Complaint acknowledged. I have taken action to ensure that no further billing or collections calls will be made to the identified company phone number.
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]
The patient came into the ER May 27th and again on June 2nd for injuries sustained on 5/16/2015. At the time of original billing, we were not given his Auto insurance information. As such, his health insurance was inappropriately billed. Humana is NOT the primary...
health insurer. When we received updated information, we sent a courtesy bill to USAA and then sent the patient statements for the visits: 1) $475.00 for the May 27th Date of Service and 2) $375.00 for the June 2nd Date of Service. USAA adjudicated the claim and sent a check for $451.25 to the patient (attached EOB indicates 9/5/2015) and another check for 356.25 (attached EOB indicates 8/10/2015). These reduced amounts were the result of a contract. USAA confirmed with us on February 24th 2016 that both checks were cashed. We contacted the patient on 3/2/2016 and informed the patient of this sequence of events and that USAA paid the patient directly. Since we have the two EOBs already from USAA, we will accept the amount paid by USAA to the patient as payment in full. I agree that Humana has not yet pulled the money. Because Humana is secondary, when we receive payment from either the patient or USAA, we are legally obligated to return any and all funds received by Humana. Knowing this, when we received notice that USAA was primary, we set the money aside to ensure we are ready to refund the insurance immediately upon payment. Unfortunately, the phone representative (not the provider) was new and did not understand the ledger entries. We have subsequently provided the representative education. Still, this does not negate the fact that the patient owes in total $807.50. There is no error. If this total amount has been paid already to the credit agency, that payment would have occurred in the last month and we have not yet been given notice (we receive monthly statements).
Complaint acknowledged. I have taken action to ensure that no further billing or collections calls will be made to the identified company phone number.
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]
The patient came into the ER May 27th and again on June 2nd for injuries sustained on 5/16/2015. At the time of original billing, we were not given his Auto insurance information. As such, his health insurance was inappropriately billed. Humana is NOT the primary...
health insurer. When we received updated information, we sent a courtesy bill to USAA and then sent the patient statements for the visits: 1) $475.00 for the May 27th Date of Service and 2) $375.00 for the June 2nd Date of Service. USAA adjudicated the claim and sent a check for $451.25 to the patient (attached EOB indicates 9/5/2015) and another check for 356.25 (attached EOB indicates 8/10/2015). These reduced amounts were the result of a contract. USAA confirmed with us on February 24th 2016 that both checks were cashed. We contacted the patient on 3/2/2016 and informed the patient of this sequence of events and that USAA paid the patient directly. Since we have the two EOBs already from USAA, we will accept the amount paid by USAA to the patient as payment in full. I agree that Humana has not yet pulled the money. Because Humana is secondary, when we receive payment from either the patient or USAA, we are legally obligated to return any and all funds received by Humana. Knowing this, when we received notice that USAA was primary, we set the money aside to ensure we are ready to refund the insurance immediately upon payment. Unfortunately, the phone representative (not the provider) was new and did not understand the ledger entries. We have subsequently provided the representative education. Still, this does not negate the fact that the patient owes in total $807.50. There is no error. If this total amount has been paid already to the credit agency, that payment would have occurred in the last month and we have not yet been given notice (we receive monthly statements).