Noriega House

This person came in for an evaluation and it was determined he needed to have lesions removed from both of his eyesHe needed to come back for this procedure because his insurance had to be contacted to see if prior authorization was needed for the procedure he wantedWhile checking to see if a
prior authorization was needed, a quote of benefits was also obtainedThere was no charge to the patient for the initial evaluationAs with all medical insurances, when benefits information was obtained from his insurance company, it came with the disclaimer: "A quote of benefits and/or authorization does not guarantee payment or verify eligibilityPayment of benefits are subject to all terms, conditions, limitations, and exclusions of the member's contract at time of service." Prior to receiving any services, he also signed a Financial Agreement (copy attached) which states "If copayments and/or deductibles are designated by my insurance company or health plan, agree to pay them to Eye Surgical Medical Associates." At no point was the patient guaranteed that he wouldn't receive a bill after his insurance processed his claimBased on the information provided to us by the insurance company, we collected a particular amount from this patient for his deductibleHe received services from the physician and was satisfied with the outcome of the procedure.When the claim was processed by his insurance company, more was applied towards his deductible than was anticipated, leaving the patient with a balanceAfter receiving his first bill, he called the billing office, stating that it was our problem if we didn't collect the full amount upfront, and that he refused to payThe billing manager tried explaining the above to the patient, but hung up on him when he started using profanity towards her.Recently, the patient called to schedule an appointment, and was connected again with the billing department since he is in a collections statusHe and the billing manager spoke again at lengthThe billing manager reviewed the above position, the patient continued to state that if the correct amount was not collected upfront the practice did not have the right to bill him (even though those terms were agreed to in writing)When he was informed that the past due balance Would not be adjusted, he started making threats that he would blast the practice all over social media, report us to the authorities, and destroy the practiceAt that point the conversation was ended