Perfect Color Tanning & Nail Salon Inc.

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
Regards,
*** ***

Deal Ms***: This letter is in response to *** ** ***'s Revdex.com complaint regarding the above date of serviceIn response to her concerns, we respectfully submit the following: The patient's spouse, *** ***, reached out to me on September 18, He advised me that he
had concerns that Medicare fraud had been committed because they were billed outside of AustinI asked a representative from our Service Center, *** ***, to review this patient's concern and to contact him with his findingsOn September 24, Mr*** called *** *** to discuss the concernMr*** was unable to reach the patient's spouse, but he did leave a detailed message advising him that the charges were listed by Humana Medicare as "non-covered," and that there was no expected reimbursement on the denied chargesDue to this these charges have now been written offUnfortunately, due to the low balance on this account, the Service Center's team did not receive this account in their queue to workHe left a strong apology on the message, as well as advised that a "zero balance statement" would be sent out in 2-business daysI have included a copy of the "zero balance statement" that was mailed out to the patient on September 30, Thank you for bringing this to our attention and allowing us the opportunity to review your concernsShould you need further information, please do not hesitate to contact me at the number listed below

Dear Ms. [redacted]: This letter is in response to [redacted]'s Revdex.com complaint regarding the above referenced date of service. In response to her concerns, we respectfully submit the following: We have reviewed Ms. [redacted]'s complaint and determined that on January 5, 2016 Ms. [redacted]'s...

insurance provider, Caloptima, was billed for her visit; however the claim was denied, leaving patient responsible for remaining balance $ 1,074.00. On April 28, 2016 Ms. [redacted]'s account was reviewed and it was determined that she qualified for a financial assistance program and the entire patient balance was written off, leaving the patient remaining balance of $0.00. On June 7th our financial counselor mailed Ms. [redacted] a letter notifying her of the $0.00 balance. Thank you for bringing this to our attention and allowing us the opportunity to review your concerns. Should you need further information, please do not hesitate to contact me at the number listed below. Sincerely,

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Regards,
[redacted]

Ms. [redacted] - please see the attached documents, which include:1.  our response letter 2.  calculations to assist in understanding how her insurance provider paid3.  a statement on her account4.  the Explanation of Benefits from her insurance provider.Our response letter is...

attached.  Of note; while our initial review is complete - Ms. [redacted]'s complaint is not resolved - as the claim has been sent back to their insurance provider for appeal.  As stated in our letter, we will continue to monitor through resolution. [redacted]Manager, Volunteer Services & Patient Relations919 E. 32nd Street, Austin, Texas  78705office  [redacted]cell  [redacted]fax  [redacted]www.stdavids.com Dear Ms. [redacted]:This letter is in response to [redacted]s’ Revdex.com complaint that was received at St. David’s Medical Center (SDMC) on November 29, 2016.In response to her concerns, we submitted a request for a thorough review to St. David’s Shared Service Center (SSC) in San Antonio. The Administrative Support Team Lead has thoroughly reviewed Ms. [redacted]’s concerns and we respectfully submit the following:6/25/16 Patient paid ‘estimated patient responsibility amount’ of $5,324.91.7/7/16 Aetna Insurance was billed for patient7/26/16 Aetna paid on claim, splitting total charges between TWO Explanations ofBenefits/Claims (EOB/Claim) Additional details and EOBs are attached.The first EOB/Claim, #[redacted] was paid, as expected, resulting in a patient responsibility of $1,450.80. Less the estimated amount due and paid at time of service of $5,324.91 – this would have resulted in a refund due to the patient of $3,874.11, as Ms. [redacted]s was advised. However – Aetna, the patient’s insurance provider (Aetna) split the total charges into TWO EOB/Claims, the second of which, #[redacted], includes charges, deemed by Aetna, as ‘non-covered charges”, thereby leaving a much greater than expected patient portion on the second EOB/claim..The SSC’s review detailed several calls which occurred between Aetna and the patient, and the SSC and Aetna over several weeks. In each case, only the first EOB/Claim number was mentioned thereby exacerbating the confusion. During this time, it was thought that a refund was due to Ms. [redacted]s (based only on the results of Aetna’s first EOB Claim) and the process for the refund was started. The Refunds Teams thoroughly reviewed the request for the refund in late November and discovered that Aetna’s second EOB/Claim for the same date of serviced indicated that the “Member plan excludes portion of services” resulting in a non-covered amount of $27,386.39. Therefore the refund, as calculated by taking into consideration only the first EOB/Claim was cancelled. At this time the SSC placed a request with the Appeals Team for review for possible appeal to Aetna. Based on the appeal inquiry, this account (including both EOB/claims) is still under review with Aetna, and we are waiting on final response regarding the ‘non-covered’ charges.The SSC has thoroughly reviewed every communication that occurred between all parties since the insurance payment process began and acknowledges errors in the internal review process resulting in incorrect information being provided to the patient, and for this we sincerely apologize. We will continue to monitor this concern through resolution.Thank you for bringing Ms. [redacted]s’ concerns to our attention and allowing us the opportunity to review his concerns. It is through feedback such as this that we are able to continually improve our service. Please provide Ms. [redacted]s’ with our contact information so that she may contact us directly.

This letter is in response to [redacted]'s Revdex.com complaint regarding the above date of service. In response to his concerns, we respectfully submit the following: We have reached out to our 3rd party collection vendor, Financial Corporation of America (FCOA), and asked them to...

review Mr. [redacted]'s concern in regards to his account appearing as a negative remark on his credit report. Kim Smith, a representative at FCOA, reported that Financial Corporation of America did not report the account to the credit agencies; therefore, a letter to credit agencies will not be necessary. At this time, we show a zero balance on the above referenced account. We apologize for any inconvenience you may have experienced while your account was in review. Thank you for bringing this to our attention and allowing us the opportunity to review your concerns. Should you need further information, please do not hesitate to contact me at the number listed below.

Please see attached response letter.