Pottstown Oral and Maxillofacial Surgery Associated Inc

Review: The provider, Pottstown Oral and Maxillofacial Surgery Associates, Inc (Address: [redacted], PA [redacted]) is billing an unwarranted service charge. No explanation was provided with the bill. The customer was actively working with the provider to resolve a medical bill with the insurance company up until the service charge was processed on 03-Mar-2014. The insurance company rejected the medical claim and the provider did not appeal the claim as requested. The medical bill was paid on 12-Mar-2014, and the customer submitted a formal appeal to the insurance company. This complaint is to highlight the provider's neglect by not taking all the appropriate steps to seek the insurance reimbursement for the customer and charging an unwarranted service fee.Desired Settlement: To remove the service charge of $9.80 from the bill.

Business

Response:

We performed surgery on the Customer's son on 10/1/13. His insurance company denied surgery stating it was not a covered since under his plan. An employee in our office called his insurance company and after being on hold for 25 minutes was again told that this was not covered under his plan even though when we called for benefits we were told it was covered. Our employee then called the Customer and told him to go to his Human Resources to have them check on their policy. Our computer system automatically charges a service charge after a claim is not paid in a timely manner.. This is a normal procedure for our practice. While this was being disputed with the insurance company the Customer paid the outstanding balance less the service charge to resolve this issue. His insurance company finally paid us on April 3,2014, at which time the service charge was reversed. This is now in the process of being returned to him. If you need anything further information please let me know

Consumer

Response:

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

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,