Progressive Medical Associates Pllc

An investigation was conducted and we have verified that a refund check was not received by the Complainant A refund check was issued and overnighted A senior administrator called to apologize for the situation and Complainant was informed of the overnight envelope and delivery date Complainant acknowledged receipt of the check on January 9th and expressed sincere thanks for fixing the problem

We have thoroughly reviewed the account records and have found them to be inconsistent with this complaint. We have asked Complainant to provide a copy of applicable EOBs for the first insurance (***) along with the payments he received directly from *** for the out-of-network
claims. Since he did not comply, we cannot submit a claim to any secondary payer. After numerous attempts by mail and telephone, we turned the accounts to a third party collection agency. If Complainant provides the necessary EOBs and associated payments he received and cashed from the *** we will work with our collection agency to resolve this account

[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.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID***, and find that this resolution would be satisfactory to me. I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.The senior administrator was sincere and helpful while reaching out to resolve the problem
Regards,*** ***

This business is unethicalSeriously, if you are billing company involved with the billing of medical services obviously something is very wrong if you are not contracted with one of the largest insurance companies in the state of ArizonaI was in OB triage and got a bill for a doctor that I DIDNT EVEN SEE ONCEI got charged $for this doctor that didnt even have the decency to see meWhen I asked why I'm paying such a giant bill for services I didnt receive they just told me "that is how it works and the on call doctor made the final diagnosis." What was my diagnosis? I was on a fetal monitor to observe the movements of my babyEven worse my insurance *** *** *** *** ** *** is not contracted with this company so they wanted me to pay out of pocket! I made them submit a claim with my insurance and luckily I was able to get a check from them that covered part of the costThis company is sketchy and the hospital should inform their patients who are thinking they are in-network that the doctor that will be seeing them does not accept their insuranceBEWARE OF THIS COMPANY

We appreciate and thank you for the opportunity to respond to this compliant We provide the following information: Based on our records, Complainant visited the emergency room at *** *** *** *** on 11/26/ The documentation within the patient record is
consistent with Complainant’s history, indicating that Complainant was in fact the individual visiting the hospital We also reviewed Complainant’s insurance eligibility While Complainant was eligible for *** *** *, Complainant was not eligible for *** *** * We had no other information regarding other insurance In regards to Complainant’s billing with the**, because the visit was for obtaining medication for pain, Complainant would have been required to obtain pre-authorization with the** if such insurance was effective As such, it would have been denied and would not have changed the personal liability status. Unfortunately, despite call attempts and statements, we do not show any notes that Complainant called to state this was not an appropriate bill or to provide us with additional insuranceComplainant stated attempts were made to call our office and could not get through So, voicemails were leftWe have no record of any attempt in this regardAs such, Complainant was sent to collections in May 2012. If Complainant still believes that there was no visit to the hospital on the date in question and that someone falsely used Complainant’s identity, we will write off the balance of amounts due upon receipt of a valid police report If further questions, Complainant can call our Patient Services Manager, ***, directly at ###-###-####. *** ** ***Director Business Operations, Billing###-###-####

An investigation was conducted and we have verified that a refund check was not received by the Complainant.  A refund check was issued and overnighted.  A senior administrator called to apologize for the situation and Complainant was informed of the overnight envelope and delivery...

date.  Complainant acknowledged receipt of the check on January 9th and expressed sincere thanks for fixing the problem.

A clerical error was found where the explanation of benefits was not attached to our system notes properly.  We will be writing down the remaining balance so the net balance is Zero.  Further, we will contact the patient to affirm that there is a zero balance, that statements for this...

visit have been turned off, and to validate that she has no additional questions or concerns.  We apologize for this clerical error and will have conversations with the staff directly responsible for this error including the impact on the patient due.  If the patient would like to discuss further, feel free to contact [redacted], V.P. of Billing Operations at [redacted] (direct line).

An investigation was conducted and we have verified that a refund check was not received by the Complainant.  A refund check was issued and overnighted.  A senior administrator called to apologize for the situation and Complainant was informed of the overnight envelope and delivery...

date.  Complainant acknowledged receipt of the check on January 9th and expressed sincere thanks for fixing the problem.

This business is unethical. Seriously, if you are billing company involved with the billing of medical services obviously something is very wrong if you are not contracted with one of the largest insurance companies in the state of Arizona. I was in OB triage and got a bill for a doctor that I DIDNT EVEN SEE ONCE. I got charged $310 for this doctor that didnt even have the decency to see me. When I asked why I'm paying such a giant bill for services I didnt receive they just told me "that is how it works and the on call doctor made the final diagnosis." What was my diagnosis? I was on a fetal monitor to observe the movements of my baby. Even worse my insurance [redacted] is not contracted with this company so they wanted me to pay out of pocket! I made them submit a claim with my insurance and luckily I was able to get a check from them that covered part of the cost. This company is sketchy and the hospital should inform their patients who are thinking they are in-network that the doctor that will be seeing them does not accept their insurance. BEWARE OF THIS COMPANY.

We have thoroughly reviewed the account records and have found them to be inconsistent with this complaint.  We have asked Complainant to provide a copy of applicable EOBs for the first insurance ([redacted]) along with the payments he received directly from [redacted] for the out-of-network...

claims.  Since he did not comply, we cannot submit a claim to any secondary payer.  After numerous attempts by mail and telephone, we turned the accounts to a third party collection agency.  If Complainant provides the necessary EOBs and associated payments he received and cashed from the [redacted] we will work with our collection agency to resolve this account.

[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 would be satisfactory to me.  I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.The senior administrator was sincere and helpful while reaching out to resolve the problem.

Regards,[redacted]

We appreciate and thank you for the opportunity to respond to this compliant.  We provide the following information: Based on our records, Complainant visited the emergency room at [redacted] on 11/26/2011.  The documentation within the patient record is...

consistent with Complainant’s history, indicating that Complainant was in fact the individual visiting the hospital.  We also reviewed Complainant’s insurance eligibility.  While Complainant was eligible for [redacted], Complainant was not eligible for [redacted].  We had no other information regarding other insurance.  In regards to Complainant’s billing with the**, because the visit was for obtaining medication for pain, Complainant would have been required to obtain pre-authorization with the** if such insurance was effective.  As such, it would have been denied and would not have changed the personal liability status. Unfortunately, despite 4 call attempts and 13 statements, we do not show any notes that Complainant called to state this was not an appropriate bill or to provide us with additional insurance. Complainant stated attempts were made to call our office and could not get through.  So, voicemails were left. We have no record of any attempt in this regard. As such, Complainant was sent to collections in May 2012.  If Complainant still believes that there was no visit to the hospital on the date in question and that someone falsely used Complainant’s identity, we will write off the balance of amounts due upon receipt of a valid police report.  If further questions, Complainant can call our Patient Services Manager, [redacted], directly at ###-###-####. [redacted]Director Business Operations, Billing###-###-####