see attachedTo: [redacted] Date; June 9, 2015Assigned ID# [redacted] Patient is correct that she visited our office as a new patient on 11/18/At that time she did make us aware that she was changing jobs, so we did in fact call the insurance company and make sure her coverage was activeWe were told by [redacted] that coverage Was active the morning of her treatmentPatient was diagnosed with cavitiesUpon leaving the office that day, patient agreed that treatment could be completed before coverage ends and took an appointment for the following dayWe did receive payments from insurance in the amount of $The patients Copay was $for her treatment and her husband had a balance of $for a total of $This payment posted to patients account on 1/3/Up to this point everything was fine and account was at a zero balanceBut in February 2014, I received a letter from [redacted] (which was the patients insurance carrier at the time of service) stating that I must return the funds of $because patients employer backdated insurance coverage dates to the time the employee left that employerNow I fully agree that insurance companies should not be allowed to practice like this and I hate that it effects the patients trust in us, but it is a realityI, the office manager, do not believe I have ever spoken to this patient, I have left Several messages regarding insurance requesting the money back and I have Several detailed notes of other desk staff speaking with her regarding this issueFrom this point until August of 2014, fought with [redacted] to try to get them to rectify this situationI resubmitted claims with an appeal letter, all with no luckOn Aug 7", 2014, I sent check #in the amount of $to [redacted] ***The very same day, I left a message with patient to see if any other coverage had overlapped at that time and to tell her that I had to send original payments back to insurance, I also sent a copy of the [redacted] request letter with a copy of the check to the patient, so she knew that it was sentl, personally never received a return callWe do have other notes pertaining to patient speaking with other front desk staffDuring one call patient stated she was going to contact HR and get back with us, but we never heard backDuring another call she stated that she was not going to pay this billOver the next few months, we continued to send statements and make phone calls regarding balanceWith no additional payment made, on Feb 27, 2015, referred this account out to second party for collections.On 5/27/15, [redacted] from our collection Company called stating that patient had called them and said that we kept her money from insurance and are trying to double bill herI told [redacted] that [redacted] had requested money back, that claims sent were paid in errorCoverage had termed on 11/15/| then called [redacted] and spent an hour on the phone, first with [redacted] who confirmed that refund check was sent by us and cashed by themNext spoke with [redacted] in the Claims Auditing DeptShe confirmed what we already knewThe patients claims were paid and then a few months later a request for money back was sent due to patients coverage terming just days prior to treatment***, from [redacted] ***, tried a way call with patient while I was on the phone but didn't get an answer, [redacted] said she would call patient again and let her know that check was sent back to them by us and that technically she should owe us the full amount of $with no write offs since coverage had termedI actually left the write offs in tact since patient was going to owe such a large balance due to the insurance issueThis was done as a courtesy.I only sent $to collections, the amount of the check that I sent back to [redacted] ***, I have notes on each phone call, a copy of the payment request letter from insurance and a copy of the cashed check we wrote to [redacted] ***.We pride ourselves in great customer service but we cannot foresee circumstances like theseThis is actually an issue between the patient and HR of her former employer.The insurance companies need to have a standard as wellShould employers be able to back date coverage dates? Should insurances be allow to request money back months after they paid for treatment? I would say no to these questions, but a patients insurance is their responsibility.I feel like I have worked numerous hours to try to help this patient avoid having to pay this bill, but in the end, my efforts did not work and the dentist deserves payment for services rendered.Practice Manager - Riversbend Dental
see attachedTo: [redacted] Date; June 9, 2015Assigned ID# [redacted]Patient is correct that she visited our office as a new patient on 11/18/2013. At that time she did make us aware that she was changing jobs, so we did in fact call the insurance company and make sure her coverage was...
active. We were told by [redacted] that coverage Was active the morning of her treatment. Patient was diagnosed with 3 cavities. Upon leaving the office that day, patient agreed that treatment could be completed before coverage ends and took an appointment for the following day. We did receive payments from insurance in the amount of $540.99. The patients Copay was $120.90 for her treatment and her husband had a balance of $61.50 for a total of $182.40. This payment posted to patients account on 1/3/2014. Up to this point everything was fine and account was at a zero balance. But in February 2014, I received a letter from [redacted] (which was the patients insurance carrier at the time of service) stating that I must return the funds of $540.99 because patients employer backdated insurance coverage dates to the time the employee left that employer. Now I fully agree that insurance companies should not be allowed to practice like this and I hate that it effects the patients trust in us, but it is a reality. I, the office manager, do not believe I have ever spoken to this patient, I have left Several messages regarding insurance requesting the money back and I have Several detailed . notes of other desk staff speaking with her regarding this issue. From this point until August of 2014, fought with [redacted] to try to get them to rectify this situation. I resubmitted claims with an appeal letter, all with no luck. On Aug 7", 2014, I sent check #13557 in the amount of $540.99 to [redacted]. The very same day, I left a message with patient to see if any other coverage had overlapped at that time and to tell her that I had to send original payments back to insurance, I also sent a copy of the [redacted] request letter with a copy of the check to the patient, so she knew that it was sent. l, personally never received a return call. We do have other notes pertaining to patient speaking with other front desk staff. During one call patient stated she was going to contact HR and get back with us, but we never heard back. During another call she stated that she was not going to pay this bill. Over the next few months, we continued to send statements and make phone calls regarding balance. With no additional payment made, on Feb 27, 2015, referred this account out to second party for collections.On 5/27/15, [redacted] from our collection Company called stating that patient had called them and said that we kept her money from insurance and are trying to double bill her. I told [redacted] that [redacted] had requested money back, that claims sent were paid in error. Coverage had termed on 11/15/13. | then called [redacted] and spent an hour on the phone, first with [redacted] who confirmed that refund check was sent by us and cashed by them. Next spoke with [redacted] in the Claims Auditing Dept. She confirmed what we already knew. The patients claims were paid and then a few months later a request for money back was sent due to patients coverage terming just days prior to treatment. [redacted], from [redacted], tried a 3 way call with patient while I was on the phone but didn't get an answer, [redacted] said she would call patient again and let her know that check was sent back to them by us and that technically she should owe us the full amount of $959 with no write offs since coverage had termed. I actually left the write offs in tact since patient was going to owe such a large balance due to the insurance issue. This was done as a courtesy.I only sent $540.99 to collections, the amount of the check that I sent back to [redacted], I have notes on each phone call, a copy of the payment request letter from insurance and a copy of the cashed check we wrote to [redacted].We pride ourselves in great customer service but we cannot foresee circumstances like these. This is actually an issue between the patient and HR of her former employer.The insurance companies need to have a standard as well. Should employers be able to back date coverage dates? Should insurances be allow to request money back months after they paid for treatment? I would say no to these questions, but a patients insurance is their responsibility.I feel like I have worked numerous hours to try to help this patient avoid having to pay this bill, but in the end, my efforts did not work and the dentist deserves payment for services rendered.Practice Manager - Riversbend Dental
see attachedTo: [redacted] Date; June 9, 2015Assigned ID# [redacted] Patient is correct that she visited our office as a new patient on 11/18/At that time she did make us aware that she was changing jobs, so we did in fact call the insurance company and make sure her coverage was activeWe were told by [redacted] that coverage Was active the morning of her treatmentPatient was diagnosed with cavitiesUpon leaving the office that day, patient agreed that treatment could be completed before coverage ends and took an appointment for the following dayWe did receive payments from insurance in the amount of $The patients Copay was $for her treatment and her husband had a balance of $for a total of $This payment posted to patients account on 1/3/Up to this point everything was fine and account was at a zero balanceBut in February 2014, I received a letter from [redacted] (which was the patients insurance carrier at the time of service) stating that I must return the funds of $because patients employer backdated insurance coverage dates to the time the employee left that employerNow I fully agree that insurance companies should not be allowed to practice like this and I hate that it effects the patients trust in us, but it is a realityI, the office manager, do not believe I have ever spoken to this patient, I have left Several messages regarding insurance requesting the money back and I have Several detailed notes of other desk staff speaking with her regarding this issueFrom this point until August of 2014, fought with [redacted] to try to get them to rectify this situationI resubmitted claims with an appeal letter, all with no luckOn Aug 7", 2014, I sent check #in the amount of $to [redacted] ***The very same day, I left a message with patient to see if any other coverage had overlapped at that time and to tell her that I had to send original payments back to insurance, I also sent a copy of the [redacted] request letter with a copy of the check to the patient, so she knew that it was sentl, personally never received a return callWe do have other notes pertaining to patient speaking with other front desk staffDuring one call patient stated she was going to contact HR and get back with us, but we never heard backDuring another call she stated that she was not going to pay this billOver the next few months, we continued to send statements and make phone calls regarding balanceWith no additional payment made, on Feb 27, 2015, referred this account out to second party for collections.On 5/27/15, [redacted] from our collection Company called stating that patient had called them and said that we kept her money from insurance and are trying to double bill herI told [redacted] that [redacted] had requested money back, that claims sent were paid in errorCoverage had termed on 11/15/| then called [redacted] and spent an hour on the phone, first with [redacted] who confirmed that refund check was sent by us and cashed by themNext spoke with [redacted] in the Claims Auditing DeptShe confirmed what we already knewThe patients claims were paid and then a few months later a request for money back was sent due to patients coverage terming just days prior to treatment***, from [redacted] ***, tried a way call with patient while I was on the phone but didn't get an answer, [redacted] said she would call patient again and let her know that check was sent back to them by us and that technically she should owe us the full amount of $with no write offs since coverage had termedI actually left the write offs in tact since patient was going to owe such a large balance due to the insurance issueThis was done as a courtesy.I only sent $to collections, the amount of the check that I sent back to [redacted] ***, I have notes on each phone call, a copy of the payment request letter from insurance and a copy of the cashed check we wrote to [redacted] ***.We pride ourselves in great customer service but we cannot foresee circumstances like theseThis is actually an issue between the patient and HR of her former employer.The insurance companies need to have a standard as wellShould employers be able to back date coverage dates? Should insurances be allow to request money back months after they paid for treatment? I would say no to these questions, but a patients insurance is their responsibility.I feel like I have worked numerous hours to try to help this patient avoid having to pay this bill, but in the end, my efforts did not work and the dentist deserves payment for services rendered.Practice Manager - Riversbend Dental
see attachedTo: [redacted] Date; June 9, 2015Assigned ID# [redacted]Patient is correct that she visited our office as a new patient on 11/18/2013. At that time she did make us aware that she was changing jobs, so we did in fact call the insurance company and make sure her coverage was...
active. We were told by [redacted] that coverage Was active the morning of her treatment. Patient was diagnosed with 3 cavities. Upon leaving the office that day, patient agreed that treatment could be completed before coverage ends and took an appointment for the following day. We did receive payments from insurance in the amount of $540.99. The patients Copay was $120.90 for her treatment and her husband had a balance of $61.50 for a total of $182.40. This payment posted to patients account on 1/3/2014. Up to this point everything was fine and account was at a zero balance. But in February 2014, I received a letter from [redacted] (which was the patients insurance carrier at the time of service) stating that I must return the funds of $540.99 because patients employer backdated insurance coverage dates to the time the employee left that employer. Now I fully agree that insurance companies should not be allowed to practice like this and I hate that it effects the patients trust in us, but it is a reality. I, the office manager, do not believe I have ever spoken to this patient, I have left Several messages regarding insurance requesting the money back and I have Several detailed . notes of other desk staff speaking with her regarding this issue. From this point until August of 2014, fought with [redacted] to try to get them to rectify this situation. I resubmitted claims with an appeal letter, all with no luck. On Aug 7", 2014, I sent check #13557 in the amount of $540.99 to [redacted]. The very same day, I left a message with patient to see if any other coverage had overlapped at that time and to tell her that I had to send original payments back to insurance, I also sent a copy of the [redacted] request letter with a copy of the check to the patient, so she knew that it was sent. l, personally never received a return call. We do have other notes pertaining to patient speaking with other front desk staff. During one call patient stated she was going to contact HR and get back with us, but we never heard back. During another call she stated that she was not going to pay this bill. Over the next few months, we continued to send statements and make phone calls regarding balance. With no additional payment made, on Feb 27, 2015, referred this account out to second party for collections.On 5/27/15, [redacted] from our collection Company called stating that patient had called them and said that we kept her money from insurance and are trying to double bill her. I told [redacted] that [redacted] had requested money back, that claims sent were paid in error. Coverage had termed on 11/15/13. | then called [redacted] and spent an hour on the phone, first with [redacted] who confirmed that refund check was sent by us and cashed by them. Next spoke with [redacted] in the Claims Auditing Dept. She confirmed what we already knew. The patients claims were paid and then a few months later a request for money back was sent due to patients coverage terming just days prior to treatment. [redacted], from [redacted], tried a 3 way call with patient while I was on the phone but didn't get an answer, [redacted] said she would call patient again and let her know that check was sent back to them by us and that technically she should owe us the full amount of $959 with no write offs since coverage had termed. I actually left the write offs in tact since patient was going to owe such a large balance due to the insurance issue. This was done as a courtesy.I only sent $540.99 to collections, the amount of the check that I sent back to [redacted], I have notes on each phone call, a copy of the payment request letter from insurance and a copy of the cashed check we wrote to [redacted].We pride ourselves in great customer service but we cannot foresee circumstances like these. This is actually an issue between the patient and HR of her former employer.The insurance companies need to have a standard as well. Should employers be able to back date coverage dates? Should insurances be allow to request money back months after they paid for treatment? I would say no to these questions, but a patients insurance is their responsibility.I feel like I have worked numerous hours to try to help this patient avoid having to pay this bill, but in the end, my efforts did not work and the dentist deserves payment for services rendered.Practice Manager - Riversbend Dental