Spectrum MRI Imaging Center

I am rejecting this response because:Mr [redacted] is once again disregarding the principal issue of my complaint; that he is bound by the signed contractual agreement with Blue Cross Blue Shield to accept customary and allowed charges as full payment of services Per Blue Cross Blue Shield, by not accepting the charges per his agreement, he is in violation of said agreement, which could result in Blue Cross Blue Shield terminating their agreement to do business with Spectrum MRI In addition, per the insurance agreement, any charges not paid by Blue Cross Blue Shield are not to be billed to the patient, irregardless of Mr [redacted] 's claim that patient's sign an agreement to pay charges not paid by insurance This clause is standard with all physician offices and has never been utilized, nor is it customary and allowed, to bill patients for any remaining balances not allowed by the insurance company Mr [redacted] 's insistence that his performance and interpretation of any MRI films as being superior and therefore, subject to greater fees than what other facilities would charge, seems to be predicated upon his failure to understand the standard operating practices of insurance billing I therefore state, uniquivacally, that I will not pay the additional charges that he has billed and will be forced to take further legal action if I do not receive a statement of account showing a zero ($0.00) balance due Also, once again, I encourage Mr [redacted] and his billing office to direct his disatisfaction with payment directly to Blue Cross Blue Shield in an attempt to see if additional payment can be approved Respectfully, [redacted] T [redacted]

When any facility or doctor's office verify a patient's insurance, the insurance carrier verifies what is on their system at that exact moment However, by the time the facility or doctor's office submits the claim it could be 1-weeks from the time of the visit which may change the co-pay based on
how much of the deductible was metAt the time of service, she had not met her deductible so her co-pay was $Additionally, all patients sign a form stating they are legally responsible for all charges incurred whether or not they are paid by their insurance.' This is what happened in her caseHer insurance did not pay for the additional procedures necessary to complete the scanThese additional procedures are part of the MRI scan and that is what her insurance is denyingWe strongly believe in the quality of our images and will not compromise our standardsThis standard is what leads to exceptional images that allows the Radiologist to correctly evaluate each scan. I am not sure who she spoke to, but both L and A deny making the claim that she states in her letterSpectrum MRI prides itself on providing exceptional imaging quality and serviceWe do not agree with all of the allegations that she made and stand behind the service that we provide our patientsWe do and have refunded patients on a case by case basisWe have evaluated her case and stand behind our decision that she is not entitled to a refundWe are sorry that this has caused her so much frustration but feel she has received an exceptional image, report, and service

I am rejecting this response because:Mr. [redacted] is once again disregarding the principal issue of my complaint; that he is bound by the signed contractual agreement with Blue Cross Blue Shield to accept customary and allowed charges as full payment of services.  Per Blue Cross Blue Shield, by not accepting the charges per his agreement, he is in violation of said agreement, which could result in Blue Cross Blue Shield terminating their agreement to do business with Spectrum MRI.  
In addition, per the insurance agreement, any charges not paid by Blue Cross Blue Shield are not to be billed to the patient, irregardless of Mr. [redacted]'s claim that patient's sign an agreement to pay charges not paid by insurance.  This clause is standard with all physician offices and has never been utilized, nor is it customary and allowed, to bill patients for any remaining balances not allowed by the insurance company.  Mr. [redacted]'s insistence that his performance and interpretation of any MRI films as being superior and therefore, subject to greater fees than what other facilities would charge, seems to be predicated upon his failure to understand the standard operating practices of insurance billing.  I therefore state, uniquivacally, that I will not pay the additional charges that he has billed and will be forced to take further legal action if I do not receive a statement of account showing a zero ($0.00) balance due.  Also, once again, I encourage Mr. [redacted] and his billing office to direct his disatisfaction with payment directly to Blue Cross Blue Shield in an attempt to see if additional payment can be approved.  Respectfully,[redacted] T. [redacted]