Spectrum Healthcare Partners

I received services over a several month period. I reviewed claims via my insurance and paid directly on those claims submitted to the insurance company directly, online. I received confirmation that an external check went out, yet months later I was still seeing a balance despite paying, finally I received a VERY RUDE call from a so called manager in billing from spectrum and I tried explaining that however the claim was submitted to the insurance is how and where the payment went to. They didn't want to listen. So I contacted my insurance company and tried figure it out. A very nice rep called Spectrum and found out they needed a new w-9 form to submit payments to the correct address and not what was actually being filed in the claims. Several months later, bill by bill I paid to make sure this didn't happen. Now I have been sent to collections for somethign I paid on and once again it's because of their incompetent billing system where they submit the claim under the parent company to the insurance instead of actually where the bill needs to be paid to. So I spent another on the phone with the insurance and she was absolutely baffled by how they could possibly expect payment not only from the patient but the insurance company if the claim isn't submitted correctly. I'm being sent to collections for a company, a partner of spectrum, that I never received a bill from them directly. I paid online via my HSA directly from the claim information as this is easiest usually. I've never had such billing issues with a medical group before NEVER. I will never willingly return to them as this practice seems fraudulent at best.

Spectrum Medical Group is Spectrum Healthcare Partners which has different billing departments.

I noticed our (my husband is the patient, and I am pay the bills) most recent invoice with the Radiology Department was not submitted to our insurance company, which prompted me to check our other bill which is through the Anesthesiology Dept. I found that neither had submitted insurance claims through Spectrum, even though the facilities that submitted them the paperwork filed their own claims; AND even though they already had insurance information on file. So I called the Anesthesiology Dept. who requested I give them the insurance information directly, again, so they can submit the claim to *** AND they told me to NOT pay my invoice until they hear back from the insurance company, which they said it would take up to four weeks to hear back. I was then sent to collections by the Radiology Dept. I spoke to both department's last week trying to resolve why I was sent to collections, and why the insurance was not submitted. I also spoke to my insurance company directly, who said that the invoice from Anesthesiology was past the 15 month window to submit a claim, however if Spectrum already had my insurance information on file, then Spectrum should have submitted the claim AND SHOULD WAIVE the balance.

After speaking with Radiology, I found that they DID have our insurance information on file, from a previous claim run in November , so she apologized and said they would submit the insurance claim and notifly collections.

Then I spoke to Anesthesiology and asked them to research prior history and she say that Spectrum does not research a patient's account to see if we have insurance from other invoices on file, they just take the information from the facility, and that it is MY responsibility to give Spectrum our insurance information directly if I notice they didn't make the adjustment on the original invoice. I asked her to research my history anyways, and she found that she had my information from a prior claim that was submitted in January. So again. they had my information in the system, just not from that specific facility. So Anesthesiology advised that my claim they submitted on 2/1/19 is now in appeals with my insurance company, but I assume my insurance company will deny the appeal since Spectrum did not submit the insurance claim within 15 months, as stated before,

It appears that one way or another you have had my insurance information on file at Spectrum. Per the rep in Anesthesiology , Spectrum's billing policyis that they do not look at a patient's history to see if they have insurance on file, prior to billing the patient. This is the first healthcare facility I have run into that doesn't look at a patient's history. They rely on each facility for the information, which clearly is not reliable, as the facility failed to give Spectrum my insurance information. This is the first medical billing I've ever had a problem with, the first company that has not done their due diligence, and the first company that has ever sent me to collections after telling me NOT to pay.

My PCP was sending my lab work to *** for study, and while under this care, I was receiving and remitting payment to ***. Care was completed and to my knowledge all bills had been paid. Months later, I start receiving phone calls from the *** Agency stating they were attempting to collect on bad debt. When I spoke to the *** Agency, they notified me the reason for the collections was that *** claimed they could not reach me to collect on $208.00. I contacted the billing office at *** and they admittedly confirmed that they somehow changed my mailing address and it was grossly incorrect. When I asked, why no one thought to contact me by phone, they claimed to have called several times, but did not leave a voicemail d/t confidentiality. This is also absurd, with the amount of scamming calls we all receive, I am not going to answer my phone in the middle of my work day to have to listen to a telemarketer or scammer. All *** had to leave on the message was something to the tone of, "this is xxx from *** looking to speak with.. " That statement in no way infringes on HIPPA or any confidentiality of any sort. Instead what they did was send my account to collections through the *** Agency. All previous bills were paid in full and on time as requested. *** did not in good faith effort attempt to contact me to collect on the bill. This entire situation caused an extreme amount of stress and anxiety for no good reason, in addition to tarnishing a perfect record. I pay all my bills on time and work hard to have wonderful credit. It is upsetting that the lack of initiative of a business's billing department could so easily tarnish all that is so hard to work towards. If my account was not in good standing and I had never paid a bill received from them, I could understand why they would seek assistance of a collections agency. However, this was not the case in my scenario.