Midwest Diagnostic Pathology

The billing company did not originally have the necessary insurance information for this case.? Consequently, a statement containing a message to contact our office to provide insurance information was sent.? Ms [redacted] called and provided the necessary information and a claim was submitted to her insurance company.? There had been no response from them after days so per our process another statement went to Ms [redacted] with a message that we had had no response from her insuranceShe provided an updated name and also paid the balance in full at that time.? An updated claim was submitted to the insurance company and they subsequently paid the claim.? The patient’s account was in the Refund Process when inquiries were made.? Upon learning of the situation, the Client Manager, [redacted] , requested an expedited check.? ? Ms [redacted] also spoke with Ms [redacted] and then met with her in person to deliver the refund check.? At that time, Ms [redacted] thanked Ms [redacted] for her help and seemed satisfied with the outcome

Initial Business Response / [redacted] (1000, 5, 2015/06/25) */ Contact Name and Title: Arleta [redacted] Contact Phone: [redacted] Contact Email: [redacted] The charge was billed with the incorrect date of serviceWhen the patient called our office her account should have been put on holdWe've adjusted off the charge, spoken with her insurance company, insurance representative Rene (call reference [redacted] )and sent a follletter to remove from her insurance history (she was cc'd this letter)We've left a voicemail message for the complaintant and will continue to try and reach herWe apologize for the inconvenience and hope this resolution is satisfactory to the complaintant

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 Sincerely, [redacted]

Patient statements had been sent on Aug 12th, Sept 12th, Oct 12th, Oct 21st, Nov 12th, and Nov19th, We were able to verify that these statements were sent to the correct patient address which was the address provided in this complaint and later confirmed by Ms [redacted] [redacted] [redacted] , Client Manager, spoke with Ms [redacted] on Tuesday, Feb 16th, Ms [redacted] stated that she had not received previous statements I explained what the charges in question were for, the services, dates, where services had been initiated, and also explained that we had not received complete insurance information I conveyed to Ms [redacted] that I had requested her accounts be pulled from collections and they had been taken care of She can disregard previous statements and any collection agency communications for these services I also confirmed her demographic information verifying that her account record was currently up to date in our system at this time I provided Ms [redacted] with my direct contact information so that any future questions could be directed to a specific MDP resource I also asked Ms [redacted] if I could be of any further assistance but she did not have any other questions She thanked me for my help and appeared satisfied with the resolution Ms [redacted] should receive a letter of closure from the collection agency in the next week

*** ***, Client Manager, spoke with Mr*** on June 29th, He explained that there had originally been an issue with how his claims were processed by his insurance company, ***, for dates of service 11/28/and 12/22/2016. Mr*** had talked with the insurance company
though and had been told that they would reprocess these claimsMs*** reviewed the account with Mr***. *** had reprocessed and paid his claim for 12/22/2016. The account was already in our refund process cycle per our standard procedures addressing credit balances. Mr*** agreed that the refund amount for this date was what he was expecting. There were no additional responses or payments indicating that *** had reprocessed the 11/28/claim though. Ms*** stated that they would follow up with the insurance company regarding this claim.Our appeals department contacted Mr***’s insurance company on June 29th, 2017. The *** representative advised that the 11/28/claim was not currently being reprocessed as the balance was the patient’s deductibleWe asked the rep to have the claim sent for further review/reprocessing as it may have been originally processed incorrectlyOur appeals department contacted *** again on July10th, to check claim status. The *** rep confirmed that the claim had been escalated to reprocessing on June 30th, and was still pending.Ms*** contacted Mr*** again on July 11th, to let him know that his refund check had been mailed and to provide a status update on the pending November claim. Ms*** provided Mr*** with her direct contact information so that any future questions could be directed to a specific MDP resource

*** ***, Client Manager, spoke with Mr*** on June 29th, He explained that there had originally been an issue with how his claims were processed by his insurance company, ***, for dates of service 11/28/and 12/22/2016. Mr*** had talked with the insurance company
though and had been told that they would reprocess these claimsMs*** reviewed the account with Mr***. *** had reprocessed and paid his claim for 12/22/2016. The account was already in our refund process cycle per our standard procedures addressing credit balances. Mr*** agreed that the refund amount for this date was what he was expecting. There were no additional responses or payments indicating that *** had reprocessed the 11/28/claim though. Ms*** stated that they would follow up with the insurance company regarding this claim.Our appeals department contacted Mr***’s insurance company on June 29th, 2017. The *** representative advised that the 11/28/claim was not currently being reprocessed as the balance was the patient’s deductibleWe asked the rep to have the claim sent for further review/reprocessing as it may have been originally processed incorrectlyOur appeals department contacted *** again on July10th, to check claim status. The *** rep confirmed that the claim had been escalated to reprocessing on June 30th, and was still pending.Ms*** contacted Mr*** again on July 11th, to let him know that his refund check had been mailed and to provide a status update on the pending November claim. Ms*** provided Mr*** with her direct contact information so that any future questions could be directed to a specific MDP resource.

*** ***, Client Manager, spoke with Mr*** on June 29th, He explained that there had originally been an issue with how his claims were processed by his insurance company, ***, for dates of service 11/28/and 12/22/2016. Mr*** had talked with the insurance company though and had been told that they would reprocess these claimsMs*** reviewed the account with Mr***. *** had reprocessed and paid his claim for 12/22/2016. The account was already in our refund process cycle per our standard procedures addressing credit balances. Mr*** agreed that the refund amount for this date was what he was expecting. There were no additional responses or payments indicating that *** had reprocessed the 11/28/claim though. Ms*** stated that they would follow up with the insurance company regarding this claim.Our appeals department contacted Mr***’s insurance company on June 29th, 2017. The *** representative advised that the 11/28/claim was not currently being reprocessed as the balance was the patient’s deductibleWe asked the rep to have the claim sent for further review/reprocessing as it may have been originally processed incorrectlyOur appeals department contacted *** again on July10th, to check claim status. The *** rep confirmed that the claim had been escalated to reprocessing on June 30th, and was still pending.Ms*** contacted Mr*** again on July 11th, to let him know that his refund check had been mailed and to provide a status update on the pending November claim. Ms*** provided Mr*** with her direct contact information so that any future questions could be directed to a specific MDP resource

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***

*** ***, Client Manager, spoke with Mr*** on June 29th, He explained that there had originally been an issue with how his claims were processed by his insurance company, ***, for dates of service 11/28/and 12/22/2016. Mr*** had talked with the insurance company though and had been told that they would reprocess these claimsMs*** reviewed the account with Mr***. *** had reprocessed and paid his claim for 12/22/2016. The account was already in our refund process cycle per our standard procedures addressing credit balances. Mr*** agreed that the refund amount for this date was what he was expecting. There were no additional responses or payments indicating that *** had reprocessed the 11/28/claim though. Ms*** stated that they would follow up with the insurance company regarding this claim.Our appeals department contacted Mr***’s insurance company on June 29th, 2017. The *** representative advised that the 11/28/claim was not currently being reprocessed as the balance was the patient’s deductibleWe asked the rep to have the claim sent for further review/reprocessing as it may have been originally processed incorrectlyOur appeals department contacted *** again on July10th, to check claim status. The *** rep confirmed that the claim had been escalated to reprocessing on June 30th, and was still pending.Ms*** contacted Mr*** again on July 11th, to let him know that his refund check had been mailed and to provide a status update on the pending November claim. Ms*** provided Mr*** with her direct contact information so that any future questions could be directed to a specific MDP resource.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***

The billing company did not originally have the necessary insurance information for this case. Consequently, a statement containing a message to contact our office to provide insurance information was sent. Ms*** called and provided the necessary information and a claim was
submitted to her insurance company. There had been no response from them after days so per our process another statement went to Ms*** with a message that we had had no response from her insuranceShe provided an updated name and also paid the balance in full at that time. An updated claim was submitted to the insurance company and they subsequently paid the claim. The patient’s account was in the Refund Process when inquiries were made. Upon learning of the situation, the Client Manager, *** ***, requested an expedited check. Ms*** also spoke with Ms*** and then met with her in person to deliver the refund check. At that time, Ms*** thanked Ms*** for her help and seemed satisfied with the outcome

Patient statements had been sent on Aug 12th, Sept 12th, Oct 12th, Oct 21st, Nov 12th, and Nov19th, 2015. We were able to verify that these statements were sent to the correct patient address which was the address provided in this complaint and later confirmed by Ms***. ***
***, Client Manager, spoke with Ms*** on Tuesday, Feb 16th, Ms*** stated that she had not received previous statements. I explained what the charges in question were for, the services, dates, where services had been initiated, and also explained that we had not received complete insurance information. I conveyed to Ms*** that I had requested her accounts be pulled from collections and they had been taken care of. She can disregard previous statements and any collection agency communications for these services. I also confirmed her demographic information verifying that her account record was currently up to date in our system at this time. I provided Ms*** with my direct contact information so that any future questions could be directed to a specific MDP resource. I also asked Ms*** if I could be of any further assistance but she did not have any other questions. She thanked me for my help and appeared satisfied with the resolution. Ms*** should receive a letter of closure from the collection agency in the next week.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** *** ***

The billing company did not originally have the necessary insurance information for this case. Consequently, a statement containing a message to contact our office to provide insurance information was sent. Ms*** called and provided the necessary information and a claim was
submitted to her insurance company. There had been no response from them after days so per our process another statement went to Ms*** with a message that we had had no response from her insuranceShe provided an updated name and also paid the balance in full at that time. An updated claim was submitted to the insurance company and they subsequently paid the claim. The patient’s account was in the Refund Process when inquiries were made. Upon learning of the situation, the Client Manager, *** ***, requested an expedited check. Ms*** also spoke with Ms*** and then met with her in person to deliver the refund check. At that time, Ms*** thanked Ms*** for her help and seemed satisfied with the outcome

Patient statements had been sent on Aug 12th, Sept 12th, Oct 12th, Oct 21st, Nov 12th, and Nov19th, 2015.  We were able to verify that these statements were sent to the correct patient address which was the address provided in this complaint and later confirmed by Ms. [redacted].  [redacted]...

[redacted], Client Manager, spoke with Ms. [redacted] on Tuesday, Feb 16th, 2016. Ms. [redacted] stated that she had not received previous statements.  I explained what the charges in question were for, the services, dates, where services had been initiated, and also explained that we had not received complete insurance information.  I conveyed to Ms. [redacted] that I had requested her accounts be pulled from collections and they had been taken care of.  She can disregard previous statements and any collection agency communications for these services.  I also confirmed her demographic information verifying that her account record was currently up to date in our system at this time.  I provided Ms. [redacted] with my direct contact information so that any future questions could be directed to a specific MDP resource.  I also asked Ms. [redacted] if I could be of any further assistance but she did not have any other questions.  She thanked me for my help and appeared satisfied with the resolution.  Ms. [redacted] should receive a letter of closure from the collection agency in the next week.

Initial Business Response /* (1000, 5, 2015/06/25) */
Contact Name and Title: Arleta [redacted]
Contact Phone: [redacted]
Contact Email: [redacted]
The charge was billed with the incorrect date of service. When the patient called our office her account should have been put on hold. We've...

adjusted off the charge, spoken with her insurance company, insurance representative Rene (call reference [redacted])and sent a follow-up letter to remove from her insurance history (she was cc'd this letter). We've left a voicemail message for the complaintant and will continue to try and reach her. We apologize for the inconvenience and hope this resolution is satisfactory to the complaintant.

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.
Sincerely,
[redacted]