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Primary Residental Mortgage, Inc.

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This letter is being sent in response to a complaint that was filed against our medical practice; the ID # [redacted] was assigned to this complaint. My apologies for the one day delay in responding within 5 business days but I...

was on vacation last week and I, just today, have been able to respond to matters that were put on my desk last week.
The complainant has stated that an appointment with Dr. Philip B[redacted], on 9/29/14, was not approved by Medicare but the service was covered by her primary carrier, Anthem Blue Cross and Blue Shield. The balance after Medicare considered the claim and after the Anthem adjustment was $25.00. We did, in fact, bill the patient for the balance, due to the fact that the patient had never informed us that she was on Medicaid. The patient never mentioned, during the course of several conversations with her, that she had Medicaid and was therefore not liable for the balance. Once we determined that she was Medicaid we immediately adjusted off her balance and she is no longer being held responsible for the $25.00 balance on this date of service.
At no time was she treated rudely or spoken to with disrespect (obviously this would be her translation of the conversations vs our translation). It would have been helpful if the patient had just made it known that she was eligible for Medicaid and the whole incident would have been solved immediately.
So, for the sake of this complaint, please note that the patient is no longer being billed for the balance due after the payment by Anthem. Please, also note, the service code billed, 90215, does not have to be billed based on the amount of time spent on the visit but was billed due to the extent of the complexity of the visit per the physician's documentation.
I am hopeful this information will serve to satisfy the patient's complaint. Please let me know if you are in need of anything further from me regarding this issue.
Sincerely,
Leanne C[redacted], Office Manager%3

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