Miller's Jewelry

RE: ID # [redacted] We are in receipt of the complaint you received from one of our patients for the service date of 7/19/After our investigation we find that Ms***' concern is a result of a third party payer error in processing the claimThe payer reprocessed approximately 1,claims during the month of December for our facilityDuring the reprocessing all claims with deductibles, co-pays or co-insurance amounts had adjustments in the patient's liability amountsMs [redacted] may call her insurance company to verify the reprocessed amount.The following provides an outline and summarizes the events of this complaint.7/19/Service Date8/2/Insurance response: Applied $ to patient's deductible on the total charges of $ 202.008/3/Patient sent statement for $ 135.978/16/Patient paid $ 135.9712/1/Insurance reprocessed claim: Applied $ to patient's deductible12/7/Patient sent statement for $ 1.9512/8/$ adjusted as a small balance write-off12/15/Received complaint from the Revdex.comIt is our policy to send out one statement on balances less than $ An automatic small balance adjustment is made after that first statementFurther collection does not occur.We continually strive to provide excellent service to our patients and regret this situationShould you need to contact us for additional clarification, please call me at ###-###-####, Jody S [redacted] , Director of Billing Services at ###-###-#### or Beth S***, Director, Financial Access/Registration.Sincerely,Kathleen S [redacted] Executive Director, Revenue CycleAttachments:Original Revdex.com of Western Pennsylvania Letter

June 19, Revdex.com of Western Pennsylvania Holiday Drive, Suite Pittsburgh, PA 15220RE: ID # [redacted] We are in receipt of a complaint you received from one of our patients for the service date of 1/27/After our investigation we find we were inattentive to the requests from the patient and his insurance company.The following provides and outline and summarizes the events to the reconciliation of this complaint.1/25/Service Date2/6/Claim Submitted to patient’s insurance company2/22/Letter from insurance- Requesting additional documentation from the patient3/16/Letter from insurance- Additional documentation not received from patient3/28/Letter from insurance- Requesting medical records from 1/2/to present4/4/Billing Service requested Medical Records to supply records - Not Sent4/15/Letter from insurance- requesting records - no follow up5/15/Letter from insurance- requesting records — no follow up5/18/EOB from insurance ~ file has been closed lack of requested informationNeed medicalrecords to reopen claim5/24/Call noted with patient - Records needed - Noted Work Item to Billing Services5/24/Comment by Billing Service patient needs to return claim statement and authorization toHCC5/26/Note by Consultant- Noted Work Item to Billing Services6/2/Note by Biller that we are in receipt of another letter6/2/Note by Biller she sent records to reopen file at HCC6/12/Note by Consultant - Noted Work Item to Billing Service6/12/Comment by Biller records sent6/13/Letter from Revdex.com6/16/Contacted [redacted] at HCC — do not send by fax, records need to be mailed6/19/Records sent USPS certifiedWe continually strive to provide excellent sendee to our patients and regret this situationShould you need to contact us for additional clarification, please call me at ###-###-####, jodv S [redacted] , Director of Billing Services at ###-###-#### or Joe D***, Supervisor, Health Information Management at ###-###-####.Sincerely,Kathleen S [redacted] Executive Director, Revenue CycleAttachments:Original Revdex.com Of Western Pennsylvania Letter