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Northwest Obstetrics & Gynecology Associates

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Northwest Obstetrics & Gynecology Associates Reviews (1)

This is in response to Ms***’s complaint When Ms [redacted] scheduled her initial appointment she was asked if her insurance was through the healthcare exchange (we are not providers for Aetna plans thru the healthcare exchange) Her insurance was through her mother and was an individual policy—not thru the exchange Individual policies vary as to what options the insured chooses to obtain Ms [redacted] asked if we were on her insurance plan and she was told that we are on her plan At no time was Ms [redacted] ever told that her visit would be paid in full She would have been told that she was covered by her insurance This means that at the time of her visit she did have insuranceBeing covered and having the insurance pay in full are two separate issues Being covered means that the patient does have insurance and the charges may be allowed per the contacted rate and are subject to the deductible and coinsurance It does not mean the charges will be paid in full When Ms [redacted] presented to the office there were numerous forms for her to complete; these forms were also made available on line prior to her office visit; which state frequently that it is ultimately the patient’s responsibility to know what their insurance coverage is and that they are responsible for all charges incurred Ms [redacted] signed all these forms It wasn’t until after her visit and it was determined that she had a viable pregnancy that her benefits were checked On October 5, she was sent a letter which explained her estimated financial responsibility for her pregnancy Her responsibility was estimated to be $after taking into consideration her deductible , coinsurance and out of pocket responsibility This amount was to be spread out over the course of months She was asked to make a $payment at her next appointment and to call the office with any questions On October 8, we received notification from the insurance company that they were not paying the charges for her September 4, visit due to the diagnosis(es) were not covered by her plan The patient would have received a copy of this notification from her insurance company also If she disagreed with her insurance companies determination she could have appealed this her insurance company She was sent statements with no response from her A final notice letter was sent on February 1, asking her to contact the office to make payment arrangements Again no response On February 25, @ 2pm a call was placed to the patient giving her the opportunity to make payment or set up a payment plan to avoid the account being turned over to our collection agency At that time she stated she would not pay the bill Ms [redacted] was given numerous attempts to contact the office to discuss her outstanding balance but this was not done in fact no contact was made to the office at all other than her sending us a release of her medical records in November of We do sympathize with Ms***’s predicament, but she was given ample opportunities to work with the office but made no attempt We do the best we can but ultimately it is the patient’s responsibility to know what their insurance covers and what their responsibility will be in regards to their insurance I am attaching all forms that Ms [redacted] signed prior to her appointment Also attached is a copy of the EOB from her insurance company

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Address: 3841 Trueman Ct, Hilliard, Ohio, United States, 43026-2496

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