Rocky Mountain Emergency Physicians, LLC

I apologize for the delay in responding to this complaint and? I appreciate your assistance? in this matterWe have been very happy with our current billing company, as they are very responsive to complaints and do everything they can to remedy problems, as you'll see below.? I? received the complaint on 4/18/and forwarded it immediately to our billing company, [redacted] ***I have included some of their responses that I've received over the last few days...? ? “This is a pretty small account, so there was very little activity ·? ? ? ? ? 01/08/an auto call was made ·? ? ? ? ? ? ? 02/02/Live call to? (208)xxx-xxxx,? where it was discovered that the phone we had on file was not valid for the patientIt appears the white pages were checked by the team, but no alternate number was located.? We were not able to locate any facesheet or demographic informationBecause of this, it appears we went by the demographic information we had on file for her when she visited the ER back in We listened to the calls and found that the patient was not notified by our staff that if she paid the agency within days of being transferred to collections it would not impact her credit in any way.? We have since re-educated our call reps that this information must be provided to patients when they call regarding collection balances.? The patient also received incorrect information as to where and how we receive demographic information from the hospital.? I’ve also notified PSD of this process and how to explain the process to the patient.” ? “..I just spoke with Ms________.? I apologized to her for the experience she had with our company.? I advised her that the entire team has been given additional training on how to handle situations such as hers, and that the reps she spoke to in each call were counseled and instructed on what should have happened.? ? She has already paid the agency $(her entire balance) and I made her aware that since she paid within the first days of being sent to the agency it will in no way affect her credit She was extremely happy at the end of the call and voiced that she appreciated the call back and all the follow up we did as a company to ensure this would not happen to another patient.” ? ? Thank you again for your assistance in helping resolve this complaint and helping us to improve our customer service ? Daniel D***, MD President, Rocky Mountain Emergency Physicians, LLC Hospital Way Pocatello, ID

I apologize for the delay in responding to this complaint and I appreciate your assistance in this matterWe have been very happy with our current billing company, as they are very responsive to complaints and do everything they can to remedy problems, as you'll see below I received the complaint on 4/18/and forwarded it immediately to our billing company, [redacted] ***I have included some of their responses that I've received over the last few days “This is a pretty small account, so there was very little activity · 01/08/an auto call was made · 02/02/Live call to (208)xxx-xxxx, where it was discovered that the phone we had on file was not valid for the patientIt appears the white pages were checked by the team, but no alternate number was located We were not able to locate any facesheet or demographic informationBecause of this, it appears we went by the demographic information we had on file for her when she visited the ER back in We listened to the calls and found that the patient was not notified by our staff that if she paid the agency within days of being transferred to collections it would not impact her credit in any way We have since re-educated our call reps that this information must be provided to patients when they call regarding collection balances The patient also received incorrect information as to where and how we receive demographic information from the hospital I’ve also notified PSD of this process and how to explain the process to the patient.” “..I just spoke with Ms________ I apologized to her for the experience she had with our company I advised her that the entire team has been given additional training on how to handle situations such as hers, and that the reps she spoke to in each call were counseled and instructed on what should have happened She has already paid the agency $(her entire balance) and I made her aware that since she paid within the first days of being sent to the agency it will in no way affect her credit She was extremely happy at the end of the call and voiced that she appreciated the call back and all the follow up we did as a company to ensure this would not happen to another patient.” Thank you again for your assistance in helping resolve this complaint and helping us to improve our customer service Daniel D***, MD President, Rocky Mountain Emergency Physicians, LLC Hospital Way Pocatello, ID

Thank you for your responseClearly you are frustrated and there doesn’t appear to be any way to help resolve that frustration.? Answering your comments would be counterproductive.? We have discovered the problem and corrected itWe were provided incorrect insurance information by the hospitalYour mistrust of our motives and authenticity significantly delayed the resolution of the problemObviously, I received your email and complaint through the Revdex.com.? But, my personal email was not all you had to validate our authenticity.? We had already sent you statements on our official letterhead which you, as the guarantor, chose to ignore.? Had you responded to any of those statements or when we made the previously mentioned phone calls, we could have easily identified the wrong information and refiled without further frustration on your part.? ? Further, we would have avoided the risk of the claim being denied for timely filing, which we now face.? Despite your unsubstantiated accusations, we were able to find out that the hospital had sent us the wrong insurance plan information (Multiplan out of Scranton PA) which resulted in your receiving the bill.? Whether that is because of a clerical error on their part or some other reason, we don’t know.? We just received updated information that you had Dakota Care that was subsequently terminated with an effective date of 12/31/2015.? So, we have submitted the bill to them.? If they pay and you don’t have any deductible or coinsurance, then this will be the last you hear from us.? If they determine you have any responsibility of the bill for whatever reason, you will receive a future statement.? Despite these administrative changes, we wish you good health Sincerely, Dr [redacted] Manager, Rocky Mountain Emergency Physicians, LLCPortneuf Medical Center Emergency Department [redacted]

Complaint: [redacted] I am rejecting(in RED) this response because: Let me be very clearI don't think you've reviewed the case or you would understand what frustrates meYour lack of understanding and familiarity with the case is clearly illustrated in your unkind, sarcastic reply, and synopsis of what has happened/is happeningIt only goes to further prove your company is as unprofessional as it gets and is likely giving Portneuf Medical Center a horrible reputation.As most physician groups do, we bill for our physician services separately from the charges you receive from the hospital (which includes facility charges, medications, nursing, etc)This is standard procedure and occurs the same way with radiologists, surgeons, anesthesiologists, cardiologists, etc, etc If you were admitted to the hospital, had a CAT scan, and surgery for appendicitis, you would receive a bill from the hospital to pay for the hospital room, the CAT scan machine, the nursing, medications, and operating room expensesYou would receive a SEPARATE bill from the radiologist that interpreted the CAT scan, the surgeon who did the surgery, the anesthesiologist who sedated you, and the ER doctor (if one was involved in your care) who cared for you in the ERThank you for explaining what SEPARATE billing meansI wasn't aware as I haven't visited a doctor or hospital in the past yearsUnfortunately for you, most other radiologists, surgeons, anesthesiologists, cardiologists, etc, etchave gotten their act together and are able to complete SEPARATE billing without causing such discontent This patient is NOT yet in collections We only can assume the patient misunderstood due to the fact that there are two billing entities billing for the professional and facility services separatelyCalling multiple times per day trying to collect a balance-owed is, by definition, collectionsJust because you haven't sent it to a third-party agency, does not imply that this is not in a collections phase of billing The demographics we received have incomplete/incorrect insurance information i.e., we didn’t have enough information to proceed to bill an insurance company The insurance we did have is NOT a standard insurance .it’s more like a supplemental insurance where if you have an event, the patient gets paid a fixed dollar amountEven so, when we called the company we had, the company did not recognize the patient nor the patient numberYour company does NOT have an accurate record of the insurance information provided on-site to the hospital; however, with that "incorrect" information, the hospital was able to get payment from insurance without any issueThe "NOT standard" insurance which was provided to the hospital has been paying doctors, radiologists, surgeons, anesthesiologists, cardiologists, etc, etcfor yearsIt's NOT supplemental insurance and is NOT used to pay the patientIf the insurance agency was in-fact ever called (which I doubt), this would have been immediately apparentYour company should have done its due diligence to ensure that 1) it receives and processes insurance information in a correct and complete manner, and/or 2) informed patients immediately that the billing is separate from the hospital and that they may be contacted by a person on the phone who refuses to provide any verifiable identification but wants you to pay $by credit card over the phonePatients are often required to sign a statement acknowledging that they understand who will be billing them and for what purpose(s), in cases of SEPARATE billingIt might be worth taking note of this common practice We are checking to see if something was lost in transmission, but so far, we are unable to validate that possibility It is possible that updates to insurance were provided to the hospital or entered by the hospital after we received our initial demographic fileIf that happened, those changes were not communicated to usTo obtain this information from the hospital after the initial download, we are required to fax any request to themYou mean HIPAA won't allow them to release personal information to a complete stranger over the phone? Shocking Unfortunately, Portneuf often doesn’t respond to our repeated faxesStill, I would not put this as an issue with the hospitalOF COURSE NOT! THEY GOT PAID!!!! The patient has the responsibility to payThe insurance information was provided to the hospital ONE TIME and they were successful in getting the payment from insurance and patientLikely, you didn't even bother to request information from the hospital since you did not even bother to send a request TO THE PATIENT This particular patient had statements, auto calls, and one live call where the responsible party refused to provide insurance information to our representativeAgain, no sane person or hospital is going to provide any personal information or credit card numbers over the phone to a complete strangerSend a request for information with the paper statement and a professional letterhead, and I'm sure you'll be collecting payment in no time We listened to the call and the responsible party refused to give our representative insurance information stating we needed to go to the hospital to get the informationOur representative did his best to inform her of the company policies but she spent most of the call trying to speak over him We can’t ascertain why this patient was unwilling to provide the requested informationI think I stated clearly, many times, that the written request can come from a professional company, not a phone call from a strangerSimple enough, I would think, but clearly over the heads of all employees involved While most patients who are at this stage in the collection process will be sent to collections, we are willing to hold off such action for another days to allow this patient to contact us at [redacted] *** with their insurance information so we can submit to the insurance carrier IF it differs from what we already have on file If the insurance information is different, we also suggest the patient contact their insurance company to tell them not to deny the claim for timely filing since their delay will likely result in such a denial Otherwise, it will remain the patient’s responsibility While I am sorry that you are frustrated with this process and I apologize for the confusion caused by a separate provider services bill, I assure you that [redacted] is a reputable company and would not contact you for further insurance information if it was not absolutely necessary and not included in the information obtained from the hospitalRMEP and [redacted] HAVE NEVER FORMALLY REQUESTED ANY INSURANCE INFORMATION FROM METHEY CALLED TO COLLECT A PAYMENT VIA CREDIT CARDI WILL NOT provide ANY personal information or credit card numbers to an unverified phone consultantYour "assurance" that this is a reputable company is both alarming and laughable- not one bit of professionalism has come from you or any member of the team.Please focus on point #6, as it provides you with the information needed to resolve this matterOUR BILLING COMPANY, [redacted] IS UNABLE TO BILL YOUR INSURANCE WITH ONLY THE INFORMATION THEY RECEIVED FROM THE HOSPITAL, WHICH WAS INCOMPLETEYOU NEED TO CALL THEM TO PROVIDE THE ADDITIONAL INFORMATION SO THEY CAN BILL YOUR INSURANCEPLEASE CALL [redacted] ***, TO RESOLVE THIS ISSUE ULTIMATELY, THE PAYMENT OF THE BILL IS YOUR RESPONSIBILITYPLEASE FOCUS ON THIS - I will NOT call a random number and give personal information to anyoneI will NOT respond to your personal gmail account and give personal information, eitherYour email response has done nothing to provide any level of assurance that either companies are reputableIn fact, I'm now more convinced that RMEP and [redacted] are likely acting fraudulently and trying to bully uninformed patients into paying bills that they do not fully understandIn most cases, patients are likely unable or unwilling to stand up to your scare tacticsYou and your billing partners are doing a huge disservice to both Portneuf Medical Center and the Pocatello region in general; it is shameful that outsourcing has ruined what used to be an honorable enterpriseYou need to send a formal written request for insurance information on a company letterhead or you will receive nothingIf you refuse to provide the formal request, please provide an explanation as to how a minor child can be bound to a contract that he did not expressly enter and that was created at the time the child was a minor, since you have clearly stated that this is entirely the patient's responsibility and you obviously didn't bother to collect accurate guarantor information Sincerely, [redacted] Sincerely, [redacted] ***

Complaint: ***
I am rejecting(in RED) this response because: Let me be very clearI don't think you've reviewed the case or you would understand what frustrates meYour lack of understanding and familiarity with the case is clearly illustrated in your unkind, sarcastic reply, and synopsis of what has happened/is happeningIt only goes to further prove your company is as unprofessional as it gets and is likely giving Portneuf Medical Center a horrible reputation.As most physician groups do, we bill for our physician services separately from the charges you receive from the hospital (which includes facility charges, medications, nursing, etc)This is standard procedure and occurs the same way with radiologists, surgeons, anesthesiologists, cardiologists, etc, etc. If you were admitted to the hospital, had a CAT scan, and surgery for appendicitis, you would receive a bill from the hospital to pay for the hospital room, the CAT scan machine, the nursing, medications, and operating room expensesYou would receive a SEPARATE bill from the radiologist that interpreted the CAT scan, the surgeon who did the surgery, the anesthesiologist who sedated you, and the ER doctor (if one was involved in your care) who cared for you in the ER. Thank you for explaining what SEPARATE billing meansI wasn't aware as I haven't visited a doctor or hospital in the past yearsUnfortunately for you, most other radiologists, surgeons, anesthesiologists, cardiologists, etc, etc. have gotten their act together and are able to complete SEPARATE billing without causing such discontent.1. This patient is NOT yet in collections. We only can assume the patient misunderstood due to the fact that there are two billing entities billing for the professional and facility services separatelyCalling multiple times per day trying to collect a balance-owed is, by definition, collectionsJust because you haven't sent it to a third-party agency, does not imply that this is not in a collections phase of billing. 2. The demographics we received have incomplete/incorrect insurance information…i.e., we didn’t have enough information to proceed to bill an insurance company. The insurance we did have is NOT a standard insurance….it’s more like a supplemental insurance where if you have an event, the patient gets paid a fixed dollar amountEven so, when we called the company we had, the company did not recognize the patient nor the patient number. Your company does NOT have an accurate record of the insurance information provided on-site to the hospital; however, with that "incorrect" information, the hospital was able to get payment from insurance without any issueThe "NOT standard" insurance which was provided to the hospital has been paying doctors, radiologists, surgeons, anesthesiologists, cardiologists, etc, etc. for yearsIt's NOT supplemental insurance and is NOT used to pay the patientIf the insurance agency was in-fact ever called (which I doubt), this would have been immediately apparent. Your company should have done its due diligence to ensure that 1) it receives and processes insurance information in a correct and complete manner, and/or 2) informed patients immediately that the billing is separate from the hospital and that they may be contacted by a person on the phone who refuses to provide any verifiable identification but wants you to pay $by credit card over the phone. Patients are often required to sign a statement acknowledging that they understand who will be billing them and for what purpose(s), in cases of SEPARATE billingIt might be worth taking note of this common practice. 3. We are checking to see if something was lost in transmission, but so far, we are unable to validate that possibility It is possible that updates to insurance were provided to the hospital or entered by the hospital after we received our initial demographic file. If that happened, those changes were not communicated to us. To obtain this information from the hospital after the initial download, we are required to fax any request to themYou mean HIPAA won't allow them to release personal information to a complete stranger over the phone? Shocking. Unfortunately, Portneuf often doesn’t respond to our repeated faxesStill, I would not put this as an issue with the hospitalOF COURSE NOT! THEY GOT PAID!!!! The patient has the responsibility to payThe insurance information was provided to the hospital ONE TIME and they were successful in getting the payment from insurance and patient. Likely, you didn't even bother to request information from the hospital since you did not even bother to send a request TO THE PATIENT. 4. This particular patient had statements, auto calls, and one live call where the responsible party refused to provide insurance information to our representativeAgain, no sane person or hospital is going to provide any personal information or credit card numbers over the phone to a complete strangerSend a request for information with the paper statement and a professional letterhead, and I'm sure you'll be collecting payment in no time. 5. We listened to the call and the responsible party refused to give our representative insurance information stating we needed to go to the hospital to get the informationOur representative did his best to inform her of the company policies but she spent most of the call trying to speak over him. We can’t ascertain why this patient was unwilling to provide the requested informationI think I stated clearly, many times, that the written request can come from a professional company, not a phone call from a strangerSimple enough, I would think, but clearly over the heads of all employees involved.6. While most patients who are at this stage in the collection process will be sent to collections, we are willing to hold off such action for another days to allow this patient to contact us at *** *** with their insurance information so we can submit to the insurance carrier IF it differs from what we already have on file. If the insurance information is different, we also suggest the patient contact their insurance company to tell them not to deny the claim for timely filing since their delay will likely result in such a denial. Otherwise, it will remain the patient’s responsibility. While I am sorry that you are frustrated with this process and I apologize for the confusion caused by a separate provider services bill, I assure you that *** is a reputable company and would not contact you for further insurance information if it was not absolutely necessary and not included in the information obtained from the hospital. RMEP and *** HAVE NEVER FORMALLY REQUESTED ANY INSURANCE INFORMATION FROM METHEY CALLED TO COLLECT A PAYMENT VIA CREDIT CARDI WILL NOT provide ANY personal information or credit card numbers to an unverified phone consultantYour "assurance" that this is a reputable company is both alarming and laughable- not one bit of professionalism has come from you or any member of the team.Please focus on point #6, as it provides you with the information needed to resolve this matterOUR BILLING COMPANY, *** IS UNABLE TO BILL YOUR INSURANCE WITH ONLY THE INFORMATION THEY RECEIVED FROM THE HOSPITAL, WHICH WAS INCOMPLETEYOU NEED TO CALL THEM TO PROVIDE THE ADDITIONAL INFORMATION SO THEY CAN BILL YOUR INSURANCEPLEASE CALL *** *** ***, TO RESOLVE THIS ISSUE. ULTIMATELY, THE PAYMENT OF THE BILL IS YOUR RESPONSIBILITY. PLEASE FOCUS ON THIS - I will NOT call a random number and give personal information to anyoneI will NOT respond to your personal gmail account and give personal information, eitherYour email response has done nothing to provide any level of assurance that either companies are reputableIn fact, I'm now more convinced that RMEP and *** are likely acting fraudulently and trying to bully uninformed patients into paying bills that they do not fully understandIn most cases, patients are likely unable or unwilling to stand up to your scare tacticsYou and your billing partners are doing a huge disservice to both Portneuf Medical Center and the Pocatello region in general; it is shameful that outsourcing has ruined what used to be an honorable enterpriseYou need to send a formal written request for insurance information on a company letterhead or you will receive nothingIf you refuse to provide the formal request, please provide an explanation as to how a minor child can be bound to a contract that he did not expressly enter and that was created at the time the child was a minor, since you have clearly stated that this is entirely the patient's responsibility and you obviously didn't bother to collect accurate guarantor information. Sincerely,*** ***
Sincerely,
*** ***

I apologize for the delay in responding to this complaint and? I appreciate your assistance? in this matterWe have been very happy with our current billing company, as they are very responsive to complaints and do everything they can to remedy problems, as you'll see
below.?
I? received the complaint on 4/18/and forwarded it immediately to our billing company, *** ***I have included some of their responses that I've received over the last few days...?
?
“This is a pretty small account, so there was very little activity
·? ? ? ? ? 01/08/an auto call was made
·? ? ? ? ? ? ? 02/02/Live call to? (208)xxx-xxxx,? where it was discovered that the phone we had on file was not valid for the patientIt appears the white pages were checked by the team, but no alternate number was located.?
We were not able to locate any facesheet or demographic informationBecause of this, it appears we went by the demographic information we had on file for her when she visited the ER back in
We listened to the calls and found that the patient was not notified by our staff that if she paid the agency within days of being transferred to collections it would not impact her credit in any way.? We have since re-educated our call reps that this information must be provided to patients when they call regarding collection balances.? The patient also received incorrect information as to where and how we receive demographic information from the hospital.? I’ve also notified PSD of this process and how to explain the process to the patient.”
?
“..I just spoke with Ms________.? I apologized to her for the experience she had with our company.? I advised her that the entire team has been given additional training on how to handle situations such as hers, and that the reps she spoke to in each call were counseled and instructed on what should have happened.? ? She has already paid the agency $(her entire balance) and I made her aware that since she paid within the first days of being sent to the agency it will in no way affect her credit
She was extremely happy at the end of the call and voiced that she appreciated the call back and all the follow up we did as a company to ensure this would not happen to another patient.”
?
? Thank you again for your assistance in helping resolve this complaint and helping us to improve our customer service
?
Daniel D***, MD
President, Rocky Mountain Emergency Physicians, LLC
Hospital Way
Pocatello, ID

My name is Dr*** *** and I am an emergency physician at Portneuf Medical Center in Pocatello and manager of Rocky Mountain Emergency Physicians, LLC(RMEP)I received your complaint via *** *** at the Boise branch of the Revdex.com a few days ago and have been reviewing your
daughter's account and discussing the matter with our billing company, ***I truly am sorry to hear about the frustration you've had with the billing process.? Before I address your account specifically, let me share a few things with you that may help explain some of what frustrates youRMEP is a private group of ER doctors and physician assistants that has contracted with Portneuf Medical Center to provide ER care for nearly yearsAs most physician groups do, we bill for our physician services separately from the charges you receive from the hospital (which includes facility charges, medications, nursing, etc)This is standard procedure and occurs the same way with radiologists, surgeons, anesthesiologists, cardiologists, etc, etc.? If you were admitted to the hospital, had a CAT scan, and surgery for appendicitis, you would receive a bill from the hospital to pay for the hospital room, the CAT scan machine, the nursing, medications, and operating room expensesYou would receive a SEPARATE bill from the radiologist that interpreted the CAT scan, the surgeon who did the surgery, the anesthesiologist who sedated you, and the ER doctor (if one was involved in your care) who cared for you in the ER.? Returning to your account, I have reviewed the chart from your daughter's visit and can assure you that she was seen and evaluated by *** *** one of RMEPs best Physician AssistantsHe is not just a nurse, but is a credentialed and competent health care providerI have also spoken with our billing company, ***, and they have reviewed your account and have provided a detailed response that I have included below:? ? Dr***, ? Thank you for sending this complaint.? There appears to be a confluence of issues.? 1.? ? ? ? ? ? ? This patient is NOT yet in collections.? We only can assume the patient misunderstood due to the fact that there are two billing entities billing for the professional and facility services separately2.? ? ? ? ? ? ? The demographics we received have incomplete/incorrect insurance information…i.e., we didn’t have enough information to proceed to bill an insurance company.? The insurance we did have is NOT a standard insurance….it’s more like a supplemental insurance where if you have an event, the patient gets paid a fixed dollar amount.? Even so, when we called the company we had, the company did not recognize the patient nor the patient number.? 3.? ? ? ? ? ? ? We are checking to see if something was lost in transmission, but so far, we are unable to validate that possibility? ? It is possible that updates to insurance were provided to the hospital or entered by the hospital after we received our initial demographic file.? ? If that happened, those changes were not communicated to us.? To obtain this information from the hospital after the initial download, we are required to fax any request to them.? Unfortunately, Portneuf often doesn’t respond to our repeated faxes.? Still, I would not put this as an issue with the hospital.? The patient has the responsibility to pay.? 4.? ? ? ? ? ? ? This particular patient had statements, auto calls, and one live call where the responsible party refused to provide insurance information to our representative.? 5.? ? ? ? ? We listened to the call and the responsible party refused to give our representative insurance information stating we needed to go to the hospital to get the informationOur representative did his best to inform her of the company policies but she spent most of the call trying to speak over him.? We can’t ascertain why this patient was unwilling to provide the requested information6.? ? ? ? ? While most patients who are at this stage in the collection process will be sent to collections, we are willing to hold off such action for another days to allow this patient to contact us at? *** ***? with their insurance information so we can submit to the insurance carrier IF it differs from what we already have on file.? If the insurance information is different, we also suggest the patient contact their insurance company to tell them not to deny the claim for timely filing since their delay will likely result in such a denial.? Otherwise, it will remain the patient’s responsibilityWhile I am sorry that you are frustrated with this process and I apologize for the confusion caused by a separate provider services bill, I assure you that *** is a reputable company and would not contact you for further insurance information if it was not absolutely necessary and not included in the information obtained from the hospital.? Please focus on point #6, as it provides you with the information needed to resolve this matterOUR BILLING COMPANY, *** IS UNABLE TO BILL YOUR INSURANCE WITH ONLY THE INFORMATION THEY RECEIVED FROM THE HOSPITAL, WHICH WAS INCOMPLETEYOU NEED TO CALL THEM TO PROVIDE THE ADDITIONAL INFORMATION SO THEY CAN BILL YOUR INSURANCEPLEASE CALL *** *** ***, TO RESOLVE THIS ISSUE.? ULTIMATELY, THE PAYMENT OF THE BILL IS YOUR RESPONSIBILITY.? ? Please contact me if you have any other concerns or questions about what I've tried to explain*** ***, MD Manager, Rocky Mountain Emergency Physicians, LLC *** *** *** *** ** *** *** ***
*** ***
*** ***
***

Thank you for your responseClearly you are frustrated and there doesn’t appear to be any way to help resolve that frustration.? Answering your comments would be counterproductive.? We have discovered the problem and corrected itWe were provided incorrect insurance information by the hospitalYour mistrust of our motives and authenticity significantly delayed the resolution of the problemObviously, I received your email and complaint through the Revdex.com.? But, my personal email was not all you had to validate our authenticity.? We had already sent you statements on our official letterhead which you, as the guarantor, chose to ignore.? Had you responded to any of those statements or when we made the previously mentioned phone calls, we could have easily identified the wrong information and refiled without further frustration on your part.? ? Further, we would have avoided the risk of the claim being denied for timely filing, which we now face.? Despite your unsubstantiated accusations, we were able to find out that the hospital had sent us the wrong insurance plan information (Multiplan out of Scranton PA) which resulted in your receiving the bill.? Whether that is because of a clerical error on their part or some other reason, we don’t know.? We just received updated information that you had Dakota Care that was subsequently terminated with an effective date of 12/31/2015.? So, we have submitted the bill to them.? If they pay and you don’t have any deductible or coinsurance, then this will be the last you hear from us.? If they determine you have any responsibility of the bill for whatever reason, you will receive a future statement.? Despite these administrative changes, we wish you good health Sincerely, Dr*** *** Manager, Rocky Mountain Emergency Physicians, LLCPortneuf Medical Center Emergency Department *** *** *** *** ** *** ***

Thank you for your response. Clearly you are frustrated and there doesn’t appear to be any way to help resolve that frustration.  Answering your comments would be counterproductive.  We have discovered the problem and corrected it. We were provided incorrect insurance information by the hospital. Your mistrust of our motives and authenticity significantly delayed the resolution of the problem. Obviously, I received your email and complaint through the Revdex.com.  But, my personal email was not all you had to validate our authenticity.  We had already sent you 3 statements on our official letterhead which you, as the guarantor, chose to ignore.  Had you responded to any of those statements or when we made the previously mentioned phone calls, we could have easily identified the wrong information and refiled without further frustration on your part.   Further, we would have avoided the risk of the claim being denied for timely filing, which we now face.  Despite your unsubstantiated accusations, we were able to find out that the hospital had sent us the wrong insurance plan information (Multiplan out of Scranton PA) which resulted in your receiving the bill.  Whether that is because of a clerical error on their part or some other reason, we don’t know.  We just received updated information that you had Dakota Care that was subsequently terminated with an effective date of 12/31/2015.  So, we have submitted the bill to them.  If they pay and you don’t have any deductible or coinsurance, then this will be the last you hear from us.  If they determine you have any responsibility of the bill for whatever reason, you will receive a future statement.  Despite these administrative changes, we wish you good health. Sincerely, Dr. [redacted] Manager, Rocky Mountain Emergency Physicians, LLC. Portneuf Medical Center Emergency Department [redacted]

My name is Dr. [redacted] and I am an emergency physician at Portneuf Medical Center in Pocatello and manager of Rocky Mountain Emergency Physicians, LLC. (RMEP). I received your complaint via [redacted] at the Boise branch of the Revdex.com a few days ago and have been reviewing your...

daughter's account and discussing the matter with our billing company, [redacted]. I truly am sorry to hear about the frustration you've had with the billing process.  Before I address your account specifically, let me share a few things with you that may help explain some of what frustrates you... RMEP is a private group of 10 ER doctors and 5 physician assistants that has contracted with Portneuf Medical Center to provide ER care for nearly 20 years. As most physician groups do, we bill for our physician services separately from the charges you receive from the hospital (which includes facility charges, medications, nursing, etc). This is standard procedure and occurs the same way with radiologists, surgeons, anesthesiologists, cardiologists, etc, etc.  If you were admitted to the hospital, had a CAT scan, and surgery for appendicitis, you would receive a bill from the hospital to pay for the hospital room, the CAT scan machine, the nursing, medications, and operating room expenses. You would receive a SEPARATE bill from the radiologist that interpreted the CAT scan, the surgeon who did the surgery, the anesthesiologist who sedated you, and the ER doctor (if one was involved in your care) who cared for you in the ER.  Returning to your account, I have reviewed the chart from your daughter's visit and can assure you that she was seen and evaluated by [redacted] one of RMEPs best Physician Assistants. He is not just a nurse, but is a credentialed and competent health care provider. I have also spoken with our billing company, [redacted], and they have reviewed your account and have provided a detailed response that I have included below:    Dr. [redacted],   Thank you for sending this complaint.  There appears to be a confluence of issues.  1.       This patient is NOT yet in collections.  We only can assume the patient misunderstood due to the fact that there are two billing entities billing for the professional and facility services separately. 2.       The demographics we received have incomplete/incorrect insurance information…i.e., we didn’t have enough information to proceed to bill an insurance company.  The insurance we did have is NOT a standard insurance….it’s more like a supplemental insurance where if you have an event, the patient gets paid a fixed dollar amount.  Even so, when we called the company we had, the company did not recognize the patient nor the patient number.  3.       We are checking to see if something was lost in transmission, but so far, we are unable to validate that possibility.   It is possible that updates to insurance were provided to the hospital or entered by the hospital after we received our initial demographic file.   If that happened, those changes were not communicated to us.  To obtain this information from the hospital after the initial download, we are required to fax any request to them.  Unfortunately, Portneuf often doesn’t respond to our repeated faxes.  Still, I would not put this as an issue with the hospital.  The patient has the responsibility to pay.  4.       This particular patient had 3 statements, 2 auto calls, and one live call where the responsible party refused to provide insurance information to our representative.  5.     We listened to the call and the responsible party refused to give our representative insurance information stating we needed to go to the hospital to get the information. Our representative did his best to inform her of the company policies but she spent most of the call trying to speak over him.  We can’t ascertain why this patient was unwilling to provide the requested information. 6.     While most patients who are at this stage in the collection process will be sent to collections, we are willing to hold off such action for another 30 days to allow this patient to contact us at [redacted] with their insurance information so we can submit to the insurance carrier IF it differs from what we already have on file.  If the insurance information is different, we also suggest the patient contact their insurance company to tell them not to deny the claim for timely filing since their delay will likely result in such a denial.  Otherwise, it will remain the patient’s responsibility. While I am sorry that you are frustrated with this process and I apologize for the confusion caused by a separate provider services bill, I assure you that [redacted] is a reputable company and would not contact you for further insurance information if it was not absolutely necessary and not included in the information obtained from the hospital.  Please focus on point #6, as it provides you with the information needed to resolve this matter. OUR BILLING COMPANY, [redacted] IS UNABLE TO BILL YOUR INSURANCE WITH ONLY THE INFORMATION THEY RECEIVED FROM THE HOSPITAL, WHICH WAS INCOMPLETE. YOU NEED TO CALL THEM TO PROVIDE THE ADDITIONAL INFORMATION SO THEY CAN BILL YOUR INSURANCE. PLEASE CALL [redacted], TO RESOLVE THIS ISSUE.  ULTIMATELY, THE PAYMENT OF THE BILL IS YOUR RESPONSIBILITY.    Please contact me if you have any other concerns or questions about what I've tried to explain. [redacted], MD Manager, Rocky Mountain Emergency Physicians, LLC [redacted]

Complaint: [redacted]
I am rejecting(in RED) this response because: Let me be very clear. I don't think you've reviewed the case or you would understand what frustrates me. Your lack of understanding and familiarity with the case is clearly illustrated in your unkind, sarcastic reply, and synopsis of what has happened/is happening. It only goes to further prove your company is as unprofessional as it gets and is likely giving Portneuf Medical Center a horrible reputation.As most physician groups do, we bill for our physician services separately from the charges you receive from the hospital (which includes facility charges, medications, nursing, etc). This is standard procedure and occurs the same way with radiologists, surgeons, anesthesiologists, cardiologists, etc, etc.  If you were admitted to the hospital, had a CAT scan, and surgery for appendicitis, you would receive a bill from the hospital to pay for the hospital room, the CAT scan machine, the nursing, medications, and operating room expenses. You would receive a SEPARATE bill from the radiologist that interpreted the CAT scan, the surgeon who did the surgery, the anesthesiologist who sedated you, and the ER doctor (if one was involved in your care) who cared for you in the ER. Thank you for explaining what SEPARATE billing means. I wasn't aware as I haven't visited a doctor or hospital in the past 100 years. Unfortunately for you, most other radiologists, surgeons, anesthesiologists, cardiologists, etc, etc. have gotten their act together and are able to complete SEPARATE billing without causing such discontent.1.       This patient is NOT yet in collections.  We only can assume the patient misunderstood due to the fact that there are two billing entities billing for the professional and facility services separately. Calling multiple times per day trying to collect a balance-owed is, by definition, collections. Just because you haven't sent it to a third-party agency, does not imply that this is not in a collections phase of billing.  2.       The demographics we received have incomplete/incorrect insurance information…i.e., we didn’t have enough information to proceed to bill an insurance company.  The insurance we did have is NOT a standard insurance….it’s more like a supplemental insurance where if you have an event, the patient gets paid a fixed dollar amount. Even so, when we called the company we had, the company did not recognize the patient nor the patient number. Your company does NOT have an accurate record of the insurance information provided on-site to the hospital; however, with that "incorrect" information, the hospital was able to get payment from insurance without any issue. The "NOT standard" insurance which was provided to the hospital has been paying doctors, radiologists, surgeons, anesthesiologists, cardiologists, etc, etc. for years. It's NOT supplemental insurance and is NOT used to pay the patient. If the insurance agency was in-fact ever called (which I doubt), this would have been immediately apparent. Your company should have done its due diligence to ensure that 1) it receives and processes insurance information in a correct and complete manner, and/or 2) informed patients immediately that the billing is separate from the hospital and that they may be contacted by a person on the phone who refuses to provide any verifiable identification but wants you to pay $585 by credit card over the phone. Patients are often required to sign a statement acknowledging that they understand who will be billing them and for what purpose(s), in cases of SEPARATE billing. It might be worth taking note of this common practice. 3.       We are checking to see if something was lost in transmission, but so far, we are unable to validate that possibility.   It is possible that updates to insurance were provided to the hospital or entered by the hospital after we received our initial demographic file. If that happened, those changes were not communicated to us. To obtain this information from the hospital after the initial download, we are required to fax any request to them. You mean HIPAA won't allow them to release personal information to a complete stranger over the phone? Shocking.  Unfortunately, Portneuf often doesn’t respond to our repeated faxes. Still, I would not put this as an issue with the hospital. OF COURSE NOT! THEY GOT PAID!!!! The patient has the responsibility to pay. The insurance information was provided to the hospital ONE TIME and they were successful in getting the payment from insurance and patient. Likely, you didn't even bother to request information from the hospital since you did not even bother to send a request TO THE PATIENT. 4.       This particular patient had 3 statements, 2 auto calls, and one live call where the responsible party refused to provide insurance information to our representative. Again, no sane person or hospital is going to provide any personal information or credit card numbers over the phone to a complete stranger. Send  a request for information with the paper statement and a professional letterhead, and I'm sure you'll be collecting payment in no time. 5.     We listened to the call and the responsible party refused to give our representative insurance information stating we needed to go to the hospital to get the information. Our representative did his best to inform her of the company policies but she spent most of the call trying to speak over him.  We can’t ascertain why this patient was unwilling to provide the requested information. I think I stated clearly, many times, that the written request can come from a professional company, not a phone call from a stranger. Simple enough, I would think, but clearly over the heads of all employees involved.6.     While most patients who are at this stage in the collection process will be sent to collections, we are willing to hold off such action for another 30 days to allow this patient to contact us at [redacted] with their insurance information so we can submit to the insurance carrier IF it differs from what we already have on file.  If the insurance information is different, we also suggest the patient contact their insurance company to tell them not to deny the claim for timely filing since their delay will likely result in such a denial.  Otherwise, it will remain the patient’s responsibility.  While I am sorry that you are frustrated with this process and I apologize for the confusion caused by a separate provider services bill, I assure you that [redacted] is a reputable company and would not contact you for further insurance information if it was not absolutely necessary and not included in the information obtained from the hospital. RMEP and [redacted] HAVE NEVER FORMALLY REQUESTED ANY INSURANCE INFORMATION FROM ME. THEY CALLED TO COLLECT A PAYMENT VIA CREDIT CARD. I WILL NOT provide ANY personal information or credit card numbers to an unverified phone consultant. Your "assurance" that this is a reputable company is both alarming and laughable- not one bit of professionalism has come from you or any member of the team.Please focus on point #6, as it provides you with the information needed to resolve this matter. OUR BILLING COMPANY, [redacted] IS UNABLE TO BILL YOUR INSURANCE WITH ONLY THE INFORMATION THEY RECEIVED FROM THE HOSPITAL, WHICH WAS INCOMPLETE. YOU NEED TO CALL THEM TO PROVIDE THE ADDITIONAL INFORMATION SO THEY CAN BILL YOUR INSURANCE. PLEASE CALL [redacted], TO RESOLVE THIS ISSUE.  ULTIMATELY, THE PAYMENT OF THE BILL IS YOUR RESPONSIBILITY. PLEASE FOCUS ON THIS - I will NOT call a random number and give personal information to anyone. I will NOT respond to your personal gmail account and give personal information, either. Your email response has done nothing to provide any level of assurance that either companies are reputable. In fact, I'm now more convinced that RMEP and [redacted] are likely acting fraudulently and trying to bully uninformed patients into paying bills that they do not fully understand. In most cases, patients are likely unable or unwilling to stand up to your scare tactics. You and your billing partners are doing a huge disservice to both Portneuf Medical Center and the Pocatello region in general; it is shameful that outsourcing has ruined what used to be an honorable enterprise. You need to send a formal written request for insurance information on a company letterhead or you will receive nothing. If you refuse to provide the formal request, please provide an explanation as to how a minor child can be bound to a contract that he did not expressly enter and that was created at the time the child was a minor, since you have clearly stated that this is entirely the patient's responsibility and you obviously didn't bother to collect accurate guarantor information.  Sincerely,[redacted]
Sincerely,
[redacted]

I apologize for the delay in responding to this complaint and I appreciate your assistance in this matter. We have been very happy with our current billing company, as they are very responsive to complaints and do everything they can to remedy problems, as you'll see...

below. 
I received the complaint on 4/18/16 and forwarded it immediately to our billing company, [redacted]. I have included some of their responses that I've received over the last few days... 
 
“This is a pretty small account, so there was very little activity...
·       01/08/2016 an auto call was made
·       02/02/2016 Live call to (208)xxx-xxxx, where it was discovered that the phone we had on file was not valid for the patient. It appears the white pages were checked by the team, but no alternate number was located. 
We were not able to locate any facesheet or demographic information. Because of this, it appears we went by the demographic information we had on file for her when she visited the ER back in 2011.
We listened to the calls and found that the patient was not notified by our staff that if she paid the agency within 30 days of being transferred to collections it would not impact her credit in any way.  We have since re-educated our call reps that this information must be provided to patients when they call regarding collection balances.  The patient also received incorrect information as to where and how we receive demographic information from the hospital.  I’ve also notified PSD of this process and how to explain the process to the patient.”
 
“..I just spoke with Ms. ________.  I apologized to her for the experience she had with our company.  I advised her that the entire team has been given additional training on how to handle situations such as hers, and that the reps she spoke to in each call were counseled and instructed on what should have happened.   She has already paid the agency $30.38 (her entire balance) and I made her aware that since she paid within the first 30 days of being sent to the agency it will in no way affect her credit.
She was extremely happy at the end of the call and voiced that she appreciated the call back and all the follow up we did as a company to ensure this would not happen to another patient.”
 
 Thank you again for your assistance in helping resolve this complaint and helping us to improve our customer service.
 
Daniel D[redacted], MD
President, Rocky Mountain Emergency Physicians, LLC.
777 Hospital Way
Pocatello, ID 83201