This will be the last letter I will write to youI want to respond to your accusations of fraudulent billing, duplicate billing and "balance billing"I would like to reiterate, again, Allergy and Dermatology Specialists does not participate in any type of "fraudulent " billing or collectionsWe also pride ourselves on our outstanding customer service to our patients I apologize if you feel you have been treated badly or in a harassing manner, that is not our practice and was never our intentionI believe this entire issue has been a huge misunderstanding on all parts.I would like to address the issue of the implied duplicate bill of charge This charge is for Pathology Examination of Tissue Using a MicroscopeMost charges allow use of a modifier and what a modifier does is specify several thingsIn this case we have billed (appropriately) for the 88305, which is the charge for the physician interpretation (reading) of the slide under a microscopeWe also billed the 88305, TC which is the charge for the technical componentModifier TC, includes billing only for the equipment, supplies, technicians, and facility, but not the interpretation of the serviceThese are completely separate charges for two separate services, not duplicates.If you refer to the billing summary I have provided you, you will notice that there are several charges for the 12/11/date of service which were charged and paid appropriatelyI have highlighted in orange the two separate charges in question, 88305,- $and the 88305, TC- $I have highlighted in yellow the two separate payments made on 12/27/for the charges, 88305, 26-$and 88305, TC- $Directly underneath each charge, highlighted in green, indicates that your insurance company recouped (took back) payment for both charges and gave absolutely no reason why or contractual adjustmentTherefore the payment responsibility became yoursWe do not contest issues between you and your insurance company nor are we trying to collect on anything other than the services that were renderedWe have been unable to obtain an explanation of benefits from your insurance companyThe one that you have previously provided clearly states that this charge is "excluded" and you may be responsible for part or all excluded chargesThe paperwork you provided with your letter dated 5/27/is completely illegible (included copy).Please understand that this matter is already in stage one of the collection processThis is not meant as a threat nor a personal attack in anyway, it is our standard processI am hap y to remove that status when payment is made in full.It is unfortunate that this issue has taken so long to resolve and I hope we can put this behind us.I also will send my response to t he Revdex.com.Please feel free to give me a call if I can be of any further service to youRespectfully, [redacted] , Practice Administrator
Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.The insurance company has contacted this office several times and attempted to explain to them that this is not a matter of excluded charges, but a matter of the physicians office submitting the claim multiple timesYes, they did do a take back because they had initially paid the claim twice for the same chargesThe physicians office was paid for the initial chargesThe office manager in this clinic was confrontational to the insurance company as well as to my wifeThe insurance company has said that they will explain it all over again to this office if necessary, but it does not seem to do any goodThese are covered services and they were paid appropriately and I have all the documentation to attest to thisI have supplied it to the office and the insurance has supplied it to the office.Regards,*** ***
This will be the last letter I will write to you. I want to respond to your accusations of fraudulent billing, duplicate billing and "balance billing". I would like to reiterate, again, Allergy and Dermatology Specialists does not participate in any type of "fraudulent " billing or collections. We also pride ourselves on our outstanding customer service to our patients. I apologize if you feel you have been treated badly or in a harassing manner, that is not our practice and was never our intention. I believe this entire issue has been a huge misunderstanding on all parts.I would like to address the issue of the implied duplicate bill of charge 88305. This charge is for Pathology Examination of Tissue Using a Microscope. Most charges allow use of a modifier and what a modifier does is specify several things. In this case we have billed (appropriately) for the 88305, 26 which is the charge for the physician interpretation (reading) of the slide under a microscope. We also billed the 88305, TC which is the charge for the technical component. Modifier TC, includes billing only for the equipment, supplies, technicians, and facility, but not the interpretation of the service. These are completely separate charges for two separate services, not duplicates.If you refer to the billing summary I have provided you, you will notice that there are several charges for the 12/11/13 date of service which were charged and paid appropriately. I have highlighted in orange the two separate charges in question, 88305,26 - $74.00 and the 88305, TC- $117.00. I have highlighted in yellow the two separate payments made on 12/27/13 for the charges, 88305, 26-$42.92 and 88305, TC- $36.81. Directly underneath each charge, highlighted in green, indicates that your insurance company recouped (took back) payment for both charges and gave absolutely no reason why or contractual adjustment. Therefore the payment responsibility became yours. We do not contest issues between you and your insurance company nor are we trying to collect on anything other than the services that were rendered. We have been unable to obtain an explanation of benefits from your insurance company. The one that you have previously provided clearly states that this charge is "excluded" and you may be responsible for part or all excluded charges. The paperwork you provided with your letter dated 5/27/15 is completely illegible (included copy).Please understand that this matter is already in stage one of the collection process. This is not meant as a threat nor a personal attack in anyway, it is our standard process. I am hap y to remove that status when payment is made in full.It is unfortunate that this issue has taken so long to resolve and I hope we can put this behind us.I also will send my response to t he Revdex.com.Please feel free to give me a call if I can be of any further service to you. Respectfully,[redacted], Practice Administrator
I have read the complaint and I can assure you Allergy & Dermatology Specialists does not fraudulently bill patients. In this particular case the patients insurance was billed, Insurance paid and subsequently took their payment back and any adjustments 6 months later. Patient was billed...
after that recoupment, the full amount because their insurance stated the allowable amount was $0.Patient mailed us a copy of their Explanation of Benefits (EOB) which clearly states that they are “excluding” those specific charges and the verbiage in this notice reads, “You may be responsible for paying some or all of the excluded charges to your provider.” It also clearly states in the patient’s statement that the reason for these charges is, “Insurance takeback”. We have tried to explain this several times to the patient in detail. Thank you for your time. [redacted], Practice AdministratorAllergy & Dermatology Specialists
This will be the last letter I will write to youI want to respond to your accusations of fraudulent billing, duplicate billing and "balance billing"I would like to reiterate, again, Allergy and Dermatology Specialists does not participate in any type of "fraudulent " billing or collectionsWe also pride ourselves on our outstanding customer service to our patients I apologize if you feel you have been treated badly or in a harassing manner, that is not our practice and was never our intentionI believe this entire issue has been a huge misunderstanding on all parts.I would like to address the issue of the implied duplicate bill of charge This charge is for Pathology Examination of Tissue Using a MicroscopeMost charges allow use of a modifier and what a modifier does is specify several thingsIn this case we have billed (appropriately) for the 88305, which is the charge for the physician interpretation (reading) of the slide under a microscopeWe also billed the 88305, TC which is the charge for the technical componentModifier TC, includes billing only for the equipment, supplies, technicians, and facility, but not the interpretation of the serviceThese are completely separate charges for two separate services, not duplicates.If you refer to the billing summary I have provided you, you will notice that there are several charges for the 12/11/date of service which were charged and paid appropriatelyI have highlighted in orange the two separate charges in question, 88305,- $and the 88305, TC- $I have highlighted in yellow the two separate payments made on 12/27/for the charges, 88305, 26-$and 88305, TC- $Directly underneath each charge, highlighted in green, indicates that your insurance company recouped (took back) payment for both charges and gave absolutely no reason why or contractual adjustmentTherefore the payment responsibility became yoursWe do not contest issues between you and your insurance company nor are we trying to collect on anything other than the services that were renderedWe have been unable to obtain an explanation of benefits from your insurance companyThe one that you have previously provided clearly states that this charge is "excluded" and you may be responsible for part or all excluded chargesThe paperwork you provided with your letter dated 5/27/is completely illegible (included copy).Please understand that this matter is already in stage one of the collection processThis is not meant as a threat nor a personal attack in anyway, it is our standard processI am hap y to remove that status when payment is made in full.It is unfortunate that this issue has taken so long to resolve and I hope we can put this behind us.I also will send my response to t he Revdex.com.Please feel free to give me a call if I can be of any further service to youRespectfully, [redacted] , Practice Administrator
Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.The insurance company has contacted this office several times and attempted to explain to them that this is not a matter of excluded charges, but a matter of the physicians office submitting the claim multiple timesYes, they did do a take back because they had initially paid the claim twice for the same chargesThe physicians office was paid for the initial chargesThe office manager in this clinic was confrontational to the insurance company as well as to my wifeThe insurance company has said that they will explain it all over again to this office if necessary, but it does not seem to do any goodThese are covered services and they were paid appropriately and I have all the documentation to attest to thisI have supplied it to the office and the insurance has supplied it to the office.Regards,*** ***
This will be the last letter I will write to you. I want to respond to your accusations of fraudulent billing, duplicate billing and "balance billing". I would like to reiterate, again, Allergy and Dermatology Specialists does not participate in any type of "fraudulent " billing or collections. We also pride ourselves on our outstanding customer service to our patients. I apologize if you feel you have been treated badly or in a harassing manner, that is not our practice and was never our intention. I believe this entire issue has been a huge misunderstanding on all parts.I would like to address the issue of the implied duplicate bill of charge 88305. This charge is for Pathology Examination of Tissue Using a Microscope. Most charges allow use of a modifier and what a modifier does is specify several things. In this case we have billed (appropriately) for the 88305, 26 which is the charge for the physician interpretation (reading) of the slide under a microscope. We also billed the 88305, TC which is the charge for the technical component. Modifier TC, includes billing only for the equipment, supplies, technicians, and facility, but not the interpretation of the service. These are completely separate charges for two separate services, not duplicates.If you refer to the billing summary I have provided you, you will notice that there are several charges for the 12/11/13 date of service which were charged and paid appropriately. I have highlighted in orange the two separate charges in question, 88305,26 - $74.00 and the 88305, TC- $117.00. I have highlighted in yellow the two separate payments made on 12/27/13 for the charges, 88305, 26-$42.92 and 88305, TC- $36.81. Directly underneath each charge, highlighted in green, indicates that your insurance company recouped (took back) payment for both charges and gave absolutely no reason why or contractual adjustment. Therefore the payment responsibility became yours. We do not contest issues between you and your insurance company nor are we trying to collect on anything other than the services that were rendered. We have been unable to obtain an explanation of benefits from your insurance company. The one that you have previously provided clearly states that this charge is "excluded" and you may be responsible for part or all excluded charges. The paperwork you provided with your letter dated 5/27/15 is completely illegible (included copy).Please understand that this matter is already in stage one of the collection process. This is not meant as a threat nor a personal attack in anyway, it is our standard process. I am hap y to remove that status when payment is made in full.It is unfortunate that this issue has taken so long to resolve and I hope we can put this behind us.I also will send my response to t he Revdex.com.Please feel free to give me a call if I can be of any further service to you. Respectfully,[redacted], Practice Administrator
I have read the complaint and I can assure you Allergy & Dermatology Specialists does not fraudulently bill patients. In this particular case the patients insurance was billed, Insurance paid and subsequently took their payment back and any adjustments 6 months later. Patient was billed...
after that recoupment, the full amount because their insurance stated the allowable amount was $0.Patient mailed us a copy of their Explanation of Benefits (EOB) which clearly states that they are “excluding” those specific charges and the verbiage in this notice reads, “You may be responsible for paying some or all of the excluded charges to your provider.” It also clearly states in the patient’s statement that the reason for these charges is, “Insurance takeback”. We have tried to explain this several times to the patient in detail. Thank you for your time. [redacted], Practice AdministratorAllergy & Dermatology Specialists