Northeast Implant & Oral Surgery, P.C.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
The only reason I am accepting this resolution is because the company has sent me a refund which I received on 11/14/The information that the doctor sent is completely incorrectMy daughter's date of service was 7/15/2016, not 10/12/as stated in the responseThe insurance never sent an $refund, since I have access to all the information on line as to when claims are processedThis business billed my primary insurance in July but some of the codes were incorrect so they had to resubmit mid AugustMy insurance sent their check for $1,629.40,on 8/31/That payment was not processed until 9/26/ Then my secondary insurance was billed in OctoberPer my insurance information $was paid to the business on 10/10/Therefore our insurance responded quickly to the claims madeThe processing time for this business is unacceptableI find the answer from the business unacceptable since they are using information that is not correctI had a similar experience when my youngest daughter had oral surgery in 12/The insurance paid the business and they billed meThe bill that I received was different from what they billed my insuranceWhen I called my insurance they told me they had paid the claim and that I should get a refund from this providerI called the provider advised them I received a bill and I checked with my insurance company who stated I should receive a refundThe providers office stated that they had not processed refunds yetIt was a month after my insurance company had sent their paymentThis provider needs to review his business practices since there is always confusion with their billingThe patient is always made to pay large amounts for a procedureEven though insurance company's give a preauthorization of what will be paid, that amount is never taken into accountIf it was, I would not have paid them $of which they refunded me $four months after the procedure was doneIf it had not been for the excellent surgeon that took care of my first daughter in December of I would not have returned for my older daughter in July of due to their billing practicesAlthough I am saddened that that wonderful surgeon left this practice I am glad I will not have to deal with this provider again, even though my daughter will need oral surgery againI will definitely not recommend this provider to anyone
Sincerely,
*** ***

We received an $85 payment for the patient in question for her 10/12/15 date of service.  However that claim was processed and paid as services rendered for the subscriber instead of his daughter therefore the member is not due money that was paid incorrectly.  We notified his insurance...

company of that error and requested for the claim to be reprocessed correctly.  We were told by the insurance company that the refund request for that incorrect payment was generated but unfortunately never received by our office.  A call was placed to the subscribers insurance company on 10/19/16 and we were informed that when a requested refund is not received within the applicable timeframe, an auto-deduct is generated and withdrawn from future insurance payments.  Sadly, the insurance company’s’ auto-deduct was left in their queue unprocessed, as well as the corrected claim for the dependant.  The representative stated that she would send in the request to have said auto-deduct and corrected claim processed and that would take up to 30 days.  Without a clear explanation of whether that auto-deduct would be withdrawn from future claims processed for the subscriber’s family or from a remittance for a different member, we were unable to close this account.   We sympathize with the subscriber but we are at the mercy of his insurance company and the frustration should be directed at them. Two more calls were placed to his insurance company on 11/7/16 to find out the progress of their auto-deduct process.   It wasn’t until after speaking with the second representative in great length that she was able to have the original overpayment request for $85 faxed to our office.   That refund request was given to the bookkeeper upon receipt and has since been issued to his insurance company.  We received and applied the payment from the patients’ secondary insurance company on 10/28/16, which was well over 90 days since the services were rendered.  The member paid $633 towards the 7/15/16 date of service and according to the secondary insurance, had a $40 financial responsibility.  His refund of $593 was issued on 11/9/16, which was twelve days from receipt of the last insurance payment and far less processing time than the insurance payment.