account XXXXXXX is not a SJPN account and is possibly from a different organization. This was communicated to Ms. [redacted]. Ms. [redacted] also stated charges for DOS 2/14/17 were never filed to her insurance. You will find in the attachments; Electronic Provider Remittance Advice (explanation of benefits) from her insurance company
that support they did received and process a claim for DOS 2/14/17 (Exhibit D).
After our investigation, it was determined that the customer's inquiry was addressed in a timely manner and fraudulent/double billing did not occur. For these reasons we are unable to satisfy the customer's desired resolution of paying back the [redacted] There is still an outstanding balance due on the account of [redacted] as of August 16, 2017 (Exhibit E).
Sincerely,
[redacted], Paralegal
Legal Services Manager
Organizational Privacy Officer (XXX) XXX-XXXX
Initial Consumer Rebuttal /* (3000, 9, 2017/08/22) */
(The consumer indicated he/she DID NOT accept the response from the business.)
There absolutely WAS an improper billing made on the account with respect to a February charge, which has been acknowledged by SJMC in writing. Additionally, the [redacted] payment issue was not resolved within 24 hours contradictory to what is stated in the Company's response. Additionally, I was supposed to received a revised bill reflecting the actual balance on the account 2 weeks ago and I am still waiting for SJMC's written response.