Orthopaedic & Spine Specialists

September 9, 2015Dear [redacted] : OSS received this complaint and we have investigated the situation [redacted] did receive statements which she should not have receivedOSS would like to apologize for thatWe are working to correct the problemI will try to highlight what has happened since [redacted] received services on 9/22/14.• 9/22/ [redacted] received durable medical equipment (DME) • 10/3/ [redacted] was electronically sent a statement for the DME • 10/17/ [redacted] denied the bill as "not payable by this provider" - OSS verified that was incorrect • 11/17/OSS rebilled [redacted] • 12/5/ [redacted] denied the bill as "not payable by this provider" - OSS worked directly with [redacted] and verified the bill should be covered and paid to OSS • 1/15/OSS rebilled [redacted] • 1/23/ [redacted] denied the payment for "billed to incorrect payer" [redacted] did not give OSS the payer to bill so we investigated and determined a third party Company Called " [redacted] " was to be billed for the DMEThis took some time to find the correct company to bill• 4/2/" [redacted] " added as a payer source to [redacted] 's account [redacted] was billed for the DME • 6/3/ [redacted] had not yet paid for the DME or denied itIn the usual course of business, billing statements were runThe electronic medical record system OSS uses somehow changed the responsible party for this bill to [redacted] rather than [redacted] A bill was sent to [redacted] This was the first bill that was sent to [redacted] Since that time [redacted] has called our billing company and has made us aware of thisOSS has changed the responsible party back to [redacted] more than onceWhen we manually make the change it is not holding in the system and the electronic system is converting it backThat puts the account in queue for another bill to be sent the next billing cycleThat has resulted in [redacted] receiving monthly bills, although we have changed the responsible payer in our systemWe have identified this problem with other patients and payers and are working with our software vendor for our system to rectify thisWe do apologize for the inconvenienceIn the complaint, [redacted] was concerned about her creditThat is understandableOSS does not send any patients to collections until there have been missed paymentsAt that time we send the bill to a collection agencyIt is at the discretion of that agency to report the collection attempt in a manner that will show up on someone's credit reportOSS is aware that this is a computer software glitch and because of that, is not forwarding the matter to the Collection agencyWe have also made a special note in [redacted] 's account not to Send her account to collectionsI hope that will make her more comfortableAs to date, OSS has not received payment for the DMEWe continue to pursue this to rectify it both for [redacted] and OSSI hope this answers the complaint to your satisfactionWe are pleased that [redacted] has kept us informed of the problem and we are sorry that we did not meet her expectationsIf you need any further information or clarification, please feel free to contact meSincerely, Carla PMSN RN NE BC CCDirector of Quality and Risk Management

September 9, 2015Dear *** ***:OSS received this complaint and we have investigated the situation*** *** did receive statements which she should not have receivedOSS would like to apologize for thatWe are working to correct the problemI will try to highlight what has happened since ***
*** received services on 9/22/14.• 9/22/*** *** received durable medical equipment (DME)• 10/3/*** was electronically sent a statement for the DME• 10/17/*** denied the bill as "not payable by this provider" - OSS verified that was incorrect • 11/17/OSS rebilled *** • 12/5/*** denied the bill as "not payable by this provider" - OSS worked directly with *** and verified the bill should be covered and paid to OSS• 1/15/OSS rebilled ***• 1/23/*** denied the payment for "billed to incorrect payer" *** *** did not give OSS the payer to bill so we investigated and determined a third party Company Called "** *** *** ***" was to be billed for the DMEThis took some time to find the correct company to bill.• 4/2/"** *** *** ***" added as a payer source to *** ***'s account*** was billed for the DME• 6/3/*** had not yet paid for the DME or denied itIn the usual course of business, billing statements were runThe electronic medical record system OSS uses somehow changed the responsible party for this bill to *** *** rather than ** ***A bill was sent to *** ***This was the first bill that was sent to *** ***.Since that time *** *** has called our billing company and has made us aware of thisOSS has changed the responsible party back to ** *** more than onceWhen we manually make the change it is not holding in the system and the electronic system is converting it backThat puts the account in queue for another bill to be sent the next billing cycleThat has resulted in *** *** receiving monthly bills, although we have changed the responsible payer in our system.We have identified this problem with other patients and payers and are working with our software vendor for our system to rectify thisWe do apologize for the inconvenience.In the complaint, *** *** was concerned about her creditThat is understandableOSS does not send any patients to collections until there have been missed paymentsAt that time we send the bill to a collection agencyIt is at the discretion of that agency to report the collection attempt in a manner that will show up on someone's credit reportOSS is aware that this is a computer software glitch and because of that, is not forwarding the matter to the Collection agencyWe have also made a special note in *** ***'s account not to Send her account to collectionsI hope that will make her more comfortableAs to date, OSS has not received payment for the DMEWe continue to pursue this to rectify it both for *** *** and OSS.I hope this answers the complaint to your satisfactionWe are pleased that *** *** has kept us informed of the problem and we are sorry that we did not meet her expectationsIf you need any further information or clarification, please feel free to contact me.Sincerely,Carla P. MSN RN NE BC CCDirector of Quality and Risk Management

September 9, 2015Dear [redacted]:
OSS received this complaint and we have investigated the situation. [redacted] did receive statements which she should not have received. OSS would like to apologize for that. We are working to correct the problem. I will try to highlight what has...

happened since [redacted] received services on 9/22/14.• 9/22/14 [redacted] received durable medical equipment (DME)
• 10/3/14 [redacted] was electronically sent a statement for the DME
• 10/17/14 [redacted] denied the bill as "not payable by this provider" - OSS verified that was incorrect
• 11/17/14 OSS rebilled [redacted]
• 12/5/14 [redacted] denied the bill as "not payable by this provider" - OSS worked directly with [redacted] and verified the bill should be covered and paid to OSS
• 1/15/15 OSS rebilled [redacted]
• 1/23/15 [redacted] denied the payment for "billed to incorrect payer" [redacted] did not give OSS the payer to bill so we investigated and determined a third party Company Called "[redacted]" was to be billed for the DME. This took some time to find the correct company to bill.
• 4/2/15 "[redacted]" added as a payer source to [redacted]'s account. [redacted] was billed for the DME
• 6/3/15 [redacted] had not yet paid for the DME or denied it. In the usual course of business, billing statements were run. The electronic medical record system OSS uses somehow changed the responsible party for this bill to [redacted] rather than [redacted]. A bill was sent to [redacted]. This was the first bill that was sent to [redacted].
Since that time [redacted] has called our billing company and has made us aware of this. OSS has changed the responsible party back to [redacted] more than once. When we manually make the change it is not holding in the system and the electronic system is converting it back. That puts the account in queue for another bill to be sent the next billing cycle. That has resulted in [redacted] receiving monthly bills, although we have changed the responsible payer in our system.
We have identified this problem with other patients and payers and are working with our software vendor for our system to rectify this. We do apologize for the inconvenience.
In the complaint, [redacted] was concerned about her credit. That is understandable. OSS does not send any patients to collections until there have been 4 missed payments. At that time we send the bill to a collection agency. It is at the discretion of that agency to report the collection attempt in a manner that will show up on someone's credit report. OSS is aware that this is a computer software glitch and because of that, is not forwarding the matter to the Collection agency. We have also made a special note in [redacted]'s account not to Send her account to collections. I hope that will make her more comfortable. As to date, OSS has not received payment for the DME. We continue to pursue this to rectify it both for [redacted] and OSS.
I hope this answers the complaint to your satisfaction. We are pleased that [redacted] has kept us informed of the problem and we are sorry that we did not meet her expectations. If you need any further information or clarification, please feel free to contact me.
Sincerely,
Carla P. MSN RN NE BC CCDirector of Quality and Risk Management