I’m following up regarding our call yesterday, in reference to the complaint listed above filed by [redacted] ***, against Little River Healthcare In doing our due diligence into Mr***’s account, we realized that in order to prepare a response to his complaint, it will necessitate that we disclose his protected health information to the Revdex.com in our response To be complaint with Texas and federal law, we need Mr***’s permission in order to release his protected health information to anyone Accordingly, I’ve attached an Authorization to Disclose form here, for Mr [redacted] to sign, which will permit Little River Healthcare to disclose his protected health information to Revdex.com in our response Is it appropriate for you to forward this form to him? We did not think it was appropriate for us to reach out to him, but if you disagree then I will email it to him today.Thank you in advance for your assistance, and I look forward to hearing from you[redacted] Associate General Counsel, Chief Compliance Officer
January 25, Submitted via [redacted] [redacted] Re: Complaint ID [redacted] To Whom It May Concern: This response is in regard to that certain Complaint ID [redacted] filed by Mr [redacted] on behalf of his wife, [redacted] (the “Patient”) against Little River Healthcare on January 14, (the “Complaint”) Patient received services from Little River Healthcare on September 19, 2017, and her insurance payment posted on October 31, Patient’s husband called Little River Healthcare on November 6, stating that he had received an EOB for Patient’s visit, showing that $was owed for the services she receivedPatient’s husband was advised that there were still outstanding charges pending with insurance, and that once these outstanding charges were processed, they would be submitted for processingOn November 22, 2017, Patient’s refund was written up and internally processed by Little River HealthcareOn November 23, 2017, Patient’s insurance company called Little River Healthcare inquiring as to why Patient was overcharged, and was informed that a refund had been submitted and was being internally processedOn January 15, 2018, Patient’s refund in the amount of $was mailed to her address on file In addition, there are still outstanding charges for Patient’s September 19, visit which were originally denied by Patient’s insurance carrierThis denial was appealed, and the appeal is currently pendingDepending on the outcome of this appeal, Patient may owe additional funds relating to her September 19, visit Given that Patient’s refund was processed and sent to her, we are hopeful that her husband’s concerns were addressed and that he has no further grievances against the company Should there be any additional questions or concerns, please contact [redacted] Sincerely, [redacted]
To our knowledge, Complaint # [redacted] has been resolved as of Feb6, 2017.A check in the requested amount was issued via overnight delivery on Thursday, Feb2, The patient was advised via telephone to alert Little River Healthcare (via [redacted] ) if they did not receive the check on Friday, Feb3, The patient has not contacted [redacted] or Little River Healthcare since then, leaving us to assume she received the check in the correct amountWe sincerely apologize for our clerical errors which caused this complaintWe will work hard to ensure it will not happen again to our wonderful, appreciated patients
Complaint: [redacted] I am rejecting this response because:The information is inaccurateThe pending insurance balance was from a procedure done in October, months after I requested my refundThe communication I received from Little River In the past two weeks that it was going out in mailI did receive a picture of the check and a tracking number and it shows to be delivered todayHowever the amount of the check I am receiving is $That is a difference of $I attached the photo that was emailed to meWhere this amount came from I don’t know Regards, [redacted]
November 6, Via Email to: [redacted] and Via Certified Mail, Return Receipt RequestedMs [redacted] ***Re: [redacted] Complaint, ID [redacted] (filed on 9/19/2017)Dear *** [redacted] :This letter is in response to the complaint filed by Mr [redacted] against Little River Healthcare (the “Complaint”), with the above-referenced ID number, on September 19, In the Complaint, Mr [redacted] stated that he received a drug screen from Little River Healthcare, and was subsequently charged $7,500, noting that “[Little River Healthcare] is in bankruptcy and it seems to be over billing to make up for the losses.” I would like to take a moment to respond to Mr***’s concerns.Little River Healthcare cannot confirm nor deny that Mr [redacted] was (or is) a patient, as it has not gotten permission from Mr [redacted] to share his confidential protected health informationHowever, while it is regrettable that the costs of medical testing is generally high, if the billing was done by Little River Healthcare then it was done correctlyAs a hospital system, Little River Healthcare’s billing rates are comparable to other hospital systems, and we are required to bill the same amount for any given serviceInsurance companies have negotiated a discounted rate whereby they (and their insureds) owe less than the full amount of the charges – which is called an “allowed amount” for any particular serviceDepending on one’s insurance plan, the insurance company may pay some or all of the “allowed amount.” Unfortunately, it seems from Mr***’s description that he was billed for the entirety of the test that was performed, which could mean that the claim was rejected by his insurance and he had to pay out of pocket, or that he did not have insurance coverage in the first placeHowever, as stated above, Little River Healthcare cannot confirm or deny these facts without consent from Mr [redacted] to do so.Further, Little River Healthcare is not in bankruptcy, and was not in bankruptcy at the time that Mr [redacted] filed the ComplaintAccordingly, his claim that he was over billed so that Little River Healthcare could “make up for the losses” is factually incorrect and entirely without meritHowever, even if Little River Healthcare was in bankruptcy, it would still have been required to charge Mr***, or any other patient, the same amount.We sincerely apologize for any stress or inconvenience that Mr***’s purported experience with Little River Healthcare may have caused him, and hope that this letter has provided some insight into his concernsIf there are any additional questions, or further follto the Complaint is needed, please contact [redacted] .Sincerely, [redacted] Chief Legal Officer
If possible, could we please have an extension on responding to the complaint filed by Ms [redacted] ? We are still undertaking due diligence into the matter.Thank You, [redacted] Associate General Counsel, Chief Compliance Officer
Please be aware that effective January 1, all providers and employees of Southwest Orthopaedic Group became a part of Little River Healthcare This complaint should be directly filed under Little River Healthcare, not to Southwest Orthopaedic Group We are in the process of dissolving this agreement; however, until that time we remain Little River Healthcare We will forward this information to Little River Healthcare management for direction Thank you,***
Re: *** *** Complaint,IS ***(filed on 09/19/2017)Ms*** *** *** *** *** *** *** *** *** *** *** *** *** *** *** ***:This Letter is in response to the complaint filed by Mr*** *** against Little River Healthcare (the "Complaint"),with the above-referenced ID number, on September 19, In the complaint, Mr*** stated that he received a drug screen from Little River Healthcare and was subsequently charged $7,500, noting that "[ Little River Healthcare] is in bankruptcy and was it seems to be over billing to make up for the losses." I would like to take a moment to respond to Mr***'s concerns. Little River Healthcare cannot confirm nor deny that Mr*** was (or is) a patient, as it has not gotten permission from Mr*** to share his confidential protected health informationHowever, while it is regrettable that the cost of medical testing is generally high, if the billing was done by Little River Healthcare then it was done correctlyAs a hospital system, Little River Healthcare's billing rates are comparable to other hospital systems, and we are required to bill the same amount for any given serviceInsurance companies have negotiated a discounted rate whereby they (and their insureds) owe less than the full amount of the charges- which is called an "allowed amount" for any particular service, Depending on one's insurance plan, the insurance company may pay some or all of the "allowed amount" Unfortunately, it seems from Mr***'s descriptions that he was billed for the entirety of the test that was preformed, which could mean that the claim was rejected by his insurance and he had to pay out of pocket, or that he did not have insurance coverage in the first placeHowever, as stated above, Little River Healthcare cannot confirm or deny these facts without consent from Mr*** to do soFurther, Little River Healthcare is not in bankruptcy , and was not in bankruptcy at the time that Mr*** filed the ComplaintAccordingly, his claim that he was over billed so that Little Rover Healthcare could "make up for the losses" is factually incorrect and entirely without meritHowever, even if Little River Healthcare was in bankruptcy, it would still have been required to charge Mr***, or any other patient, the same amount. We sincerely apologize for any stress or inconvenience that Mr*** purported experience with Little River Healthcare may have caused him, and hope that this letter has provided soem insight into his concernsIf there are any additional questions, or further follto the Complaint is needed, please contact ***.Sincerely,*** ***Chief Legal Officer
January 25, 2018 Submitted via [redacted] [redacted] Re: Complaint ID [redacted] To Whom It May Concern: This...
response is in regard to that certain Complaint ID [redacted] filed by Mr. [redacted] on behalf of his wife, [redacted] (the “Patient”) against Little River Healthcare on January 14, 2018 (the “Complaint”). Patient received services from Little River Healthcare on September 19, 2017, and her insurance payment posted on October 31, 2017. Patient’s husband called Little River Healthcare on November 6, 2017 stating that he had received an EOB for Patient’s visit, showing that $8.88 was owed for the services she received. Patient’s husband was advised that there were still outstanding charges pending with insurance, and that once these outstanding charges were processed, they would be submitted for processing. On November 22, 2017, Patient’s refund was written up and internally processed by Little River Healthcare. On November 23, 2017, Patient’s insurance company called Little River Healthcare inquiring as to why Patient was overcharged, and was informed that a refund had been submitted and was being internally processed. On January 15, 2018, Patient’s refund in the amount of $246.12 was mailed to her address on file. In addition, there are still outstanding charges for Patient’s September 19, 2017 visit which were originally denied by Patient’s insurance carrier. This denial was appealed, and the appeal is currently pending. Depending on the outcome of this appeal, Patient may owe additional funds relating to her September 19, 2017 visit. Given that Patient’s refund was processed and sent to her, we are hopeful that her husband’s concerns were addressed and that he has no further grievances against the company. Should there be any additional questions or concerns, please contact [redacted]. Sincerely, [redacted]
November 6, 2017 Via Email to: [redacted] and Via Certified Mail, Return Receipt RequestedMs. [redacted]Re: [redacted] Complaint, ID [redacted] (filed on 9/19/2017)Dear [redacted]...
[redacted]:This letter is in response to the complaint filed by Mr. [redacted] against Little River Healthcare (the “Complaint”), with the above-referenced ID number, on September 19, 2017. In the Complaint, Mr. [redacted] stated that he received a drug screen from Little River Healthcare, and was subsequently charged $7,500, noting that “[Little River Healthcare] is in bankruptcy and it seems to be over billing to make up for the losses.” I would like to take a moment to respond to Mr. [redacted]’s concerns.Little River Healthcare cannot confirm nor deny that Mr. [redacted] was (or is) a patient, as it has not gotten permission from Mr. [redacted] to share his confidential protected health information. However, while it is regrettable that the costs of medical testing is generally high, if the billing was done by Little River Healthcare then it was done correctly. As a hospital system, Little River Healthcare’s billing rates are comparable to other hospital systems, and we are required to bill the same amount for any given service. Insurance companies have negotiated a discounted rate whereby they (and their insureds) owe less than the full amount of the charges – which is called an “allowed amount” for any particular service. Depending on one’s insurance plan, the insurance company may pay some or all of the “allowed amount.” Unfortunately, it seems from Mr. [redacted]’s description that he was billed for the entirety of the test that was performed, which could mean that the claim was rejected by his insurance and he had to pay out of pocket, or that he did not have insurance coverage in the first place. However, as stated above, Little River Healthcare cannot confirm or deny these facts without consent from Mr. [redacted] to do so.Further, Little River Healthcare is not in bankruptcy, and was not in bankruptcy at the time that Mr. [redacted] filed the Complaint. Accordingly, his claim that he was over billed so that Little River Healthcare could “make up for the losses” is factually incorrect and entirely without merit. However, even if Little River Healthcare was in bankruptcy, it would still have been required to charge Mr. [redacted], or any other patient, the same amount.We sincerely apologize for any stress or inconvenience that Mr. [redacted]’s purported experience with Little River Healthcare may have caused him, and hope that this letter has provided some insight into his concerns. If there are any additional questions, or further follow-up to the Complaint is needed, please contact [redacted].Sincerely,[redacted]Chief Legal Officer
I’m following up regarding our call yesterday, in reference to the complaint listed above filed by [redacted], against Little River Healthcare. In doing our due diligence into Mr. [redacted]’s account, we realized that in order to prepare a response to his complaint, it will necessitate that we disclose his protected health information to the Revdex.com in our response. To be complaint with Texas and federal law, we need Mr. [redacted]’s permission in order to release his protected health information to anyone. Accordingly, I’ve attached an Authorization to Disclose form here, for Mr. [redacted] to sign, which will permit Little River Healthcare to disclose his protected health information to Revdex.com in our response. Is it appropriate for you to forward this form to him? We did not think it was appropriate for us to reach out to him, but if you disagree then I will email it to him today.Thank you in advance for your assistance, and I look forward to hearing from you.[redacted]Associate General Counsel, Chief Compliance Officer
Complaint: [redacted]
I am rejecting this response because: it has no time frame for resolution, nor possible options for my request. As of this date, there has been no completion of my file request to be sent for medical treatment in Ohio from April.
Regards,
[redacted]
Complaint: [redacted]
I am rejecting this response because:The information is inaccurate. The pending insurance balance was from a procedure done in October, 3 months after I requested my refund. The communication I received from Little River In the past two weeks that it was going out in mail. I did receive a picture of the check and a tracking number and it shows to be delivered today. However the amount of the check I am receiving is $306.86. That is a difference of $95.14. I attached the photo that was emailed to me. Where this amount came from I don’t know.
Regards,
[redacted]
April 9, 2018 Submitted via [redacted]
[redacted]
[redacted]
[redacted] Re: Complaint ID [redacted] To Whom It May Concern: This...
response is in regard to that certain complaint ID [redacted] filed by a certain patient (the “Patient”) against Little River Healthcare on March 29, 2018 (the “Complaint”). After completing due diligence into Patient’s account, it was found that in August 2017 Patient’s health insurance company reprocessed her claim relating to the services in question, recouping previous payments and denying additional line items. As a result, the corrected balance due on Patient’s account has changed, and is now less than $100.00. In the interest of protecting Patient’s privacy, Little River Healthcare cannot divulge the exact amount of this corrected balance; however, Patient will continue to receive statements until this reduced amount is paid in full. If any additional information is needed regarding the Complaint, or if Patient would like to request additional information from Little River Healthcare, please contact [redacted]. Sincerely, [redacted]
[redacted]
Please be aware that effective January 1, 2017 all providers and employees of Southwest Orthopaedic Group became a part of Little River Healthcare. This complaint should be directly filed under Little River Healthcare, not to Southwest Orthopaedic Group. We are in the...
process of dissolving this agreement; however, until that time we remain Little River Healthcare. We will forward this information to Little River Healthcare management for direction. Thank you,[redacted]
If possible, could we please have an extension on responding to the complaint filed by Ms. [redacted]? We are still undertaking due diligence into the matter.Thank You,[redacted]Associate General Counsel, Chief Compliance Officer
To our knowledge, Complaint #[redacted] has been resolved as of Feb. 6, 2017.A check in the requested amount was issued via overnight delivery on Thursday, Feb. 2, 2017. The patient was advised via telephone to alert Little River Healthcare (via [redacted]) if they did not receive the check on...
Friday, Feb. 3, 2017. The patient has not contacted [redacted] or Little River Healthcare since then, leaving us to assume she received the check in the correct amount. We sincerely apologize for our clerical errors which caused this complaint. We will work hard to ensure it will not happen again to our wonderful, appreciated patients.
and Via Certified Mail, Return Receipt RequestedMs. [redacted]Dispute Resolution SpecialistRevdex.com[redacted]
[redacted]Re: Response to Complaint - [redacted] ID [redacted]Dear Ms. [redacted]:This letter is in regard to that certain complaint filed by Ms. [redacted] against Little River Healthcare on November 6, 2017, with the ID number referenced above (the “Complaint”).Ms. [redacted]’s payment for the services she received from Little River Healthcare in March 2017 was applied to her account in June 2017. However, at the time this payment was applied, she had a pending insurance balance on her account. It is company policy (and standard industry practice) that refunds are not sent to patients while there is a pending insurance balance on their account. While Ms. [redacted] requested a refund in July 2017, there was still a pending insurance balance on her account at that time so the refund was not yet authorized to be processed.However, in October 2017, Ms. [redacted] became more determined and insistent upon receiving her refund. Accordingly, despite that there was still a pending insurance balance on her account, her refund was submitted for processing and then forwarded to Little River Healthcare’s Accounting Department for payment. As a result, a refund check in the amount of $402.00 was sent to Ms. [redacted]’s address via FedEx on December 4, 2017. In addition, a representative from Little River Healthcare reached out to Ms. [redacted] via email to inform her that her refund had been sent to her, and answer any remaining questions regarding her account.Given that Ms. [redacted]’s refund was processed and sent to her, and a representative of Little River Healthcare reached out to her, we are hopeful that Ms. [redacted]’s concerns were addressed and that she has no further grievances against the company. Should there be any additional questions or concerns, please contact [redacted].Sincerely,[redacted]ManagerDocuSign Envelope ID: 70B09B4D-EE29-4039-B325-FC08EB0A5873DocuSign Envelope ID: 70B09B4D-EE29-4039-B325-FC08EB0A5873
I’m following up regarding our call yesterday, in reference to the complaint listed above filed by [redacted] ***, against Little River Healthcare In doing our due diligence into Mr***’s account, we realized that in order to prepare a response to his complaint, it will necessitate that we disclose his protected health information to the Revdex.com in our response To be complaint with Texas and federal law, we need Mr***’s permission in order to release his protected health information to anyone Accordingly, I’ve attached an Authorization to Disclose form here, for Mr [redacted] to sign, which will permit Little River Healthcare to disclose his protected health information to Revdex.com in our response Is it appropriate for you to forward this form to him? We did not think it was appropriate for us to reach out to him, but if you disagree then I will email it to him today.Thank you in advance for your assistance, and I look forward to hearing from you[redacted] Associate General Counsel, Chief Compliance Officer
January 25, Submitted via [redacted] [redacted] Re: Complaint ID [redacted] To Whom It May Concern: This response is in regard to that certain Complaint ID [redacted] filed by Mr [redacted] on behalf of his wife, [redacted] (the “Patient”) against Little River Healthcare on January 14, (the “Complaint”) Patient received services from Little River Healthcare on September 19, 2017, and her insurance payment posted on October 31, Patient’s husband called Little River Healthcare on November 6, stating that he had received an EOB for Patient’s visit, showing that $was owed for the services she receivedPatient’s husband was advised that there were still outstanding charges pending with insurance, and that once these outstanding charges were processed, they would be submitted for processingOn November 22, 2017, Patient’s refund was written up and internally processed by Little River HealthcareOn November 23, 2017, Patient’s insurance company called Little River Healthcare inquiring as to why Patient was overcharged, and was informed that a refund had been submitted and was being internally processedOn January 15, 2018, Patient’s refund in the amount of $was mailed to her address on file In addition, there are still outstanding charges for Patient’s September 19, visit which were originally denied by Patient’s insurance carrierThis denial was appealed, and the appeal is currently pendingDepending on the outcome of this appeal, Patient may owe additional funds relating to her September 19, visit Given that Patient’s refund was processed and sent to her, we are hopeful that her husband’s concerns were addressed and that he has no further grievances against the company Should there be any additional questions or concerns, please contact [redacted] Sincerely, [redacted]
To our knowledge, Complaint # [redacted] has been resolved as of Feb6, 2017.A check in the requested amount was issued via overnight delivery on Thursday, Feb2, The patient was advised via telephone to alert Little River Healthcare (via [redacted] ) if they did not receive the check on Friday, Feb3, The patient has not contacted [redacted] or Little River Healthcare since then, leaving us to assume she received the check in the correct amountWe sincerely apologize for our clerical errors which caused this complaintWe will work hard to ensure it will not happen again to our wonderful, appreciated patients
Complaint: [redacted] I am rejecting this response because:The information is inaccurateThe pending insurance balance was from a procedure done in October, months after I requested my refundThe communication I received from Little River In the past two weeks that it was going out in mailI did receive a picture of the check and a tracking number and it shows to be delivered todayHowever the amount of the check I am receiving is $That is a difference of $I attached the photo that was emailed to meWhere this amount came from I don’t know Regards, [redacted]
November 6, Via Email to: [redacted] and Via Certified Mail, Return Receipt RequestedMs [redacted] ***Re: [redacted] Complaint, ID [redacted] (filed on 9/19/2017)Dear *** [redacted] :This letter is in response to the complaint filed by Mr [redacted] against Little River Healthcare (the “Complaint”), with the above-referenced ID number, on September 19, In the Complaint, Mr [redacted] stated that he received a drug screen from Little River Healthcare, and was subsequently charged $7,500, noting that “[Little River Healthcare] is in bankruptcy and it seems to be over billing to make up for the losses.” I would like to take a moment to respond to Mr***’s concerns.Little River Healthcare cannot confirm nor deny that Mr [redacted] was (or is) a patient, as it has not gotten permission from Mr [redacted] to share his confidential protected health informationHowever, while it is regrettable that the costs of medical testing is generally high, if the billing was done by Little River Healthcare then it was done correctlyAs a hospital system, Little River Healthcare’s billing rates are comparable to other hospital systems, and we are required to bill the same amount for any given serviceInsurance companies have negotiated a discounted rate whereby they (and their insureds) owe less than the full amount of the charges – which is called an “allowed amount” for any particular serviceDepending on one’s insurance plan, the insurance company may pay some or all of the “allowed amount.” Unfortunately, it seems from Mr***’s description that he was billed for the entirety of the test that was performed, which could mean that the claim was rejected by his insurance and he had to pay out of pocket, or that he did not have insurance coverage in the first placeHowever, as stated above, Little River Healthcare cannot confirm or deny these facts without consent from Mr [redacted] to do so.Further, Little River Healthcare is not in bankruptcy, and was not in bankruptcy at the time that Mr [redacted] filed the ComplaintAccordingly, his claim that he was over billed so that Little River Healthcare could “make up for the losses” is factually incorrect and entirely without meritHowever, even if Little River Healthcare was in bankruptcy, it would still have been required to charge Mr***, or any other patient, the same amount.We sincerely apologize for any stress or inconvenience that Mr***’s purported experience with Little River Healthcare may have caused him, and hope that this letter has provided some insight into his concernsIf there are any additional questions, or further follto the Complaint is needed, please contact [redacted] .Sincerely, [redacted] Chief Legal Officer
If possible, could we please have an extension on responding to the complaint filed by Ms [redacted] ? We are still undertaking due diligence into the matter.Thank You, [redacted] Associate General Counsel, Chief Compliance Officer
Please be aware that effective January 1, all providers and employees of Southwest Orthopaedic Group became a part of Little River Healthcare This complaint should be directly filed under Little River Healthcare, not to Southwest Orthopaedic Group We are in the process of dissolving this agreement; however, until that time we remain Little River Healthcare We will forward this information to Little River Healthcare management for direction Thank you,***
Re: *** *** Complaint,IS ***(filed on 09/19/2017)Ms*** *** *** *** *** *** *** *** *** *** *** *** *** *** *** ***:This Letter is in response to the complaint filed by Mr*** *** against Little River Healthcare (the "Complaint"),with the above-referenced ID number, on September 19, In the complaint, Mr*** stated that he received a drug screen from Little River Healthcare and was subsequently charged $7,500, noting that "[ Little River Healthcare] is in bankruptcy and was it seems to be over billing to make up for the losses." I would like to take a moment to respond to Mr***'s concerns. Little River Healthcare cannot confirm nor deny that Mr*** was (or is) a patient, as it has not gotten permission from Mr*** to share his confidential protected health informationHowever, while it is regrettable that the cost of medical testing is generally high, if the billing was done by Little River Healthcare then it was done correctlyAs a hospital system, Little River Healthcare's billing rates are comparable to other hospital systems, and we are required to bill the same amount for any given serviceInsurance companies have negotiated a discounted rate whereby they (and their insureds) owe less than the full amount of the charges- which is called an "allowed amount" for any particular service, Depending on one's insurance plan, the insurance company may pay some or all of the "allowed amount" Unfortunately, it seems from Mr***'s descriptions that he was billed for the entirety of the test that was preformed, which could mean that the claim was rejected by his insurance and he had to pay out of pocket, or that he did not have insurance coverage in the first placeHowever, as stated above, Little River Healthcare cannot confirm or deny these facts without consent from Mr*** to do soFurther, Little River Healthcare is not in bankruptcy , and was not in bankruptcy at the time that Mr*** filed the ComplaintAccordingly, his claim that he was over billed so that Little Rover Healthcare could "make up for the losses" is factually incorrect and entirely without meritHowever, even if Little River Healthcare was in bankruptcy, it would still have been required to charge Mr***, or any other patient, the same amount. We sincerely apologize for any stress or inconvenience that Mr*** purported experience with Little River Healthcare may have caused him, and hope that this letter has provided soem insight into his concernsIf there are any additional questions, or further follto the Complaint is needed, please contact ***.Sincerely,*** ***Chief Legal Officer
January 25, 2018 Submitted via [redacted] [redacted] Re: Complaint ID [redacted] To Whom It May Concern: This...
response is in regard to that certain Complaint ID [redacted] filed by Mr. [redacted] on behalf of his wife, [redacted] (the “Patient”) against Little River Healthcare on January 14, 2018 (the “Complaint”). Patient received services from Little River Healthcare on September 19, 2017, and her insurance payment posted on October 31, 2017. Patient’s husband called Little River Healthcare on November 6, 2017 stating that he had received an EOB for Patient’s visit, showing that $8.88 was owed for the services she received. Patient’s husband was advised that there were still outstanding charges pending with insurance, and that once these outstanding charges were processed, they would be submitted for processing. On November 22, 2017, Patient’s refund was written up and internally processed by Little River Healthcare. On November 23, 2017, Patient’s insurance company called Little River Healthcare inquiring as to why Patient was overcharged, and was informed that a refund had been submitted and was being internally processed. On January 15, 2018, Patient’s refund in the amount of $246.12 was mailed to her address on file. In addition, there are still outstanding charges for Patient’s September 19, 2017 visit which were originally denied by Patient’s insurance carrier. This denial was appealed, and the appeal is currently pending. Depending on the outcome of this appeal, Patient may owe additional funds relating to her September 19, 2017 visit. Given that Patient’s refund was processed and sent to her, we are hopeful that her husband’s concerns were addressed and that he has no further grievances against the company. Should there be any additional questions or concerns, please contact [redacted]. Sincerely, [redacted]
This complaint is being reviewed and internally investigated by Little River Healthcare
November 6, 2017 Via Email to: [redacted] and Via Certified Mail, Return Receipt RequestedMs. [redacted]Re: [redacted] Complaint, ID [redacted] (filed on 9/19/2017)Dear [redacted]...
[redacted]:This letter is in response to the complaint filed by Mr. [redacted] against Little River Healthcare (the “Complaint”), with the above-referenced ID number, on September 19, 2017. In the Complaint, Mr. [redacted] stated that he received a drug screen from Little River Healthcare, and was subsequently charged $7,500, noting that “[Little River Healthcare] is in bankruptcy and it seems to be over billing to make up for the losses.” I would like to take a moment to respond to Mr. [redacted]’s concerns.Little River Healthcare cannot confirm nor deny that Mr. [redacted] was (or is) a patient, as it has not gotten permission from Mr. [redacted] to share his confidential protected health information. However, while it is regrettable that the costs of medical testing is generally high, if the billing was done by Little River Healthcare then it was done correctly. As a hospital system, Little River Healthcare’s billing rates are comparable to other hospital systems, and we are required to bill the same amount for any given service. Insurance companies have negotiated a discounted rate whereby they (and their insureds) owe less than the full amount of the charges – which is called an “allowed amount” for any particular service. Depending on one’s insurance plan, the insurance company may pay some or all of the “allowed amount.” Unfortunately, it seems from Mr. [redacted]’s description that he was billed for the entirety of the test that was performed, which could mean that the claim was rejected by his insurance and he had to pay out of pocket, or that he did not have insurance coverage in the first place. However, as stated above, Little River Healthcare cannot confirm or deny these facts without consent from Mr. [redacted] to do so.Further, Little River Healthcare is not in bankruptcy, and was not in bankruptcy at the time that Mr. [redacted] filed the Complaint. Accordingly, his claim that he was over billed so that Little River Healthcare could “make up for the losses” is factually incorrect and entirely without merit. However, even if Little River Healthcare was in bankruptcy, it would still have been required to charge Mr. [redacted], or any other patient, the same amount.We sincerely apologize for any stress or inconvenience that Mr. [redacted]’s purported experience with Little River Healthcare may have caused him, and hope that this letter has provided some insight into his concerns. If there are any additional questions, or further follow-up to the Complaint is needed, please contact [redacted].Sincerely,[redacted]Chief Legal Officer
I’m following up regarding our call yesterday, in reference to the complaint listed above filed by [redacted], against Little River Healthcare. In doing our due diligence into Mr. [redacted]’s account, we realized that in order to prepare a response to his complaint, it will necessitate that we disclose his protected health information to the Revdex.com in our response. To be complaint with Texas and federal law, we need Mr. [redacted]’s permission in order to release his protected health information to anyone. Accordingly, I’ve attached an Authorization to Disclose form here, for Mr. [redacted] to sign, which will permit Little River Healthcare to disclose his protected health information to Revdex.com in our response. Is it appropriate for you to forward this form to him? We did not think it was appropriate for us to reach out to him, but if you disagree then I will email it to him today.Thank you in advance for your assistance, and I look forward to hearing from you.[redacted]Associate General Counsel, Chief Compliance Officer
Complaint: [redacted]
I am rejecting this response because: it has no time frame for resolution, nor possible options for my request. As of this date, there has been no completion of my file request to be sent for medical treatment in Ohio from April.
Regards,
[redacted]
Complaint: [redacted]
I am rejecting this response because:The information is inaccurate. The pending insurance balance was from a procedure done in October, 3 months after I requested my refund. The communication I received from Little River In the past two weeks that it was going out in mail. I did receive a picture of the check and a tracking number and it shows to be delivered today. However the amount of the check I am receiving is $306.86. That is a difference of $95.14. I attached the photo that was emailed to me. Where this amount came from I don’t know.
Regards,
[redacted]
April 9, 2018 Submitted via [redacted]
[redacted]
[redacted]
[redacted] Re: Complaint ID [redacted] To Whom It May Concern: This...
response is in regard to that certain complaint ID [redacted] filed by a certain patient (the “Patient”) against Little River Healthcare on March 29, 2018 (the “Complaint”). After completing due diligence into Patient’s account, it was found that in August 2017 Patient’s health insurance company reprocessed her claim relating to the services in question, recouping previous payments and denying additional line items. As a result, the corrected balance due on Patient’s account has changed, and is now less than $100.00. In the interest of protecting Patient’s privacy, Little River Healthcare cannot divulge the exact amount of this corrected balance; however, Patient will continue to receive statements until this reduced amount is paid in full. If any additional information is needed regarding the Complaint, or if Patient would like to request additional information from Little River Healthcare, please contact [redacted]. Sincerely, [redacted]
[redacted]
Please be aware that effective January 1, 2017 all providers and employees of Southwest Orthopaedic Group became a part of Little River Healthcare. This complaint should be directly filed under Little River Healthcare, not to Southwest Orthopaedic Group. We are in the...
process of dissolving this agreement; however, until that time we remain Little River Healthcare. We will forward this information to Little River Healthcare management for direction. Thank you,[redacted]
If possible, could we please have an extension on responding to the complaint filed by Ms. [redacted]? We are still undertaking due diligence into the matter.Thank You,[redacted]Associate General Counsel, Chief Compliance Officer
To our knowledge, Complaint #[redacted] has been resolved as of Feb. 6, 2017.A check in the requested amount was issued via overnight delivery on Thursday, Feb. 2, 2017. The patient was advised via telephone to alert Little River Healthcare (via [redacted]) if they did not receive the check on...
Friday, Feb. 3, 2017. The patient has not contacted [redacted] or Little River Healthcare since then, leaving us to assume she received the check in the correct amount. We sincerely apologize for our clerical errors which caused this complaint. We will work hard to ensure it will not happen again to our wonderful, appreciated patients.
December 5, 2017 Via Email to: [redacted]...
and Via Certified Mail, Return Receipt RequestedMs. [redacted]Dispute Resolution SpecialistRevdex.com[redacted]
[redacted]Re: Response to Complaint - [redacted] ID [redacted]Dear Ms. [redacted]:This letter is in regard to that certain complaint filed by Ms. [redacted] against Little River Healthcare on November 6, 2017, with the ID number referenced above (the “Complaint”).Ms. [redacted]’s payment for the services she received from Little River Healthcare in March 2017 was applied to her account in June 2017. However, at the time this payment was applied, she had a pending insurance balance on her account. It is company policy (and standard industry practice) that refunds are not sent to patients while there is a pending insurance balance on their account. While Ms. [redacted] requested a refund in July 2017, there was still a pending insurance balance on her account at that time so the refund was not yet authorized to be processed.However, in October 2017, Ms. [redacted] became more determined and insistent upon receiving her refund. Accordingly, despite that there was still a pending insurance balance on her account, her refund was submitted for processing and then forwarded to Little River Healthcare’s Accounting Department for payment. As a result, a refund check in the amount of $402.00 was sent to Ms. [redacted]’s address via FedEx on December 4, 2017. In addition, a representative from Little River Healthcare reached out to Ms. [redacted] via email to inform her that her refund had been sent to her, and answer any remaining questions regarding her account.Given that Ms. [redacted]’s refund was processed and sent to her, and a representative of Little River Healthcare reached out to her, we are hopeful that Ms. [redacted]’s concerns were addressed and that she has no further grievances against the company. Should there be any additional questions or concerns, please contact [redacted].Sincerely,[redacted]ManagerDocuSign Envelope ID: 70B09B4D-EE29-4039-B325-FC08EB0A5873DocuSign Envelope ID: 70B09B4D-EE29-4039-B325-FC08EB0A5873