A representative from our Revenue Management Department contacted [redacted] on 5/12/and informed her that a Release of Information form is required in order to provide the records she is requesting Ms [redacted] provided her email address to our representative and the information was provided to our Health Information Management (HIM) Department Ms [redacted] was advised that our outsourced billing agency has been contacted to produce the denial referenced in account notes for the claim submitted under the father’s insurance and a response is pending The information will be relayed to Ms [redacted] when it is received
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.***,I am very aware of HIPAA and I have provided my son's information several times in the past as well as have tried to get things resolved for almost yrs - I have and will continue to make payments on my son's account - you stated you tried to call me ?? - should have left a message !!! - which would have been the appropriate thing to do. My son's number again is ***-***-***. [Provide details of why you are not satisfied with this resolution.]
Regards,
*** ***
"height: 32px; width: 32px; background-">
***
Oct (days ago)
tome
To: Ms*** ***, Business Relations Executive
Customer Experience, Revdex.com complaint #***
With regard to the above referenced complaint, we unfortunately do not have a final response as of this date. However, the purpose of this email is to provide you with the current status of our research.
The complaint included concerns regarding:
Payments not posted timely to patient accounts
Monthly statements that may have been discontinued prematurely
Telephone contact with the consumer from a “rude” representative of the facility
Concern regarding the possibility of credit bureau reporting
I
First, please note that the person who filed the complaint with the Revdex.com, *** ***, is not the patient. She indicated the patient is her son, but it does not appear he was a minor at the time of service. Therefore, in order to remain compliant with HIPAA regulations, we will need permission from the patient in order to respond to this matter. I attempted to call Ms*** today at *** to obtain her son’s contact information, but did not leave a message on her voice mail. If someone would please provide me with the son’s phone number, I will contact him and confirm his permission to respond.
In the meantime, I have been researching the complaint, and should have all relevant facts to bring resolution within a few days. Unfortunately, this has not been a simple task, as the Hospital converted the Patient Accounts Receivable System in June 2014. Hospital accounts with open balances as of the conversion date were outsourced to a vendor for folland collection. In addition, the previous Accounts Receivable System was temporarily unavailable this past week, which has further complicated our research.
I apologize for the delay, but we hope to have a final resolution and response back to you next week. Please let me know if you have any questions or concerns. Thank you*** ***
AVP CRM
Parallon Business Performance Group
Atlanta Shared Service Center
Cell: ***
***
www.parallon.net
Ms*** ***
arial, sans-serif;">Revdex.com
Re: Complaint ***
We have reviewed our records and call recordings associated with the patient complaint referenced above and have determined the following1. We have found no evidence that our customer service representative was rude to the patient during the telephone call referenced in the complaint. In fact, the representative had to place the patient on a brief hold during which time the call recording continued, and several inappropriate and disparaging comments were made by the complainant about our representative and were recorded during the “hold time” on the call2. The patient complained that he requested to know the exact amount that would be due from him for a procedure after the insurance carrier paid their portion. Our representative complied with his request and contacted his insurance carrier to request assistance. Unfortunately, when the insurance carrier processed the claim, the amount estimated on the date of service was less than the amount subsequently reported to us on the explanation of benefits as due from the patient. This is not an uncommon event. Even though we use the latest technology to verify insurance benefits and estimate the amount due from the patient, the actual patient liability is determined by the insurance carrier when they process the claim. We try to stress to the patient that any collection made on the date of service is only an estimate, and any remaining portion will be balance billed
In conclusion, we followed appropriate protocol in handling the collection of this patient account. He was offered and received a prompt pay discount of 20% of the amount collected on the date of service. At this time we would like to extend the same prompt pay discount of 20% on his remaining liability of $103.38, which would leave him a balance of $82.70.
Please let me know if you have any further questions. Thank you*** ***
*** ***
*** *** *** ***
*** *** *** ***
Ms***:
As you know, I have been researching the complaint referenced above for a couple of weeks, and believe I now have the information needed to respond. In addition, I was able to reach the patient, Mr***, today via telephone. He granted his permission for me to respond, which takes care of the HIPAA privacy concern.
The complainant, Ms*** ***, indicated the following:
1. Concern regarding missing payments, or payments not posted to the accounts in a timely fashion.
I reconciled the payments listed on Ms***’s bank account to the Midtown Medical Center patient accounts, and determined three payments in the amount of $each had not been posted. We are in process of making the appropriate correction to the balances as follows:
2. Concern regarding rudeness of representative during recent phone call.
As previously mentioned, the Hospital converted the Accounts Receivable system on 6/17/2014, and all open accounts were outsourced to a vendor for collection. We requested the vendor listen to call recordings and evaluate for appropriate nature of discussion and helpfulness of the representative. The vendor replied as follows: “Our QA Supervisor found nothing that we construed to be rudeness.”
3. Concern that the accounts had been turned over to collection agency with reporting to the credit bureauWe were able to confirm with our Accounts Receivable vendor that none of the accounts have been reported to the credit bureau4. Concern regarding statements no longer being sentAgain, our Accounts Receivable vendor was able to confirm that statements are still being sent. The September statement was actually included in the packet originally provided by the patient to the Revdex.com. The Accounts Receivable system shows that the most recent statements were dated 10/28/5. Concern we are not honoring the payment arrangement established some time agoBased on the call recording pulled by the vendor, Mrs*** was actually advised that the payment plan has not been discontinued.
In summary, it appears there was a process breakdown and three payments were not posted timely. Corrections to the Patient Accounts are in process to remedy that issue, and we will also be reviewing and revising our posting process accordingly. We are pleased to report we were unable to find evidence to support Ms***’s other concerns. However, we would like to offer Ms*** a discount of 50% to settle the balance of Mr***’s accounts for a sum of $76.94. If Ms*** would like to take advantage of this offer, I would request she contact me at ***. I will personally handle the account to ensure there are no further issues.
Ms***, please relay to Ms*** that we value our patients and appreciate the opportunity to serve their healthcare needs. If there is anything further we can do to regain her confidence, I would appreciate that feedback as well. Please let me know if you require further information, and thank you so much for your patience in this matter*** ***
AVP CRM
Parallon Business Performance Group
Atlanta Shared Service Center
Cell: ***
***
www.parallon.net
A representative from our Revenue Management Department contacted [redacted] on 5/12/16 and informed her that a Release of Information form is required in order to provide the records she is requesting. Ms. [redacted] provided her email address to our representative and the information was provided to our Health Information Management (HIM) Department. Ms. [redacted] was advised that our outsourced billing agency has been contacted to produce the denial referenced in account notes for the claim submitted under the father’s insurance and a response is pending. The information will be relayed to Ms. [redacted] when it is received.
[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 resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
[redacted]
10:30 AM (12 minutes ago)
tome,[redacted]
I spoke with [redacted] this morning – thank you!!!!!!!!!!!!!!!!!!!!!!!!
[redacted]
Environmental Health
Cabell Huntington Health Department
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that I want proof that this was filed as the insurance has been in contact with the collection agency and told them no claim on this was filed. The insurance has no record of this information. Further I want proof of this order and the lab results from hospital. They can mail this information to me. This continues to be poor communication on hospital.
that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.[Provide details of why you are not satisfied with this resolution.]
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.[Provide details of why you are not satisfied with this resolution.]
I will contact business tomorrow in ref to discount!! they state - while 50% is nice after all of this but amount is wrong - I am glad finally talked to my son and as far as reps being rude - they are incorrect on this matter - I have talked to various people about this before Revdex.com was ever involved.
Regards,
[redacted]
Tell us why here...
The patient presented to MMC for lab work on 11/11/2014,
ordered by the primary care...
physician. Blue Cross was listed as
primary payer and was contacted for eligibility for this date of service, the
patient’s date of birth was not on the eligibility file. Blue Cross AL
was contacted and the representative stated that the patient was not added to
the insured’s policy. This was the mother’s insurance. The
patient’s father later provided his Blue Cross policy number. According
to our records, the claim was billed to Blue Cross and denied as expenses
incurred during a lapse in coverage.
There was no false claim.
The initial insurance information provided was incorrect (mother’s
policy)
The correct information was provided March 2015 (father’s policy)
Total charges $149.05
The account balance is $73.96 – no patient payments
A representative from our Revenue Management Department contacted [redacted] on 5/12/and informed her that a Release of Information form is required in order to provide the records she is requesting Ms [redacted] provided her email address to our representative and the information was provided to our Health Information Management (HIM) Department Ms [redacted] was advised that our outsourced billing agency has been contacted to produce the denial referenced in account notes for the claim submitted under the father’s insurance and a response is pending The information will be relayed to Ms [redacted] when it is received
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.***,I am very aware of HIPAA and I have provided my son's information several times in the past as well as have tried to get things resolved for almost yrs - I have and will continue to make payments on my son's account - you stated you tried to call me ?? - should have left a message !!! - which would have been the appropriate thing to do. My son's number again is ***-***-***. [Provide details of why you are not satisfied with this resolution.]
Regards,
*** ***
"height: 32px; width: 32px; background-">
***
Oct (days ago)
tome
To: Ms*** ***, Business Relations Executive
Customer Experience, Revdex.com complaint #***
With regard to the above referenced complaint, we unfortunately do not have a final response as of this date. However, the purpose of this email is to provide you with the current status of our research.
The complaint included concerns regarding:
Payments not posted timely to patient accounts
Monthly statements that may have been discontinued prematurely
Telephone contact with the consumer from a “rude” representative of the facility
Concern regarding the possibility of credit bureau reporting
I
First, please note that the person who filed the complaint with the Revdex.com, *** ***, is not the patient. She indicated the patient is her son, but it does not appear he was a minor at the time of service. Therefore, in order to remain compliant with HIPAA regulations, we will need permission from the patient in order to respond to this matter. I attempted to call Ms*** today at *** to obtain her son’s contact information, but did not leave a message on her voice mail. If someone would please provide me with the son’s phone number, I will contact him and confirm his permission to respond.
In the meantime, I have been researching the complaint, and should have all relevant facts to bring resolution within a few days. Unfortunately, this has not been a simple task, as the Hospital converted the Patient Accounts Receivable System in June 2014. Hospital accounts with open balances as of the conversion date were outsourced to a vendor for folland collection. In addition, the previous Accounts Receivable System was temporarily unavailable this past week, which has further complicated our research.
I apologize for the delay, but we hope to have a final resolution and response back to you next week. Please let me know if you have any questions or concerns. Thank you*** ***
AVP CRM
Parallon Business Performance Group
Atlanta Shared Service Center
Cell: ***
***
www.parallon.net
Ms*** ***
arial, sans-serif;">Revdex.com
Re: Complaint ***
We have reviewed our records and call recordings associated with the patient complaint referenced above and have determined the following1. We have found no evidence that our customer service representative was rude to the patient during the telephone call referenced in the complaint. In fact, the representative had to place the patient on a brief hold during which time the call recording continued, and several inappropriate and disparaging comments were made by the complainant about our representative and were recorded during the “hold time” on the call2. The patient complained that he requested to know the exact amount that would be due from him for a procedure after the insurance carrier paid their portion. Our representative complied with his request and contacted his insurance carrier to request assistance. Unfortunately, when the insurance carrier processed the claim, the amount estimated on the date of service was less than the amount subsequently reported to us on the explanation of benefits as due from the patient. This is not an uncommon event. Even though we use the latest technology to verify insurance benefits and estimate the amount due from the patient, the actual patient liability is determined by the insurance carrier when they process the claim. We try to stress to the patient that any collection made on the date of service is only an estimate, and any remaining portion will be balance billed
In conclusion, we followed appropriate protocol in handling the collection of this patient account. He was offered and received a prompt pay discount of 20% of the amount collected on the date of service. At this time we would like to extend the same prompt pay discount of 20% on his remaining liability of $103.38, which would leave him a balance of $82.70.
Please let me know if you have any further questions. Thank you*** ***
*** ***
*** *** *** ***
*** *** *** ***
Ms***:
As you know, I have been researching the complaint referenced above for a couple of weeks, and believe I now have the information needed to respond. In addition, I was able to reach the patient, Mr***, today via telephone. He granted his permission for me to respond, which takes care of the HIPAA privacy concern.
The complainant, Ms*** ***, indicated the following:
1. Concern regarding missing payments, or payments not posted to the accounts in a timely fashion.
I reconciled the payments listed on Ms***’s bank account to the Midtown Medical Center patient accounts, and determined three payments in the amount of $each had not been posted. We are in process of making the appropriate correction to the balances as follows:
2. Concern regarding rudeness of representative during recent phone call.
As previously mentioned, the Hospital converted the Accounts Receivable system on 6/17/2014, and all open accounts were outsourced to a vendor for collection. We requested the vendor listen to call recordings and evaluate for appropriate nature of discussion and helpfulness of the representative. The vendor replied as follows: “Our QA Supervisor found nothing that we construed to be rudeness.”
3. Concern that the accounts had been turned over to collection agency with reporting to the credit bureauWe were able to confirm with our Accounts Receivable vendor that none of the accounts have been reported to the credit bureau4. Concern regarding statements no longer being sentAgain, our Accounts Receivable vendor was able to confirm that statements are still being sent. The September statement was actually included in the packet originally provided by the patient to the Revdex.com. The Accounts Receivable system shows that the most recent statements were dated 10/28/5. Concern we are not honoring the payment arrangement established some time agoBased on the call recording pulled by the vendor, Mrs*** was actually advised that the payment plan has not been discontinued.
In summary, it appears there was a process breakdown and three payments were not posted timely. Corrections to the Patient Accounts are in process to remedy that issue, and we will also be reviewing and revising our posting process accordingly. We are pleased to report we were unable to find evidence to support Ms***’s other concerns. However, we would like to offer Ms*** a discount of 50% to settle the balance of Mr***’s accounts for a sum of $76.94. If Ms*** would like to take advantage of this offer, I would request she contact me at ***. I will personally handle the account to ensure there are no further issues.
Ms***, please relay to Ms*** that we value our patients and appreciate the opportunity to serve their healthcare needs. If there is anything further we can do to regain her confidence, I would appreciate that feedback as well. Please let me know if you require further information, and thank you so much for your patience in this matter*** ***
AVP CRM
Parallon Business Performance Group
Atlanta Shared Service Center
Cell: ***
***
www.parallon.net
A representative from our Revenue Management Department contacted [redacted] on 5/12/16 and informed her that a Release of Information form is required in order to provide the records she is requesting. Ms. [redacted] provided her email address to our representative and the information was provided to our Health Information Management (HIM) Department. Ms. [redacted] was advised that our outsourced billing agency has been contacted to produce the denial referenced in account notes for the claim submitted under the father’s insurance and a response is pending. The information will be relayed to Ms. [redacted] when it is received.
[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 resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
[redacted]
10:30 AM (12 minutes ago)
tome,[redacted]
I spoke with [redacted] this morning – thank you!!!!!!!!!!!!!!!!!!!!!!!!
[redacted]
Environmental Health
Cabell Huntington Health Department
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that I want proof that this was filed as the insurance has been in contact with the collection agency and told them no claim on this was filed. The insurance has no record of this information. Further I want proof of this order and the lab results from hospital. They can mail this information to me. This continues to be poor communication on hospital.
that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.[Provide details of why you are not satisfied with this resolution.]
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.[Provide details of why you are not satisfied with this resolution.]
I will contact business tomorrow in ref to discount!! they state - while 50% is nice after all of this but amount is wrong - I am glad finally talked to my son and as far as reps being rude - they are incorrect on this matter - I have talked to various people about this before Revdex.com was ever involved.
Regards,
[redacted]
Tell us why here...
The patient presented to MMC for lab work on 11/11/2014,
ordered by the primary care...
physician. Blue Cross was listed as
primary payer and was contacted for eligibility for this date of service, the
patient’s date of birth was not on the eligibility file. Blue Cross AL
was contacted and the representative stated that the patient was not added to
the insured’s policy. This was the mother’s insurance. The
patient’s father later provided his Blue Cross policy number. According
to our records, the claim was billed to Blue Cross and denied as expenses
incurred during a lapse in coverage.
There was no false claim.
The initial insurance information provided was incorrect (mother’s
policy)
The correct information was provided March 2015 (father’s policy)
Total charges $149.05
The account balance is $73.96 – no patient payments