Physician Financial Recovery Services, LLC

We apologize for not making it clear that the list of printed
patient statements were from Dr*** ***’s office. The account was referred to PFRS on
7/17/PFRS sent notices on 07/17/and 7/28/On 7/30/PFRS
received a call from Mr*** that he received a letter from PFRS and
wanted to know why he got a collection letter for Dr***. Our office then proceeded to suspend Mr
***’s account and request the documents from Dr***’s officeDr
***’s office provided PFRS with a copy of the statement along with the
patient information sheet that was provided by Maui Memorial indicating that
Mr*** did not have any insurance at the time of serviceMr***
did not respond to any of the statements that Dr***’s office sent which
forced Dr***’s office to proceed with sending Mr*** to collections
Mr*** says Dr***’s office has access to
insurance information from via Citrix or other HIPAA-accessible network however
it is not their responsibility to search for a patient’s insurance
information. It is the patient’s
responsibility to provide insurance information or updated insurance
information to the doctor’s office at the time of service Mr*** can contact HMSA QUEST to make a
direct request and appeal the denial as Dr***’s request was denied as
previously mentioned (denial letter was previously provided)
Dr***’s office has agreed to have PFRS remove this account from the credit bureaus when
the account is paid in full and satisfied

Complaint: [redacted]
I am rejecting this response because: no mention was made on any written statements to me, that patient coverage status needed to be updated by the patent, at time of service.
At no time was I informed that I had to update [redacted]'s office individually, of my update to coverage. When his bill came, I called his office with my HMSA subscriber number, as all the others.
There were numerous other service providers that billed me, yet none of them sent me to collections except for [redacted]'s office. I find it difficult to believe that with all of the resources his office -- and all medical healthcare providers -- had at their disposal (access to HIPAA data), that this whole conflict is somehow my responsibility. When I received a bill, I responded to it, all back in summer 2013. If you need a list of the other service providers that seemed to bill HMSA just fine despite my not having to contact them twice, respond in kind to this rebuttal.
Sincerely,
[redacted]

Mr. [redacted] did not provide
the doctor’s office ([redacted] MD) with any insurance information at the time
of his visit therefore they were not able to...

file an insurance claim at that
time (date of service was on 5/10-5/14 2013). Numerous statements were
mailed to Mr. [redacted] from 5/22/13 through 9/4/2014. M. [redacted] provided PFRS with his HMSA/QUEST information on
9/3/2014. This insurance information was provided to the doctor's office and on 9/8/2014 an electronic submission was made to QUEST.  The insurance claim was denied due to the filing deadline was not submitted within 365
days from the date of service (copy of HMSA letter provided). On 11/3/2014 the doctor's office tried to file a deadline waiver and this submission was also denied as past filing deadline.
The balance of $916.00 is due by Mr. [redacted] as the doctor's office has tried to remedy this situation prior to the insurance filing deadline.  Please direct Mr. [redacted] to PFRS to make payment arrangements.