Radiology Associates Fox Valley

I was misdiagnosed in January by one of the physicians and spent one month worried that at any moment one of my three aneurysms would explode as I waited for an additional appointment and the chance to see another specialist. The film that was taken and the test that were done, were done poorly and the other specialist was in shock that my first neurologist from Radiology Associates of Fox Valley could even determine what he did. I still have one aneurysm but at least not three as was first told to me, while I was under sedation. And when my husband asked to schedule an appt with the doctor, he said there was no need, he explained everything to us already. I am having a difficult time paying my bill because I feel we were misinformed and treated poorly causing a great deal of stress that could have been avoided.

Review: I received several different statements from the business requesting several different amounts, and attempted to receive clarification on what amount was actually owed. I sent a letter to the business, dated October 16, 2012, requesting the total amount. The business ignored my letter. I sent a second letter, dated November 1, 2012, again requesting the total amount. I explained I would immediately issue a full payment if I knew what the total amount was. Again, the business ignored my letter.

I sent a third letter, dated November 20, 2012. I again requested a total balance, and explained I would assume no balance existed if they ignored me a third time. It should be noted all three letters were mailed to the same address. I received a response from McKesson Revenue Management Solutions, which provides "Full-Service Revenue Management" to Radiology Associates of the Fox Valley, S.C. McKesson provided what was described as a "Special Statement". The statement included details for two separate accounts with Radiology Associates of the Fox Valley, S.C., totaling $367.72.

On January 3, 2013, I provided Check #7585 in the amount of $367.72 to Radiology Associates of the Fox Valley, S.C., with an accompanying letter. The letter explained the payment was for the total amount of my accounts, pursuant to the "Special Statement". The letter explicitly stated acceptance of the check "constitutes full, complete, and final payment on any outstanding balance relative to any account(s)" and served as a "final remedy to any dispute" between the parties. The check was accepted, and no further contact was initiated by Radiology Associates of the Fox Valley, S.C.

After 10 months without any additional communication, I received contact from Americollect, Inc. stating I did not provide Radiology Associates of the Fox Valley, S.C. with payment on the accounts, and they now demanded $387.62. The correspondence referenced the same account number and service dates from the "Special Statement" I received from McKesson, only with a larger amount due. Further, upon information and belief, these additional amounts were never submitted to my health care insurance company.

I feel I have gone far beyond the normal responsibility of a customer to remedy the matter. Despite cancer and the related challenges, I still sought out clarification regarding the total amount Radiology Associates of the Fox Valley, S.C. felt they were owed. Three letters later, and after being ignored for months, I finally received communication from McKesson. I issued a full payment, and made it clear if this was not the final balance, let me know. After 10 months, I am once again forced to deal with this mess.Desired Settlement: I request Radiology Associates of the Fox Valley, S.C. immediately placate the matter by withdrawing any claim they have regarding the accounts I already paid off, in full, on January 3, 2013.

Business

Response:

I checked into the patient’s accounts and the following is what I found:

The patient had services provided by RAF that we billed for. The first of these services was performed on 2/17/12; the second of these was done on 5/17/12. In both instances, we billed the patient’s insurance, Anthem, which processed he claims and made partial payment and part of the allowed amount was applied to the patient’s co-pay/deductible. The patient balance on the first account (DOS 2/17/12) was $313.86; the patient balance on the second account (DOS 5/17/12) was $113.86. We received a payment of $60.00 toward the first account on 6/6/12 which reduced the balance to $253.86. We received note form the patient’s spouse which accompanied the $60 payment which indicated that they would be sending monthly payments (I can provide a copy of this note if needed). There were no further payments received and no other response to statements sent. The first account was transferred to Americollect on 7/21/12 with a balance of $253.86. The second account was transferred to Americollect on 10/20/12 with a balance of $113.86.

I suspect that the patient may for a period of time (between 7/21/12 and 10/20/12) received statements from both us for the second account and Americollect regarding the first account. As such, it’s possible that some of the letters were sent to the collection agency as a result. I could only find record of our having received the letter of 11/20/12 which the patient references in his letter. Upon receipt of this letter, we sent the patient “demand statements” for both of the accounts on 11/30/12.

I‘ve asked our payments staff to research to see if the check to see if the check for $387.62 was received; they did not find any record of this check. I did check with Americollect to see if they had received the check and they advise that no payments have been received on the accounts.If the patient would supply a copy of the cleared check, we can search again and in more detail.

Review: In August of 2013 shortly after my son was born he received services. We never received a bill for services and assumed insurance covered any costs as we had met our out of pocket max. In March 2014 I received a call from a collection agency telling me I owed a debt. I was unaware of any debt and told the collection agency I would follow up with the service provider. After calling the service provider I was informed of an outstanding bill which I paid immediately. The billing department informed me that the charges were submitted to my insurance and rejected because my son was not listed as covered at the time because he was recently born. The billing department also informed me that only one statement was sent attempting to collect on the bill before they turned it over to collections. After learning of the bill I immediately paid it and am following up with my insurance company for reimbursement. All of this could have been avoided if someone simply followed up with a second statement or even better a phone call to inquire why the bill wasn't paid.Desired Settlement: Change your billing policy and don't immediately turn unpaid bills over to collection without contacting your customer first. Had I been contacted after the bill was past due I could have immediately resolved things. Instead it was turned over to a bill collector and may have negatively impacted my credit score. This was easily avoidable if the service provider followed up directly with me before turning things over to collections. Please change your policy so that patients are treated like people and not dead beats who will only pay their bills if they are harassed by credit collectors. A follow up past due statement and/ or telephone call would have alerted me to the outstanding bill and allowed me to take care of it.

Business

Response:

I reached out to the Billing company manager and asked for detailed notes on this account.

Services were rendered to the patient’s son on 8/2/13 and 8/27/13, at Mercy Medical Center. The information we received from Affinity was that the patient was covered by Network Health. As such, claims were sent out to Network Health on 8/6/13 and 8/30/13 respectively. We received denials for both accounts from Network advising us that they could not identify the patient because the contract number was invalid. We subsequently sent a statement out to the patient for each account; the statements were sent out on 10/8/13 and 10/10/13. Both statements were sent to the address we had received in the demographics sent to us by Affinity. The address was 747 S. Pioneer Parkway, Fond du Lac, WI 54935. Both statements were returned to us by the USPO as undeliverable and no forwarding address was provided. Since we have access to the Affinity system, we checked to see if the hospital had updated the patient’s address in their system. The address on the Affinity system was the same as what we had billed out. At this point, the accounts were transferred to Americollect.

When speaking with our collection agency, they had the same address with the exception of a different city name and zip code, and sent a statement on Jan 7th, 2014. This was also returned. Since the collection agency has access to different data systems, they were able to branch out further and came up with a totally different address in a different city than either of the above, and sent this on March 19th, 2014. This was accurate.

Our normal parameters for patient billing call for a minimum of two statements and an automated call to the patient or responsible party. If a statement is returned by the USPO and a forwarding address indicated, we will update our records and begin the self pay billing cycle again. If the statement is returned without forwarding information, we will try to identify a “better address” as best we can. If this is unsuccessful, we will transfer the account to collections as a bad address account. This is what occurred in this case.

I hope this helps clear this up. Please let me know if you have any further questions.

Sincerely,

Executive Assistant

Radiology Associates of the Fox Valley

Consumer

Response: