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Mercer Bucks Orthopedics

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Mercer Bucks Orthopedics Reviews (4)

I am writing in response to ID [redacted] The authorization department at Mercer Bucks Orthopaedics called the carrier, ***, the same day as the patient’s original orthotics appointment for authorization requirementsThe representative from [redacted] explained that no authorization was required for DME under $and gave a call reference number to confirm the decisionThe patient was called and informed that authorization to dispense was not required per the carrierAuthorization by a carrier does not equal paymentWhile it is the office’s responsibility to check with the carrier if authorization is required, it is the patient’s responsibility to have an understanding of their insurance plan and what services are covered under that planThis specific service was not covered per the patients insurance policyThe original bill was sent to [redacted] and the explanation of benefits was returned to both the billing office and the patient explaining the decision by the carrierThe patient was billed by the billing office, not a collection agency as stated, per the explanation of benefits

Complaint: [redacted]
I am rejecting this response because:[redacted] insurance never received a call from Mercer Bucks. I ,[redacted] was never told authorization was not needed for under $500.00.Mercer Bucks told me that my orthodics were approved.Again I would never have agreed to get them if they were not covered by my insurance as I clearly stated to Mercer Bucks when the doctor told me I needed them. 
Regards,
[redacted]

I am writing in response to ID [redacted]. The authorization department at Mercer Bucks Orthopaedics called the carrier, [redacted], the same day as the patient’s original orthotics appointment for authorization requirements. The representative from [redacted] explained that no authorization was required for...

DME under $500.00 and gave a call reference number to confirm the decision. The patient was called and informed that authorization to dispense was not required per the carrier. Authorization by a carrier does not equal payment. While it is the office’s responsibility to check with the carrier if authorization is required, it is the patient’s responsibility to have an understanding of their insurance plan and what services are covered under that plan. This specific service was not covered per the patients insurance policy. The original bill was sent to [redacted] and the explanation of benefits was returned to both the billing office and the patient explaining the decision by the carrier. The patient was billed by the billing office, not a collection agency as stated, per the explanation of benefits.

Review: I was under the care of [redacted] and he suggested that I have orthodics made for my shoes.He said he would need authorization from my insurance company and would call when it was approved. I was called a week later and was told my orthodics were approved and to come in for a fitting and I did. Weeks later I received a bill from their collections department saying I owed the money for the Orthodics because my insurance company did not cover them. I have been in touch with my insurance company,[redacted] and they never had a request from Mercer Bucks for othodics. [redacted] also said all conversations are recorded and logged and they have nothing in my file.I have reached out to Mercer Bucks several times and each time I get a different story.First they said they were approved and when the bill was sent it was denied (impossible)then I was told that anything under $500.00 did not have to be approved and orthodcs are not covered under my plan.Desired Settlement: I feel I should not have to pay for the orthodics.I was told they were covered that is the only reason I got them.I feel someone in the office dropped the ball and never realy contacted my insurance company. Why would I get something that I knew my insurance would not cover.

Business

Response:

I am writing in response to ID [redacted]. The authorization department at Mercer Bucks Orthopaedics called the carrier, [redacted], the same day as the patient’s original orthotics appointment for authorization requirements. The representative from [redacted] explained that no authorization was required for DME under $500.00 and gave a call reference number to confirm the decision. The patient was called and informed that authorization to dispense was not required per the carrier. Authorization by a carrier does not equal payment. While it is the office’s responsibility to check with the carrier if authorization is required, it is the patient’s responsibility to have an understanding of their insurance plan and what services are covered under that plan. This specific service was not covered per the patients insurance policy. The original bill was sent to [redacted] and the explanation of benefits was returned to both the billing office and the patient explaining the decision by the carrier. The patient was billed by the billing office, not a collection agency as stated, per the explanation of benefits.

Consumer

Response:

Review: [redacted]

I am rejecting this response because:[redacted] insurance never received a call from Mercer Bucks. I ,[redacted] was never told authorization was not needed for under $500.00.Mercer Bucks told me that my orthodics were approved.Again I would never have agreed to get them if they were not covered by my insurance as I clearly stated to Mercer Bucks when the doctor told me I needed them.

Regards,

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Description: Physicians & Surgeons - Orthopedic Surgery

Address: 3120 Princeton Pike, Lawrenceville, New Jersey, United States, 08648

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