Initial Business Response / [redacted] (1000, 9, 2015/09/17) */ Contact Name and Title: Pamela [redacted] Contact Phone: (XXX) XXX-XXXX Contact Email: [redacted] @med-pay.com This debt has been resolvedNo payment is due from the memberWe apologize for any confusion regarding this matter Initial Consumer Rebuttal / [redacted] (2000, 11, 2015/09/18) */ Revdex.com Comment - The consumer called the Revdex.com and stated the complaint has been resolved
Initial Business Response / [redacted] (1000, 15, 2015/09/15) */ ________________ September 10, MsRose [redacted] Revdex.com SCampbell Ave Springfield MO Re: Case # XXXXXX Name: [redacted] Group: XXXXXXIHC ID: XXXXXX Claims: XXXXXXXXXX, XXXXXXXXXXX, XXXXXXO Dear Ms [redacted] Our office received the first notice of complaint on the above case via facsimile on September 9, As Third Party Administrator, Med-Pay, Inc., has a fiduciary responsibility to issue benefits according to all plan document specificationsThe Integrity Home Care health plan is a self-insured, ERISA plan, under the jurisdiction of the Department of LaborClaims payment must be made as outlined in the plan documentFailure to correctly adjudicate claims, including the application of provisions and penalties can result in civil and/or criminal charges against the administrator by the Department of Labor Please note, due to HIPAA privacy we cannot disclose specific details concerning this member's medical claimsHowever, I can provide the following information: The claims were correctly paid based on the information available at the time the claims were submitted for payment - The member did call our office and provide additional details - The member has been notified that charges will be reconsidered at the in-network benefit level Review of the member's account does not indicate any other services were provided by onetwork providers and all other claims were correctly paid according to the plan's benefits." I can find no other instance where the member would be under the impression that they had been "over charged" At this point we would consider the matter with the Revdex.com resolved Sincerely, Sheen [redacted] Customer Service Manager
Initial Business Response /* (1000, 15, 2015/09/15) */
________________
September 10, 2015
Ms. Rose [redacted] Revdex.com 2754 S. Campbell Ave Springfield MO 65807
Re: Case # XXXXXX Name: [redacted]
Group: XXXXXXIHC ID: XXXXXX Claims: XXXXXXXXXX, XXXXXXXXXXX, XXXXXXO867
Dear...
Ms. [redacted]
Our office received the first notice of complaint on the above case via facsimile on September 9, 2015.
As Third Party Administrator, Med-Pay, Inc., has a fiduciary responsibility to issue benefits according to all plan document specifications. The Integrity Home Care health plan is a self-insured, ERISA plan, under the jurisdiction of the Department of Labor. Claims payment must be made as outlined in the plan document. Failure to correctly adjudicate claims, including the application of provisions and penalties can result in civil and/or criminal charges against the administrator by the Department of Labor.
Please note, due to HIPAA privacy we cannot disclose specific details concerning this member's medical claims. However, I can provide the following information:
The claims were correctly paid based on the information available at the time the claims were submitted for payment.
- The member did call our office and provide additional details.
- The member has been notified that charges will be reconsidered at the in-network benefit level.
Review of the member's account does not indicate any other services were provided by out-of network providers and all other claims were correctly paid according to the plan's benefits." I can find no other instance where the member would be under the impression that they had been "over charged".
At this point we would consider the matter with the Revdex.com resolved.
Sincerely,
Sheen [redacted] Customer Service Manager
Initial Business Response /* (1000, 9, 2015/09/17) */
Contact Name and Title: Pamela [redacted]
Contact Phone: (XXX) XXX-XXXX
Contact Email: [redacted]@med-pay.com
This debt has been resolved. No payment is due from the member. We apologize for any confusion regarding this matter.
Initial Consumer...
Rebuttal /* (2000, 11, 2015/09/18) */
Revdex.com Comment - The consumer called the Revdex.com and stated the complaint has been resolved.
Initial Business Response / [redacted] (1000, 9, 2015/09/17) */ Contact Name and Title: Pamela [redacted] Contact Phone: (XXX) XXX-XXXX Contact Email: [redacted] @med-pay.com This debt has been resolvedNo payment is due from the memberWe apologize for any confusion regarding this matter Initial Consumer Rebuttal / [redacted] (2000, 11, 2015/09/18) */ Revdex.com Comment - The consumer called the Revdex.com and stated the complaint has been resolved
Initial Business Response / [redacted] (1000, 15, 2015/09/15) */ ________________ September 10, MsRose [redacted] Revdex.com SCampbell Ave Springfield MO Re: Case # XXXXXX Name: [redacted] Group: XXXXXXIHC ID: XXXXXX Claims: XXXXXXXXXX, XXXXXXXXXXX, XXXXXXO Dear Ms [redacted] Our office received the first notice of complaint on the above case via facsimile on September 9, As Third Party Administrator, Med-Pay, Inc., has a fiduciary responsibility to issue benefits according to all plan document specificationsThe Integrity Home Care health plan is a self-insured, ERISA plan, under the jurisdiction of the Department of LaborClaims payment must be made as outlined in the plan documentFailure to correctly adjudicate claims, including the application of provisions and penalties can result in civil and/or criminal charges against the administrator by the Department of Labor Please note, due to HIPAA privacy we cannot disclose specific details concerning this member's medical claimsHowever, I can provide the following information: The claims were correctly paid based on the information available at the time the claims were submitted for payment - The member did call our office and provide additional details - The member has been notified that charges will be reconsidered at the in-network benefit level Review of the member's account does not indicate any other services were provided by onetwork providers and all other claims were correctly paid according to the plan's benefits." I can find no other instance where the member would be under the impression that they had been "over charged" At this point we would consider the matter with the Revdex.com resolved Sincerely, Sheen [redacted] Customer Service Manager
Initial Business Response /* (1000, 15, 2015/09/15) */
________________
September 10, 2015
Ms. Rose [redacted] Revdex.com 2754 S. Campbell Ave Springfield MO 65807
Re: Case # XXXXXX Name: [redacted]
Group: XXXXXXIHC ID: XXXXXX Claims: XXXXXXXXXX, XXXXXXXXXXX, XXXXXXO867
Dear...
Ms. [redacted]
Our office received the first notice of complaint on the above case via facsimile on September 9, 2015.
As Third Party Administrator, Med-Pay, Inc., has a fiduciary responsibility to issue benefits according to all plan document specifications. The Integrity Home Care health plan is a self-insured, ERISA plan, under the jurisdiction of the Department of Labor. Claims payment must be made as outlined in the plan document. Failure to correctly adjudicate claims, including the application of provisions and penalties can result in civil and/or criminal charges against the administrator by the Department of Labor.
Please note, due to HIPAA privacy we cannot disclose specific details concerning this member's medical claims. However, I can provide the following information:
The claims were correctly paid based on the information available at the time the claims were submitted for payment.
- The member did call our office and provide additional details.
- The member has been notified that charges will be reconsidered at the in-network benefit level.
Review of the member's account does not indicate any other services were provided by out-of network providers and all other claims were correctly paid according to the plan's benefits." I can find no other instance where the member would be under the impression that they had been "over charged".
At this point we would consider the matter with the Revdex.com resolved.
Sincerely,
Sheen [redacted] Customer Service Manager
Initial Business Response /* (1000, 9, 2015/09/17) */
Contact Name and Title: Pamela [redacted]
Contact Phone: (XXX) XXX-XXXX
Contact Email: [redacted]@med-pay.com
This debt has been resolved. No payment is due from the member. We apologize for any confusion regarding this matter.
Initial Consumer...
Rebuttal /* (2000, 11, 2015/09/18) */
Revdex.com Comment - The consumer called the Revdex.com and stated the complaint has been resolved.