Marshfield Clinic

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Ms. Kathy [redacted] has stated that she will not respond further this unresolved issue. What remains is my request for information about why I have been billed for a $372.40 office visit.   With Ms. [redacted] refusing to clarify/explain  information further, I am asking that she refer the matter to the clinic's board of directors and the clinic's director.   
Regards,
Alan [redacted]

Mr. [redacted] has also written to Marshfield Clinic. Another letter is in the process of being sent to Mr. [redacted].  His concern has been reviewed by our patient experience director and the medical documentation supports the billing of the service.  This appears that an agreement is not possible. Thank youKathy [redacted]Manager - Patient Financial Services

Due to privacy regulations, I am not able to provide additional information.  An authorization has been sent to Mr. [redacted].  As soon as I receive the authorization back, I will be able to respond.Kathy [redacted]Marshfield Clinic

A letter was sent to Revdex.com and a copy to Mr. [redacted] earlier this week. Kathy [redacted]

Tell us why here...As I previously stated, I will not be responding further to this concern Kathy [redacted]

Revdex.com:
I have reviewed the response made by the...

business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
Carol [redacted]

Marshfield Clinic received a HIPAA...

authorization which allows me to respond to this concern for date of service 7/47/17.  Mr. [redacted] initially contacted Marshfield Clinic on 9/8/17.  The charges in question were an office visit in the amount of $372.40 and the simple repair in the amount of $467.20.  The contract discount applied was $33.57 and $806.03 was applied to your deductible by Medica, your insurance company.  The charges were sent to our coding/reimbursement department who concluded that the documentation supports the billing of the services.  The coding correct letter was mailed to Mr. [redacted] on 9/19/17.  After receiving a letter from the patient, Marshfield Clinic responded via the US Mail on 10/11/17, the letter is as follows:Thank you for contacting Marshfield Clinic regarding your account.I had the opportunity to review your concern and the charges in question from 07/17/2017. Based on my review it has been determined that the coding of these services is appropriate and will remain as billed. I have also attached an itemized statement, which you requested.If you are unable to pay your balance in full, please contact Marshfield Clinic, Patient Financial Services Department at ###-###-#### and select the appropriate phone option to establish a monthly payment plan within the next 10 business days or by 10/25/2017, as we consider this matter to be concluded.We appreciate the opportunity to serve you and are committed to service excellence in meeting your health care needs.Mr. [redacted] contacted Marshfield Clinic via a letter on 11/2/17 with the same concern. Marshfield Clinic responded with the following letter:I had the opportunity to review your concern regarding your charges on July 17, 2017 for your Initial Office visit level 4 and the Simple Repair 2.5 CM or less.At your request, our coding- reimbursement staff reviewed the medical documentation and confirmed that the billing of the charges and the fees are appropriate.Marshfield Clinic fees are based on a wide range of factors: time, staff requirements, equipment, supplies and risk involved. Just like other businesses, we have different p[redacted]s than other health care providers. Our fees are published and are available to you in our business office.At this time, we have no additional itemized information we are able to provide and the balance due on your account of $806.03 will remain as patient responsibility. We will also no longer hold your account and without payment in full or contacting us to establish a payment arrangement, this balance will risk being placed with a collection agency.This will be the final review of your concerns, as we consider this matter to be concluded. Mr. [redacted] is asking for a copy of the fees, I apologize that MC is not able to supply Mr. [redacted] with a copy of the fees but he can contact our fee estimators at ###-###-####, extension 94475 to obtain a fee quote.The fees for these services are the standard fees for all patients.  The cpt (procedure) codes are created by the AMA and are used by all medical facilities.  Mr. [redacted] may visit the AMA on line for further information.  Time is not a factor for most procedural codes.  Components of the service provided play an important role when establishing the correct CPT code which in turns creates the correct fee.Sincerely,Kathy [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
In response to Mr. [redacted]'s letter of January 9, I am replying in a separate letter.  I am emailing that letter to Revdex.com this morning.  Thank you.
Alan [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Marshfield  Clinic continues to "address"  (or more accurately "reply" to) my concerns, but not "answer" them.  I have sent you a copy of my postal letter to Mr. [redacted] and to the clinic director under separate cover.   This is in reply to Mr. [redacted]'s postal letter.  If Marshfield Clinic can not or will not explain to me the  specific reasons for the office call visit charge, they should delete the charge from my bill.
Regards,
Alan [redacted]

As I previously stated, I will not be responding further to this concern. Kathy [redacted]

November 22, 2017Marshfield Clinic:Again, your reply did not address my specific questions.   This is happening repeatedly. Your  most recent reply said I should call [redacted] for a fee quote.  I called that number five  times from both my cell and home phones and got messages that the number was "not available from calling area."  I also got recordings about "team mobile, medical alert system, and a Florida cruise."  So again, Marshfield, please just inform me of the itemization on my specific bill.  I want to know what I was charged for, which I would think would be easily assessable to you since you sent me the bill.It would greatly expedite this matter if you would get me this information.   I would like to know the code numbers, what they mean, and the itemized amounts.   This would give information on how the $806.03 was reached. Also, Marshfield,  to avoid continuously repeating myself, please just re-read my previous correspondences  so that all of my questions will be addressed. This includes the "desired outcome" in the Revdex.com document. In addition to the reply I just sent, please be aware that I did do what you told me to do, "visit the AMA on line for further information."  I also called their toll free number and listened to many menus and recordings.  The information was not helpful to me and did not address my questions.   Thank you.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
I will pay the $467.20  for the stitches, but not the office  visit,  by the December 13 due date.  I will attempt to get the reasons for the office visit charge from other contacts (director, board of directors?) at Marshfield clinic, unless I hear back with a response from Marshfield within the ten day time limit.
Regards,
Alan [redacted]

As stated
in previous replies, Marshfield Clinic is not able to disclose further
information without appropriate authorization. Ms. [redacted] may call me at
###-###-#### to discuss her concern.
[redacted]
Manager,
Patient Financial Services

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
I still have not received detailed itemization as to where they are getting the Emergency Room Level 5 from.  His medical records show a level 4 emergency room visit.  Lakeview Medical Center (also owned by the same entity as Marshfield Clinic) shows an Emergency Room Level 4, which we have already paid to Lakeview Medical Center.  The physician notes from Lakeview Medical center (also the same physician that Marshfield is billing under, just under a separate entity in order to double collect for the same visit) shows ER Level 4.In regards to [redacted]'s visit on 2.14.2015 with a charge of $250.60.  Marshfield Clinic never submitted to our insurance.  I provided an insurance card upon check in on 2.14.15, of which the receptionist scanned and recorded our Insurance Card.  Anthem has no record of any claims for [redacted] on 2.14.15 from Marshfield Clinic.  I was also seen on the same day, during the same visit, for the same problem.  They did submit my claim, of which insurance paid 100% of the visit.  I will not pay the $250.60, until they have done their due diligence to submit to our in network insurance.
Regards,
[redacted]

Marshfield Clinic follows the Evaluation and Management Coding and Documentation Guide that is based on material from the American Medical Association and CMS. The specific components are outlined under the AMA web site.  A level of service is determined by the components for History of Present Illness (HPI), Review of Systems and Past Medical, Family and Social History.  Mr. [redacted] and I agree that we disagree on the level of service.  Marshfield Clinic follows all guidelines established for coding and billing.  Cost is not based on time but on components which I have listed above, the number of components was listed in a previous message.  Thank youKathy [redacted]

Thank you for the recent correspondence regarding the account for Ms. [redacted].  Increased privacy regulations prevent me from disclosing additional information without signed authorization.  A HIPAA has been mailed to Ms. [redacted], after I receive it back, I will then respond to the concern. ...

Kathy [redacted] ###-###-####

I had the opportunity to review the concern expressed by Trever [redacted].  Without authorization, I am not able to disclose information regarding this account.  An authorization has been mailed to the guarantor.  When the authorization is received back, I will be able to respond. ...

Mr. [redacted] should receive the authorization in the next 7- 10 days.Thank youKathy [redacted]

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you...

may update it before sending it.]
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Regards,
Jessica [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
I have contacted Marshfield Clinic Multiple times requesting an itemized statement and an explanation of the inaccuracies of their Emergency Room Billing.  I have yet to receive an actual itemized bill from their billing office.  I have only ever received a basic summary billing statement.  I have also not received any explanation as to why Lakeview Medical Center Emergency Room department is billing me for an Emergency room Level FOUR visit.  And Marshfield Clinic is double dipping and also billing me for an Emergency Room Level FIVE visit.  They can't even accurately double bill based on medical records, as you can see the difference in the level of emergency room care my son received.  I have not ever received an explanation of any of this, nor have I ever received an itemized billing statement from Marshfield Clinic.
Regards,
[redacted]

I had the
opportunity to review the concern expressed by Mr. [redacted]. Mr. [redacted] has
concerns with his account as well as his "girlfriend."
Due to
privacy regulations, I am not able to provide additional information regarding
Mr. [redacted]'s account nor do I have the name of the account...

holder for his
girlfriend.
Mr. [redacted]
can call me at ###-###-#### if he would like to discuss his concerns. Marshfield
Clinic would require that all necessary authorizations were in place before a conversation
takes place regarding the account for his girlfriend.
Sincerely,
[redacted]Manager -
Patient Financial Services