Main Street Urgent Care

When this patient called our billing department on 1/22, our employee told him that we'd be happy to issue a refund, and we have done so. The refund typically takes a week to process, so it should come through today or tomorrow.

Our billing team member explained that our policy is to keep any overpayments as a credit on the patient's account that can be applied towards their next visit for copays/payments, etc., but we will gladly issue a refund if the patient requests it. Because it was the insurance company who called to request the claim be filed to them, we did not receive any request to refund the money until the patient called on 1/22.

During the call on 1/22, our billing team member noted that this patient threatened to sue and began using profanity, calling our employee foul names such as the *** I have pasted the notes from our billing team member below. Due to this patient's hostile tone, we do not feel disciplinary action should be taken against our billing team for their customer service.

"Advised that I can process the refund back to the card. Pt started telling me he was "going to sue this ugly company" Advised since he has brought up an attorney I can no longer speak with him but I will get the credit refunded. Pt started continuously saying "Okay b***" over and over again. I stated that I was not calling him names and I was processing the refund. He continued to say that so I advised him that I was discontinuing the phone call and to have a great day."

Yes, we have refunded your money, and I'm happy to hear it has processed. We agree your insurance should not have been denied in the first place. We have followed up with our clinic staff in regards to the clerical error made.

Our billing policy is outlined on our website and we provide a laminated copy to every patient when they fill out an intake form. Our policy does explain that if there is overpayment, it is kept as a credit to be applied to the patient's next visit, but we will gladly issue a refund if you contact our billing department. The first contact our billing department has regarding this visit was when the insurance company reached out on 11/5/18 to authorize us to file the claim to them. But again, we did not receive a request for refund until 1/22/19. We would have happily refunded the money sooner, had we received the request sooner.

And yes, when a patient threatens legal action and to involve attorneys, our staff is trained that we let our attorney handle it from there after. It was the patient's threat for legal action that prompted our billing team member to calmly explain that we would process the refund, but we would not be able to speak further if the plan was to take legal action.

If you have additional concerns regarding your experience or the care that you received, we would be happy to look into it and follow up with our staff. You may contact our corporate office at XXX-XXX-XXXX.

Contact Name and Title: ***, CSMO
Contact Phone: XXX-XXX-XXXX
Contact Email: ***@mainstreetfamilycare.com
Thank you so much for reaching out! We truly value our patients' feedback and are always striving to improve.

We do teach and instruct our staff to explain the billing options so that a patient can choose whether they would like to use the *** system or pay a patient deposit. We provide each patient with a laminated copy of the policy, and we provide our staff with a script that explains the both options. We even go so far as to require every patient to sign a copy of the billing policy where they've selected their payment choice.

We would be happy to provide a copy of the billing policy, signed by Ms., that shows where she elected for us to charge her card through the *** policy. As I told the patient during our email exchange on 4/4/18, I will certainly follow up with our staff at the *** to ensure they are utilizing those tools and explaining the policy thoroughly enough.

We implemented the *** policy because unfortunately we have had a number of patients who have neglected to pay their bills. *** offers a convenient and hassle-free way to stay on top of your healthcare bills. Much like when you put a credit card on file with a hotel reservation, we use *** to do the same thing! When a patient opts in for ***, they would pay their co-pay as normal and provide a debit or credit card to guarantee their account. *** Family Urgent Care does not store any credit card information in our system. Instead, we use a third party payment company called *** which complies with the highest ***. Once the insurance has paid its portion, *** and the patient will receive an Explanation of Benefits in the mail which gives the remaining amount owed by the patient. Once a patient receives that Explanation of Benefits, they have 15 days from the date of the letter to contact our billing team to change payment methods or opt for a payment plan. If we do not hear from that patient in 15 days, we will charge the card that *** has stored on file.

If a patient chooses the Patient Deposit option, they do not have to put a debit/credit card on file, but rather the patient will pay a deposit to guarantee the visit. The deposit amount is determined by looking at the co-pay and whether or not the deductible has been met for the year. Once insurance pays their part, the deposit can be applied to the remaining amount owed, it can be stored as a credit to be used as a deposit for the next visit, or it can be refunded to the patient.

We certainly understand your concern, and not only have we followed up with a company-wide reminder of their training on how to appropriately explain the *** policy, we have taken disciplinary action with out staff members at that clinic to ensure they understand the proper protocol.