Oregon Urology Institute

Complaint: [redacted] I am rejecting this response because: Sincerely, [redacted] ***

January 17, 2018RE: Complaint ID ***01/18/12:I am in receipt of the above referenced complaint regarding a Billing disputeThis letter is in response to the complaintas a detailed summary of both verbal and written correspondence with the patient in question as well as both of hersons
who she has authorized to be her representatives in this matterI will also attempt to clarify some points on herservices and Insurance benefits.*Of note•• The complaint states "This has been going on for a few years"The account with our office does not reflect anysort of questions or concerns on any statements or balances prior to 2017.• The Medicare Advantage plan that patient is covered by has two co pay allocations depending on service with anMD ($40) or Physician assistant ($15).• The weekly service performed is done with our Nursing Staff with Supervision of either the ordering MD orPhysician Assistant per CPT /CMS coding guidelinesPatient informed of her benefit estimate for upcoming weekly service to be the MD copay as service wasschedule for the ordering Physician.No documentation of any questions or concerns on this informationPatient son called and spoke with Business Office wanting to know why the co pay being collected was $Theprocess was explained and it was agreed that patient could pay the lower $capay at cheknowing that if MDsupervises the treatment, there could be an additional balanceConference call made to patient and her son at their request with me (Billing Office) and Nurse Manager toexplain the different copays assessed by the insurance and how the service is billedAt the end of the call, everyoneseemed to understand and agree.MidDecPatient herself called and questioned balanceAccount was reviewed with each date that had a currentbalancePatient and son arrived in the office to ask again about balances and wanted to know where a specific check#was applied toWhile account was being reviewed, the patient's son made several statements about how they did nottrust our office, they felt like we were doing things incorrect and stated that they had contacted the insurance company.While trying to explain again about the billing process, he became quite agitated and it was agreed by him and myselfthat the conversation was over at that point and I would put a detailed report in the mail to the patientDetailed report was mailed to patient outlining all services for the entire year of Included on this was allclaims submitted with date of service, explanations of payments that were received and method of payment (cash,check or credit card) with dates, all insurance payments receivedFurther information provided was additional handwrittennotes to show when an overpayment made on one date of service was moved to a balance on a different date ofserviceDetail included a note on the date it was moved from and a note on the date it was moved toPatients son arrived in the office and apologized for previous interactionHe asked a couple specific questionson the detailed report as to where a check was applied toAt that time he let me know that we may be hearing fromthe Insurance carrierHe was fully encourage to contact the Health plan and have them do a three way call to our Officeso that we could all understand together and come to a final resolution on thisReceived a call from the patients other son who also had the same questions about the billingAll 2017services were reviewed on the phoneAgain a three way call with the Insurance carrier was encouraged so we couldresolve any mistrust or doubtPatients son came to the Office and paid current balance in fullReceived letter from Revdex.com outlining complaint.*It is understood that our statement and detailed reports can be confusing for patients to understandEverything wasexplained several times verballyThe report given to patient had additional notes to help clarify and they wereencouraged twice to have the Insurance do a three way call to assist with understanding.Please feel free to contact our office with any additional questions or concerns.Thank You,AngieOregon Urology Institute Business Office541-334-ex***541-746-4569fax***

Complaint: [redacted]
I am rejecting this response because:
Sincerely,
[redacted]