Neuropsychiatric & Counseling

Revdex.com spoke with [redacted] from the company and she stated that at the time of the service the consumer did not tell them she wanted to be a cash pay patient and paid the co pays and they confirmed her benefitsThey billed the consumer's insurance company and did not hear back from them until December [redacted] stated that the insurance company and their company sent the consumer a letter and they did not hear back from the consumer until May when they were told they should have told the consumer about the high deductible [redacted] stated that she explained to the consumer to be more aware of the insurance policy they have and they were not aware the consumer was a cash pay patient and they cannot change it once it has been submitted to the insurance company

Revdex.com:
I have reviewed the offer 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
The business is acknowledging a "lower price available", but that I was not intelligent enough to ask for it. At the next appointment I will insisting on paying the "cash price" as I wanted to initially. This business is unethical in trying to deceive people into paying higher pricing & fudging the truth. We have had a high-deductible health insurance plan for many years & know how it works. This isn't our 1st-time around the block, this business office is simply unethical in dealing with patients financial matters
Regards,
*** ***

Revdex.com spoke with [redacted] from the company and she stated that at the time of the service the consumer did not tell them she wanted to be a cash pay patient and paid the co pays and they confirmed her benefits. They billed the consumer's insurance company and did not hear back from them until December...

2013. [redacted] stated that the insurance company and their company sent the consumer a letter and they did not hear back from the consumer until May 2014 when they were told they should have told the consumer about the high deductible. [redacted] stated that she explained to the consumer to be more aware of the insurance policy they have and they were not aware the consumer was a cash pay patient and they cannot change it once it has been submitted to the insurance company.

Review: The billing staff ignored the request for 'cash' or 'self-pay' pricing and insisted on billing an office visit to our insurance carrier. This resulted in paying $137.79(negotiated price) instead of $85, the self-pay price.In addition, the staff waited almost a year to bill for the balance, and when I questioned this was not billed as "self-pay" price(for those who do not have, or opt not to use insurance) in this case, they implied I would be committing insurance fraud. My health insurance is a "high deductible/catastrophic coverage" plan, most everything is paid out-of-pocket. The billing staff completed disregarded this advisement & billed our insurance.This office offers "service X" for an $85 "self pay" fee, but instead they elected to run our insurance, which pays nothing, yet has a contract price of $137.79 for the exact same service & procedure-code.Desired Settlement: Would like to pay the self-pay price, as was initially inquired about, but ignored.Chart # [redacted] - Statement date 05/05/14 - Service Date 07/10/13

Business

Response:

Revdex.com spoke with [redacted] from the company and she stated that at the time of the service the consumer did not tell them she wanted to be a cash pay patient and paid the co pays and they confirmed her benefits. They billed the consumer's insurance company and did not hear back from them until December 2013. [redacted] stated that the insurance company and their company sent the consumer a letter and they did not hear back from the consumer until May 2014 when they were told they should have told the consumer about the high deductible. [redacted] stated that she explained to the consumer to be more aware of the insurance policy they have and they were not aware the consumer was a cash pay patient and they cannot change it once it has been submitted to the insurance company.

Consumer

Response:

I have reviewed the offer 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.

The business is acknowledging a "lower price available", but that I was not intelligent enough to ask for it. At the next appointment I will insisting on paying the "cash price" as I wanted to initially. This business is unethical in trying to deceive people into paying higher pricing & fudging the truth. We have had a high-deductible health insurance plan for many years & know how it works. This isn't our 1st-time around the block, this business office is simply unethical in dealing with patients financial matters.

Regards,