Medstar Eye Institute

May 7, 2015This letter responds to the complaint submitted by the above referenced patient/consumerThank you for bringing this matter to our attentionWe regret the inconvenienced caused to our patient.History MedStar Eye Institute is a newly established ophthalmology practice acquired from private owners, the practice is formerly known as CEPASWith the transition of ownership, there have been changes to operational prolocolsMedStar Eye Institute's policy of offering a "self pay" charge rate applies only to patients who do not have medical insurance coverage (which is compliant with MedStar Eye Institute contracts with various medical insurance plans).Patient Complaint Patient was seen on March The total charges are $along with a $25,co-paymentDue to a computer entry error the claim was not initially processed to the insurance carrier, Our billing department was informed on April 2014, and the error has been correctedThe claim is currently being processed by the patient's insurance carrier, and the outstanding balance of $230,was placed on hold by our billing departmentThe patient will be billed any outstanding “allowed" balance once the insurance claim process is completed as per the insurance carrier.Commitment to Service We called the insurance company to verify if the diagnosis code for the March date of service would be considered Medical or Routine, And was informed the diagnosis code falls underneath medical coverageAs stated by the patient her insurance covers a Routine eye exam only once every months, her last routine exam was December We understand the significance of providing exceptional eye care along with resolution to patient concernsWe will monitor this account over the next thirty daysPatient satisfaction is very important to MedStar Eye Institute.Thank you for allowing MedStar Eye Institute the opportunity to address this issueI may be reached on [redacted] should you need additional information

May 7, 2015This letter responds to the complaint submitted by the above referenced patient/consumer. Thank you for bringing this matter to our attention. We regret the inconvenienced caused to our patient.History MedStar Eye Institute is a newly established ophthalmology practice acquired from...

private owners, the practice is formerly known as CEPAS. With the transition of ownership, there have been changes to operational prolocols. MedStar Eye Institute's policy of offering a "self pay" charge rate applies only to patients who do not have medical insurance coverage (which is compliant with MedStar Eye Institute contracts with various medical insurance plans).Patient Complaint Patient was seen on 10 March 2015. The total charges are $270.00 along with a $25,00 co-payment. Due to a computer entry error the claim was not initially processed to the insurance carrier, Our billing department was informed on 23 April 2014, and the error has been corrected. The claim is currently being processed by the patient's insurance carrier, and the outstanding balance of $230,00 was placed on hold by our billing department. The patient will be billed any outstanding “allowed" balance once the insurance claim process is completed as per the insurance carrier.Commitment to Service We called the insurance company to verify if the diagnosis code for the 10 March 2015 date of service would be considered Medical or Routine, And was informed the diagnosis code falls underneath medical coverage. As stated by the patient her insurance covers a Routine eye exam only once every 24 months, her last routine exam was 22 December 2014. We understand the significance of providing exceptional eye care along with resolution to patient concerns. We will monitor this account over the next thirty days. Patient satisfaction is very important to MedStar Eye Institute.Thank you for allowing MedStar Eye Institute the opportunity to address this issue. I may be reached on [redacted] should you need additional information.

[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.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this end result worked to my benefit. 
Regards,
[redacted]

Review: Medstar Eye Institute (formerly [redacted]) erroneously billed my primary insurance company on 12/05/13. They should have billed my secondary insurance company(which pays 100% of my eye exams). I have repeatedly brought this to their attention and have each time been informed that it would be taken care of. On 07/31/2014, I received a call from a collection agency. I would like to file a complaint regarding their customer service and billing practices. They have been unresponsive and dismissive of my attempts to correct the matter.Desired Settlement: I would like them to remove the charges totaling $270.00 and dismiss the collection agency.

Business

Response:

November 4, 2014This letter responds to the complaint submitted by the above referenced patient/consumer. Thank you for bringing this matter to our attention. We regret the inconvenienced caused to our patient.Our billing department incorrectly processed two services resulting in the charges being applied as patient responsibility. As a result of this action the balance ($270.00) due from the patient was submitted to collections by the billing department. Once our patient notified MEI of the possible billing error, MedStar Eye Institute (MEI) researched the claim(s); resubmitted a corrections request on August 4, 2014; and requested resubmission of claim to insurance company. This action resulted in full payment by insurance of $230,00 (minus co-payment). A request was submitted again on August 4" to adjust off balance for second service ($40.00) which will result in a zero balance for DOS 12.5.2013.While the initial request for correction began before March 2014, we regret the time line involved to fully resolve the issue. And we understand it appeared to the patient we were inactive on her behalf. Our patient has maintained eye care with our office with a visit as recent as October 30, 2014 along with two previous visits. We understand the significance of providing exceptional eye care and will have forged an enhanced relationship with the third party billing company to nurture our patient relationships. Again thank you for allowing MedStar Eye Institute the opportunity to address this issue. I may be reached on 301.464.1277 should you need additional information.Regards,Jacqueline YOM