Psychological & Psychiatric Consultants, LLC

From: Elizabeth P*** Date: Tue, Jun 14, at 12:PMSubject: Fwd: Revdex.com Paper we received this mid last weekTo: ***@cleveland.Revdex.com.org
Dear Revdex.com:
RE: Complaint
Our office received your letter from the postal service mid last week per *** *** email attached below with
letterHere is our response.
I spoke with Ms*** on the May 3rd at 4:00PMI explained why her insurance company *** processed her *** out of networkMs.*** was not satisfied with what I was explaining and was very upset and hung the phone up on meI then called *** ***, PCC and explained what happened and asked her to contact Ms*** as she would not speak with me, and *** explained the same process below:As of January *** *** had *** as her insurance carrier. *** *** is a non-participating provider under her provider Tax Identification Number within the *** network
*** denied all *** from as patient responsibilityI provided the patient with *** EOB Claim reference number 160325ethat clearly states to charge the member for DOS and $each for a total responsibility of $220.00.
All patients are told at time of scheduling that they are to contact their insurance company to verify their in and out of network benefitsWe are not responsible for the way their insurance company processes their ***.
I have also attached a ledger that shows all payments made to the Beachwood office by Ms*** for
As explained to Ms*** prior to her hanging up on meHer $payment that was made on April 12, was posted by the office on 4/14/and was applied to DOS 1/12/as the staff will always post payments to the oldest balance on the account. (the software we use does not allow me to save this ledger as a PDF but I would be happy to have the Beachwood Office fax a copy to you if you would like.)
In addition to all thisI personally reached out to *** Contracting Department and began working with Scott Williams at *** contracting to see if they would be willing to contract *** ***, PCC for this plan and if they would also backdate the contracting to January 2016.
This was out of courtesy as we do not have to take all insurance plans.
If *** does contract *** ***, PCC under her own TIN and they are willing to backdate her start date we will then be able to ask the *** Department at *** to reconsider Ms***s *** for for In Network processing.
However, as I explained to Ms.*** until *** adds our Provider as In Network and reprocesses the *** for payment or reprocesses the *** at a lesser patient responsibility I cannot adjust any non-covered charges as we currently have everything processed according to the *** Explanation of Benefits(The patient also receives EOBS from the Insurance Carrier)
Scott Williams has added *** *** to *** as of Friday 6/10/and he did backdate he emailed the provider and myself staring the *** will reprocess as in network and allow their *** department business days for reprocessingOnce we have a new EOB from *** showing us how they have reprocessed we can adjust the account accordingly.
Sincerely, Elizabeth P***
CC: *** ***--
Elizabeth P***
Phone: 855-346-8500 Fax:
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