Our Choice Medical PC

Review: I have full medical insurance (United Health Care) paid my employer and myself. At the Doctor's visit, I was told I need to pay co-pay and they will reimburse if the explanation of benefit say I do not have to pay. I came back with the explanation of benefit that I have a ZERO dollars amount for PREVENTIVE care, therefore I will need my reimbursement back. They said that they are still waiting for the insurance company to pay them my co-pay. This is a very deceptive practice (unethical) because customer are not suppose to pay Co-pay upfront and have the potential to bill both the customer and medical insurance as they are collecting the same payment at two different places.Desired Settlement: $25 Co-pay.

Business

Response:

To Whom It May Concern:

Please be aware that [redacted] was seen in office on June *, 2013.

According to the insurance policy and routine and customary practice in the vast majority of medical offices, co-payment of $25 was collected at the time of the visit. It was explained to [redacted] that if the doctor will bill this visit as a preventive care and after submitting the claim the insurance company would not apply the co-payment amount to this visit, he will be reimbursed.

On July [redacted] just walked into the office in the middle of the very busy and hectic day demanding an immediate refund after reviewing explanation of benefits (EOB) on the insurance company 's website. It was explained to him that it was impossible to issue a refund at this particular moment because the billing department, which handles all financial transactions, did not receive and review the EOB yet. It was also told to [redacted] that most likely it will be a matter of a few days to handle his request appropriately. But [redacted] was extremely upset with this answer and left the office very angry.

The EOB from his insurance company was received three days ago and a refund in the amount of $25 was mailed to [redacted] yesterday.

Please feel free to contact our office should you have any addi tional questions or concerns.

Sincerely,

Consumer

Response:

I did receive the check due to Revdex.com involvement. Thanks for your remediation.

There are few items from the letter that it is listed incorrect.

I visited the doctor's office around 6:00 PM and there were no customers. There were 4 office clerks. One was on the phone, one was training another employee how to input data onto the application, while another was filing paper. After the trainer finished with the training, I was able to speak to her.

After speaking with the trainer, I did show her my printed explanation of benefits (EOB) that it is listed with ZERO (0) co-pay and I would like my co-pay back. She informs me that she will not be able to give me anything until they receive payment from the insurance company. If the co-pay is listed as zero, doctor should not charge customer anything.

I explained to her what they are doing is unethical and I will file to the Revdex.com.

She did not tell me that it takes few days to handle my request. She simply said I will not get pay until they get pay by the insurance company.

Since I did receive my co-pay, I will treat this matter resolve thanks to Revdex.com's involvement.

Sincerely,