Medical College of Wisconsin Children's Specialty

Review: We received several bills from Medical College and kept in contact with the Medical College as our insurance was NOT paying timely. When we were then sent to collection and were told that this would be on our credit report we called again and stated that the insurance company was reviewing the bills and that we would send in payments. Which we did, in the end we have received credit back from Medical College for overpayments because the insurance finally did pay. But, in the mean time we were sent to collection and it is on our credit report!! We need this removed as we have worked very hard to keep our credit up.Desired Settlement: to have this removed from our credit report

Business

Response:

This letter is response to correspondence that the Medical College of Wisconsin received from the RevDex.com (Revdex.com), dated September 3, 2013. I reviewed the issues noted in your complaint to the Revdex.com and the billing

records for Medical College Physicians account #[redacted]. A summary of the billing history for this account

follows.

After receiving a denial from your insurance carrier, the Medical College of Wisconsin Billing Office made numerous

attempts to obtain payment from you:

• 3 itemized statements were mailed to your home. (September, 2012 - November, 2012)

• A final notice was also mailed to your home in November, 2012.

• We attempted to contact you by phone in December, 2012. Our phone call was not answered, so we

mailed a post card to your home address requesting you to contact the billing office.

Your account balance was referred to the collection agency in January, 2013 because we hadn't received response

from you for any of the aforementioned notifications. Our first conversation with you occurred after the collection

agency began to contact you for payment.

The balance due on this account was satisfied shortly after the referral to the collection agency. This balance was

not reported to your credit record.

Please advise if you have any further questions. My contact information is noted below.

Sincerely,

Customer Service Lead, CPS Billing & Collections

Medical College of Wisconsin

10000 Innovation Drive, Suite 300

Milwaukee, WI 53226

Review: Hi: My medical insurance is Preferred Medical Plan, membership # [redacted].I got a thyroid surgery. It took place in a hospital that belongs to the owner of the insurance, so I have all maximum coverage on the expenses. It costs $400.00 USD and all other expenses were covered by the insurance.After the surgery I receive a bill from this lab, $338.00 USD and I give them my insurance information. I called to my insurance and they told me that instead of sending the test to their labs, they sent it to a lab that is not covered by my insurance, so they will not pay for it.The Doctor who wrongly send the test to the lab was:[redacted]Any of the two business involved in this issue are responding to my claim. And they still sending me the invoice, and recently I received a letter from some collection agency.I have an excellent credit history, so I don't want to have my credit affected due to the wrong procedure committed by both business. They should call the insurance first to ensure that they will pay, instead of send it to the lab without the required authorization from the insurance. At this time, they will let them know to which lab the test should be send that will be covered 100% by the insurance.I'll appreciate your help on this case. I'll submit the same claim to the Doctor's Business in Revdex.com at Miami location.Thanks in advance, looking forward to hear from you.Regards,[redacted]Desired Settlement: The invoice should be charged to the Doctor's Office, since they sent it to the wrong lab. I'll need to have my credit clean if they report it already.

Business

Response:

This letter is in response to the Revdex.com complaint that was received dated

September 3, 2014 submitted by [redacted] pertaining to services

received on July 8, 2013.

A diagnostic consultation was provided on July 8, 2013 based on a referral

received from her referring physician, [redacted], MD (located in

Miami, FL).

The Medical College of Wisconsin billed the insurance carrier that was on

file and provided by the patient, [redacted]. Claim submitted on

August 20, 2013 to Preferred Medical Plan (located in Coral Gables, FL).

Based on follow-up that was taken on the outstanding claim with the

patient's insurance carrier (Preferred Medical Plan) on October 16, 2013, it

was determined that there was no claim on file to be processed and another

claim was submitted on October 16, 2013.

On November 20, 2013 a denial was received and posted on the patient's

account regarding an issue with the provider indicated on the claim. A

corrected claim was submitted to Preferred Medical Plan on November 26,

2013 resulting in receipt of another denial on January 23, 2014 stating the

same issue with the provider.

Per a phone call with a claims' representative at Preferred Medical Plan (on

January 23, 2014) the claims were denied due to the servicing provider

being out-of-network.

On February 19, 2014 another phone call occurred with a claims' representative at Preferred

Medical Plan. The claims' representative stated that a bill/claim would need to be sent to the

referring physician, [redacted] A. [redacted] (who is located in the same city/state as the patient); that

he was financially responsible for the outstanding balance.

The Medical College of Wisconsin's policy states that for scenarios such as this the patient

receives a statement of outstanding services which could be provided by the patient to the

referring physician for payment consideration.

The patient has received itemized statements on August 3, 2013, March 1 and 29, 2014 and

on April 26, 2014 (Final Notice) indicating the outstanding balance of $338.00 with the intent

of the patient forwarding these charges to her referring physician for payment. The patient's

account was referred to a pre-collection agency on May 3, 2014 with a subsequent referral to

a collection agency on July 5, 2014 due to non-receipt of payment.

The Medical College of Wisconsin is not contracted with the patient's insurance, Preferred

Medical Plan, so any services rendered by Medical College of Wisconsin physicians would

be processed as out-of-network resulting in the outstanding balances being the patient's

responsibility .

Please note: the patient's account (and credit bureau history) has not been negatively

impacted at this time.

The Medical College of Wisconsin placed a call to [redacted], MD (in the Pathology

Department at Westchester General Hospital) on September 18, 2014. Dr. [redacted] assured the

Medical College of Wisconsin that Westchester General Hospital will reimbursement for

these services once a statement is forwarded to him. The Medical College of Wisconsin will

be sending a statement to Dr. [redacted] within one week. The Medical College of Wisconsin

called the patient on September 18, 2014, to inform them of this new information.

If you should have any questions please contact me.

Sincerely,