NeuroCognitive Institute

We would like to inform you that we did not refuse to work with *** ***. Patient has out of state insurance so all communication is being done with *** NJ and then ***NJ is sending message to his homeplanClaim was first received by *** on 9/8/and was finalized on
9/16/with EFT trace number *** stating these services (Date of service: 8/22/billed amt $768.80) are ineligible as they are not considered medically necessary. Next action item on our part, is to rebill this with corrected diagnosis codeWe use other code based on the result of evaluation with patient. Second denial was received on 10/24/14 stating this service is investigative procedure not a benefit. We presented them all diagnosis codes based on the result of the testBut still they denied the claims on Dec 5, with EFT trace number ***On January 8, 2015, one of our staff called *** to follow up the denial. We were advised that they need medical report showing medical necessity of the procedure and fax it to *** ATTN: *** Medical records DeptRef# ***Advised to follow up business days to finalize We did sent the medical records on that day. On 2/18/ we followed up with *** out of state provider service to check status of the claimThe csr said they did not yet forwarded the records to the homeplanPer *** R, she will be forwarding it to the homeplan and it would take about 7-business days to follow upRef# ***. We called *** today per *** medical records were not sent properly and she sent again the medicalrecords to the homeplan and it would take business days to finalize. She advised we can follow up with them on Tuesday if the reports were sent properly to the homeplanRef# ***We are billing the patient for this service on 8/22/with discounted rate of $because of the denial we are receiving from his insurance. If ever the insurance will pay us for the service we provided to the patient, we are returning the full amount of payment he made for that service. We have a signed agreement with patient signed on 6/23/stating that he agreed to pay for services and tests not covered by his insurance plan

Review: This company , scheduled me , without my knowledge for therapy appointments with less then one days notice . The first time I was available , and agreed while I also explained I needed more then one day notice . I spoke to the treating provider at the appointment and was told " yea , we have problems with our scheduling " . The second time I told them , I could not keep the appointment , was told it would be cancelled , the day of the appointment was called by a male and asked if I was coming as it was past the time of my appointment . I explained to this person what happened and that I already told them I was unable to make the appt d/t short notice . He said again " Yea, we have problems with the scheduling here " and giggled but assured me the appt was cancelled , Today, 10/20/15 I get a bill for an additional $75 for a missed appt . I cancelled this when they called me . The day of the appt I was told they would make sure it was cancelled . Now I get a bill for a no show .Desired Settlement: I don't think I should have to pay for a no show appt when 1. The co called me telling me less then 24 hours before the appt that I had an appt 2. I cancelled the appt , technically twice

Business

Response:

After conducting an investigation on the brought up matter, We have found out that the error was made on our end. The scheduling team endorsed Ms. [redacted] to the Finance Dept. to be charged for the 19th of September missed appointment for the reason that the patient had come to a decision to stop being rescheduled. This charge was included on the patient statement on Oct 15, 2015. We have tried getting in touch with the patient couple of times to inform her that the missed appointment charge was already waived and sanctions will be given to those who have committed their errors, which may have caused her inconvenience. Unfortunately, we are only reaching her voice mail. Pls see file attached to see the call history of the Finance Dept made to her mobile. We do not have her email address on file so we can not send her an email.We are extending our sincerest apology to the patient, Ms. [redacted], and would like to inform your party, as well, that we are taking this issue seriously.We are committed to providing exceptional service to all our clients, and for that, we are putting sanctions to those who have committed their errors on this case, regardless of the position. We are re-training them as well and will strictly impose the 48-hr notice to all the schedulers.Hope this concludes the case.Thank you so much for bringing this up.

Review: This company has refused to work with my health insurer. According to [redacted] my health insurer they are using the wrong codes. [redacted] via a case I initiated to rectify the situation has tried to reach out to them and this company will not talk to them. I'm the main insured and my son Jeffrey was the patient. This is for services dated 8/22/14 charging $545.00. Please try and get them to work together to resolve this billing issue.Desired Settlement: I would like this company to reissue bill to [redacted] with correct codes so that [redacted] can make their payment and then I can pay the balance.

Business

Response:

We would like to inform you that we did not refuse to work with [redacted]. Patient has out of state insurance so all communication is being done with [redacted] NJ and then [redacted]NJ is sending message to his homeplan. Claim was first received by [redacted] on 9/8/14 and was finalized on 9/16/14 with EFT trace number [redacted] stating these services (Date of service: 8/22/14 billed amt $768.80) are ineligible as they are not considered medically necessary. Next action item on our part, is to rebill this with corrected diagnosis code. We use other code based on the result of evaluation with patient. Second denial was received on 10/24/14 stating this service is investigative procedure not a benefit. We presented them all diagnosis codes based on the result of the test. But still they denied the claims on Dec 5, 2014 with EFT trace number [redacted]. On January 8, 2015, one of our staff called [redacted] to follow up the denial. We were advised that they need medical report showing medical necessity of the procedure and fax it to [redacted] ATTN: [redacted] Medical records Dept. Ref# [redacted]. Advised to follow up 30 business days to finalize. We did sent the medical records on that day. On 2/18/14 we followed up with [redacted] out of state provider service to check status of the claim. The csr said they did not yet forwarded the records to the homeplan. Per [redacted] R, she will be forwarding it to the homeplan and it would take about 7-10 business days to follow up. Ref# [redacted]. We called [redacted] today per [redacted] medical records were not sent properly and she sent again the medicalrecords to the homeplan and it would take 30 business days to finalize. She advised we can follow up with them on Tuesday if the reports were sent properly to the homeplan. Ref# [redacted]We are billing the patient for this service on 8/22/14 with discounted rate of $525 because of the denial we are receiving from his insurance. If ever the insurance will pay us for the service we provided to the patient, we are returning the full amount of payment he made for that service. We have a signed agreement with patient signed on 6/23/14 stating that he agreed to pay for services and tests not covered by his insurance plan.