Millennium Surgical

Initial Business Response / [redacted] (1000, 5, 2014/06/25) */ Initial Consumer Rebuttal / [redacted] (3000, 7, 2014/07/04) */ (The consumer indicated he/she DID NOT accept the response from the business.) This is not a responseIt is an attached form to release health care informationI do not see a reason to release my health care information and provide my social securityIf the Revdex.com needs a copy of the invoice I will attach itI have stated the information needed in my complaint The business simply attached a document with no response Final Business Response / [redacted] (4000, 9, 2014/07/17) */ It is true that my initial response did not address questions posed by the Consumer The reason is that Consumer's questions pertain to information protected by federal HIPPA law (Health Insurance Portability and Accountability Act), and I do not have patient's authorization to release such information to anyone other than the patient himselfI would be more than happy to respond to specific health-related Consumer/patient's questions, if he signs the release allowing me to do so This is not an act of ill will on my part, but simply necessary compliance with federal and state laws, that have been put in place to PROTECT patient's privacy and health care related information With regards to patient's allegation that I did not accept his insurance, allow me to repeat my statement from initial reply - I am an in-network provider contracted with patient's insurance company and I do accept it for all patients with this particular insurance carrierTherefore Consumer's statement is incorrect, as I not only accept the insurance, but I am a registered provider for this companyPerhaps the issue is pertaining to coverage of certain services not covered by patient's insurance policy? The issue of coverage with regards to specific medical services should be addressed directly to patient's insurance company, since insurance policy is a contract between the patient and insurance companyProvider, such as myself, does not have the ability to change the policy which might cover certain procedures, but not cover othersThis has been explained to the patient during numerous phone calls With regards to the demand that bill should be waived, I would like to respond that the service (medical consultation) for which the bill was generated - did in fact take placePatient obviously has the right to agree or disagree with the opinion of the providerBut since the service actually took place, the bill was generated and sent to patient per the contractual agreement provided by patient's insurance companyAgain, if patient disagrees with the conditions of his insurance policy, he most certainly should call his insurance company to voice his concernsNot billing the insurance for service provided is considered "underbilling" and constitutes insurance fraudThis is a criminal insurance offence reportable to the Illinois Attorney General Office, Insurance Division In addition, all details regarding patient's billing and insurance matters are also considered confidential and protected under privacy laws Once again, I am attaching the Authorization to Release Health Care Information Without this properly executed form, I am not allowed, under current Privacy Laws, to release any health-care related information to the patient A copy of this email is also sent to the consumer, as he has provided his email address to us and his authorization to use it Should you have any further questions, please do not hesitate to contact me I also encourage the patient to call my office for answers to his questions directly from me Sincerely, Dr [redacted]

Initial Business Response /* (1000, 5, 2014/06/25) */
Initial Consumer Rebuttal /* (3000, 7, 2014/07/04) */
(The consumer indicated he/she DID NOT accept the response from the business.)
This is not a response. It is an attached form to release health care information. I do not...

see a reason to release my health care information and provide my social security. If the Revdex.com needs a copy of the invoice I will attach it. I have stated the information needed in my complaint.
The business simply attached a document with no response.
Final Business Response /* (4000, 9, 2014/07/17) */
It is true that my initial response did not address questions posed by the Consumer.
The reason is that Consumer's questions pertain to information protected by federal HIPPA law (Health Insurance Portability and Accountability Act), and I do not have patient's authorization to release such information to anyone other than the patient himself. I would be more than happy to respond to specific health-related Consumer/patient's questions, if he signs the release allowing me to do so.

This is not an act of ill will on my part, but simply necessary compliance with federal and state laws, that have been put in place to PROTECT patient's privacy and health care related information.

With regards to patient's allegation that I did not accept his insurance, allow me to repeat my statement from initial reply - I am an in-network provider contracted with patient's insurance company and I do accept it for all patients with this particular insurance carrier. Therefore Consumer's statement is incorrect, as I not only accept the insurance, but I am a registered provider for this company. Perhaps the issue is pertaining to coverage of certain services not covered by patient's insurance policy? The issue of coverage with regards to specific medical services should be addressed directly to patient's insurance company, since insurance policy is a contract between the patient and insurance company. Provider, such as myself, does not have the ability to change the policy which might cover certain procedures, but not cover others. This has been explained to the patient during numerous phone calls.

With regards to the demand that bill should be waived, I would like to respond that the service (medical consultation) for which the bill was generated - did in fact take place. Patient obviously has the right to agree or disagree with the opinion of the provider. But since the service actually took place, the bill was generated and sent to patient per the contractual agreement provided by patient's insurance company. Again, if patient disagrees with the conditions of his insurance policy, he most certainly should call his insurance company to voice his concerns. Not billing the insurance for service provided is considered "underbilling" and constitutes insurance fraud. This is a criminal insurance offence reportable to the Illinois Attorney General Office, Insurance Division.
In addition, all details regarding patient's billing and insurance matters are also considered confidential and protected under privacy laws.

Once again, I am attaching the Authorization to Release Health Care Information.
Without this properly executed form, I am not allowed, under current Privacy Laws, to release any health-care related information to the patient.

A copy of this email is also sent to the consumer, as he has provided his email address to us and his authorization to use it.

Should you have any further questions, please do not hesitate to contact me.
I also encourage the patient to call my office for answers to his questions directly from me.

Sincerely,

Dr [redacted]