Pinnacle Health Hospital

We are doing further investigation of the claim The account was referred to our surgical services department to review the coding and we are waiting for their response We are hoping to receive a response no later than Fri, 7/28/but will notify you with results as soon as we receive it

We offer a 20% prompt pay discount when patient's pay their co-pay prior to or at time of service Since the co-pay amount for the Emergency Room is $per her insurance coverage we will make an exception and honor the 20% discount which is $and the patient will be responsible for $

------ Forwarded message ----------From: Sharon C***Date: Fri, Apr 21, at 9:AMSubject: FW: ID# ***To: "*** The patient contacted our Business Office regarding her visit to PinnacleHealth *** *** *** Emergency Room on January 4, 2017. Her concerns were
immediately forwarded to the Clinical Manager of the Emergency Services for his review. The patient received a letter from the Customer Relations Department on 4/7/stating her concerns were forwarded to the appropriate department managers for their review. Another letter was mailed to the patient on 4/13/with the results of the review. The clinical manager reviewed her record and according to documentation in the triage area the patient was assessed, protocol orders placed and labs were drawn. For that reason, they did not recommend that the charges be reduced or written off. The charges were appropriate for the services rendered. The Customer Relations Department did apologize for the wait which she endured but due to the flu season there was an increase in volume and the Emergency Departments were doing their best to get their patient’s treated in a timely manner. The insurance company assigned an Emergency Room visit co-pay in the amount of $100. That amount is also shown on the front of her insurance card. The patient should have also received an explanation of benefits from her insurance company. Sincerely Sharon C***ManagerPinnacleHealth Patient Financial Customer RelationsPO Box ***Harrisburg, PA ***###-###-#### Office###-###-#### Fax

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed as Answered]
Complaint: ***
I am rejecting this response because:I will pay 50% but nothing more Pinnacle needs to own the mistake that they made and the mis-information I was given I will pay 50% of $80, so $ That is all I am willing to pay
Regards,
*** ***

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed as Answered]
Complaint: ***
I am rejecting this response because:I see the "skin Tag " coding has finally been removed THANK YOU! But now, I have still have to question line #I see a code of: "MSD The allowable amount for this surgery has been reduced in accordance with guidelines for payment of multiple surgeries on the same day"There were NOT multiple surgeries done on the same daySeems to me this is a sneaky way of still getting around charging me for something that wasn't done! All you did was remove the coding BUT NOT the CHARGESThere was one surgery done that day ONLY ONE!!!! Please correct this!!! Line # needs to be REMOVED ENTIRELY.
Regards,
*** * ***

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 since once the collection is paid, it will be removed from my credit reportThey still need to learn more about customer service skills and fix their billing issues.
Regards,
*** ***

After the case was reviewed the billing code that was to be updated did not get 100% completed. We apologize for the resubmitted claim not being fully updated. I contacted our billing department today and the claim was rebilled on 8/24/17. Our billing department called *** *** and was told that the claim is being finalized today (8/30/17)If the patient has not met her deductible her insurance may assign her a portion of patient responsibility even after they receive the resubmitted claim. As a courtesy we will offer a 15% discount off of the fully assigned patient responsibility amount for this date of service. As previously stated please feel free to reach out to us with any further questions.Della M***, Director Patient Financial Support ServicesSharon C***, Manager Patient Financial Customer Relations

We are doing further investigation of the claim.  The account was referred to our surgical services department to review the coding and we are waiting for their response.  We are hoping to receive a response no later than Fri, 7/28/17 but will notify you with results as soon as we...

receive it.

April 13, 2016We reviewed the billing for services rendered to the patient in January and February 2014. Both of the patient's insurances were properly billed. The amounts billed to the patient, which total $221.54, were patient responsibility as determined by patient's insurances. These amounts...

would be substantiated by the Explanation of Benefits that patient received from patient's insurance. The address on file may not have been patient's current address, but our efforts to contact the patient in regard to this debt included 21 calls to the phone number noted on the filing to the Revdex.com. On 6/2/2014 we spoke to the patient and patient said they would be paying the balance on 6/8/2014. When this payment was never received, the accounts were then sent to an outside collection agency and they commenced to call the same telephone number for 40 times over a 9 month time period with still no answer or return call. That agency returned the accounts to us in August 2015, based on our timing protocol, and the accounts were then sent on to a second collections agency where they now reside.Since this is a valid debt, we have no reason to recall it from collections. Once the debt is paid, it will no longer be reflected on the patient's credit report, which will meet the requirement of the mortgage Company.Please feel free to call me for further clarification.Sincerely,Patrice *. TVice President, Revenue Cycle

We offer a 20% prompt pay discount when patient's pay their co-pay prior to or at time of service.  Since the co-pay amount for the Emergency Room is $100.00 per her insurance coverage we will make an exception and honor the 20% discount which is $20.00 and the patient will be responsible for $80.00.