Sailfish ER Services Partnership

Review: Guarantor of account should have been changed to my daughter, mother of patient to whom services were provided. After two phone calls and an email, I was told it had been corrected. Instead the account was sent to collections and placed on my credit report with any contact to the correct guarantor. After two hours on the phone talking to six different people, no resolution.

Further, charges have never been filed with patient's insurance, which would drastically reduce bill.Desired Settlement: Removal of charges from credit report -- correct guarantor billed. File insurance!

Review: My son. [redacted]. [redacted], ** (DOB 5-25-1991) was treated at [redacted] Hospital [redacted], [redacted], FL in the Emergency Room on April 12, 2012. The ER physicians are contracted with the hospital ER through Sailfish ER Services Partnership and are not participating with the insurance that my son had at that time which was [redacted]. Apparently Sailfish ER Services Partnership engages in a practice known as "balance billing" where the patient is billed for any remaining balance that insurance does not pay. The issue with this particular ER encounter was between [redacted] ad Sailfish ER Services Partnership. Apparently Sailfish did not get an EOB from [redacted] (although they did get a check which they cashed) and for that reason they turned my son over to a collection agency, [redacted]. On July 31, 2012 I contacted [redacted] and together we contacted Sailfish and I thought the issue was resolved. The collection calls stopped and we did not receive any more bills from Sailfish. Apparently [redacted] has put this information on my son's credit report however, and because this is the only thing on it, he has a bad credit rating. Through no fault of his own. He was turned down for a job after a credit check which is how we learned of this matter. I have spoken with Sailfish and [redacted] assured me that they would work on it but it will take time to get this resolved. I do not want to have to continue to call and call and call when nothing ever seems to be completed there.Desired Settlement: Notice of collection removed from my son's credit report immediately.

Business

Response:

October 14, 2013

Dear **. [redacted]:

This letter is a response to the complaint sent to you by our patient’s mother [redacted] regarding her son's account. [redacted] was treated at [redacted] Medical Center on April 11, 2012. After reviewing the complaint, I understand that **. [redacted] did not expect the physician's bill to be denied as out-of-network by [redacted], as the facility is an in-network provider.

In this letter, we will address what the account is for and the status of the account to date.

Our office billed this visit as a level 5 evaluation and management for this date of service on April 11, 2012. We billed [redacted] and there was an outstanding balance of $382.37.

I understand that the patient appealed the claim with [redacted]. When a patient is treated for a true emergency situation e.g. injuries or if a high level of care is required, insurance carriers may process out-of-network claims as in-network. This determination is based on the insurance policy coverage.

The account has been adjusted to reflect a zero balance. The Client Manager of the collection agency has been notified to remove and close the account from a collection status,

We do hope this letter provides some resolution to the matter and we appreciate the time you have taken to address the patient's mother concerns over the emergency room physician's billing.

Very truly yours,