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Prabhav Tella M.D., M.P.H.

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Reviews Prabhav Tella M.D., M.P.H.

Prabhav Tella M.D., M.P.H. Reviews (1)

January 18, 2013
Prabhav Tella, M.D., M.P.H.
7301 N. State Hwy. 161, Ste. 160
Irving, TX XXXXX

Attn: Ms. Julie Monson
Atlanta, GA XXXXX

RE: [redacted] Anthony, MRls Ordered by Dr. Tella and Administered by Touchstone Imaging 4-15-11
Over the past near-two-year-period, the issues of necessary and authorized medical care by Dr. Tella
and authorized procedure and billing by Touchstone have become an ordeal that has required
considerable patience and endurance for me as the unfortunate patient in all of this. An enormous
amount of time, energy, trouble, and expense have been required to search for the truth in the matter.
The fluctuating billed amount by Touchstone has been secondary to the principle of duly authorized
medical procedure and billing. Dealing with Anthem Blue Cross has not lessened the burden ofthings
and has added to aggravation in this matter, although I have grown to learn more about its process of
proper pre-approval and authorization for coverage of the procedure ordered by Dr. Tella.
I have made countless phone calls to all three parties in this matter. I have sent a number of emails to
the extent that email addresses where made available to me. And I have sent written communication to
each party including a milestone listing of key actions with dates in the provision of services and the
billing and insurance processing for them. I have also appealed to the sense of responsibility and
fairness with each of the three parties, asking for documentation of insurance authorization and
approval for the procedures.
And, after finally obtaining copies of medical records from Touchstone, I sent on December 10, 2012, a
final appeal letter for resolution and any further statements or documents from each of the three
parties. Copies were sent to all three via FedEx requiring signature at delivery, and postmail copies were
mailed as duplicate communication as well. FedEx billing for delivery with signature receipt was charged
to me on December 27,2012. Again, an over-abundance of time, energy, and expense from me alone to
try and resolve this. Yet today, I am no more informed than I was when I sent that final letter of appeal.
My letter only asked three questions, which were exactly:
* Did the physician who ordered the procedure-Dr. Prabhav Tella-either obtain or not obtain
proper pre-approval from my health insurance?
* Did the healthcare provider-Touchstone Imaging-either receive or not receive pre-approval
from my health insurance?
* Did the health insurance provider-Anthem Blue Cross-either approve or deny physician and
healthcare provider requests that the procedures be administered and payment covered
subject to any co-payor deductible sums?
I asked for a response within 10 days. I have received absolutely no response at all. So, here is what I
have to say, with copies not only to accompany complaints being filed with the
and all three credit reporting agencies:
1. An almost endless number of attempts to communicate with all parties in this matter have
received little or no response.
2. Based on documented entries in medical records received from Touchstone Imaging, no
authorization was received from Anthem Blue Cross for the second procedure (cervical spine
MRI) ordered by Dr. Tella.
3. Dr. Tella has not responded to my attempts to obtain official records documenting that his office
received authorization from Anthem Blue Cross for the second procedure, which has continued
to be billed to me over the past 21 months.
4. Touchstone has billed for the second procedure at different times for $460.37 (4-3-12), changed
to $1,215.00 (9-27-12) with a balance of $1,175.37 after a credit of $39.63 for the first
procedure was posted X-XX-XX but not shown until 9-27-12.
5. On 11-28-12, Touchstone again changed course and returned billing to $1,175.37.
6. In addition to this constantly changing course of direction, Touchstone damaged my credit for a
procedure for which it never received authorization by stating on its X-XX-XX billing "Collection
Pending," of which I had no knowledge in addition to the issue of billing for an unauthorized
7. later on 9-27-12 billing, a Touchstone entry back-dated to X-XX-XX showed "Collection letter"
and "Courtesy call made to patient" which I never received.
8. Regarding Dr. Tella, I would never have consented to any procedures he prescribed without
being advised that my insurance provider had approved the procedure and authorized payment
with an itemized explanation by the physician's billing staff. I am just the patient here, and alii
was told that Dr. Tella ordered procedures to be done by Touchstone without explanation of
whether one, two or more procedures were involved. Who am I to question a physician at such
a time? There is a level of trust and confidence at issue here, and those were not properly
handled by Dr. Tella and/or his staff.
9. Accordingly, I refuse to pay for a procedure not authorized by my insurance provider, not fully
explained to me to prevent me from receiving something which appears unnecessary, and which
subjected me to financial obligations for which there was no authorization by my insurer and
certainly not by me. If Touchstone wants any payment at all, Dr. Tella should be the one
responsible for what he ordered and did not secure authorization from the insurer or me.
This appears to be an unfortunate example of the abuse of trust and abuse of power by a physician and
a medical service provider toward a patient. Neither of these has put forth much effort to forthrightly
address the issues of responsibility and fairness concerning all the actions that have taken place in this
ordeal. In addition to the strain on my health along with the stress over principle and finances, I feel as
JAN 23 2013
if the physician just largely ignored my attempts to find out the facts and that the medical service
provider just kept billing me until the "bullying" was hoped to force me as the patient to relent and pay
no matter what has happened. What a sad commentary on what can happen to people depending on
physicians and related medical services for healthcare.
Enclosed for the sake of the and credit reporting agencies are copies of my December 10, 2012,
letter and the milestone of events listing provided to the parties in this matter. To the agencies, I
lodge my complaint about everything that has happened here with a desired resolution that all billing
cease and desist. To the credit bureaus, if any adverse actions have appeared on my credit report as a
result of this matter, I dispute the billing by Touchstone Imaging. Thank you.
rillien G. Anthony
Enclosures (to Cc addressees only; enclosed documents previously provided to main addressees)
Attn: Gina Rodriguez, Grievance/Appeals Associate
los Angeles, CA XXXXX-XXXX
PO Box 919
2014th Ave N., Ste. 100
Nashville, TN XXXXX
1601 Elm St., Ste. 3838
Dallas, TX XXXXX
(RE: Disputed Touchstone billing & any
collection activity reports)
(RE: Disputed Touchstone billing & any
collection activity reports)
(RE: Disputed Touchstone billing & any
collection activity reports)
(RE: Complaint for billing dispute &
business conduct by Touchstone,
HO'ed in Brentwood, TN)
(RE: Complaint for business conduct &
lack of responsiveness by Dr. Tella)

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Description: Health & Medical - General, Physicians & Surgeons - Medical-M.D.

Address: 825 W. Royal Ln., Ste. 230 Interventional Pain Solutions, PA, Irving, Texas, United States, 75039


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