Helena
Montana 59601*Ph (406)442-2480* www.stpetes.org
September
20, 2015
RevDex.com
Re: Mary * R[redacted]
#10807478
To
whom it Concerns,
I
am in receipt of the concern filed by Ms R[redacted]. My responses to her concerns *re *s follows:
She
is correct in her statement that if * person only has Part A coverage, Medicare
does not pay for services in the Emergency Room. Medicare recipients get a detailed book
explaining what each portion of coverage will pay for. Emergency room services are clearly defined
in their literature as being covered under Part B benefits.
She
is also correct in stating she did not get a statement right away from our
facility. Our facility does not send out
statements to our customers until there is a self pay portion owing on their
bill. We were getting indications from
Medicare Ms R[redacted] had other primary coverage and we were investigating this to
see if the services could be billed to another insurance. Many of our patients that do not have a certain part of Medicare do carry
alternative insurance. Once it was
found the patient had no additional insurance to bill, a statement was sent out
to her.
Ms
R[redacted] has since reached out to our Financial advocate team and is in the
process of filing for assistance with her outstanding balances. If she is eligible for our program, her
balances will be reduced between 15-100%.
We
are sympathetic to her situation, but it is imperative people understand how their insurance works. If they have questions we do have a team of
people in place to answer questions prior to or after services are done.
Please
let me know if you need any additional information.
Sincerely
Sheri
R[redacted]
Director of Patient Business Services
Phone:
(406) 444-2184
Fax: (406) 444-2169
[redacted]
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received, your complaint will be closed Administratively Resolved]
Revdex.com,
I have reviewed the response made by the business in reference to complaint ID and have determined that this does not resolve my complaintFor your reference, details of the offer I reviewed appear below
September 25,
Cathy [redacted]
Revdex.com
Complaint ID
Dear Cathy [redacted],
Upon reading the page book sent by Medicare, it is true
that Medicare states that visits to the ER are processed under Part BFour of
my friends who all are on Medicare thought as I did, that the ER facility is
covered under Part AI guess there are a lot of us who don't read the bookNOTE:
IT WOULD BE A VERY INFORMATIVE, EASY AND NOVEL THING TO DO IF ER STAFF,
CHECKING PEOPLE WITH MEDICARE CARDS INTO THE ST PETER'S ER, TOLD THEM ALL
SERVICES ARE COVERED UNDER PART B.
THE FOLLOWING IS MY BIG ISSUEIf I'd found out in April or
May that I was going to be paying $I would have taken my chances with
bacteria getting into my bones and I would have not gone into the ER for
visits in JuneSo w/that, THERE WAS NEVER A CLAIM SUBMITTED TO MEDICARE (OR
[redacted]) BY ST PETER'S ER FACILITY FOR THE MARCH 4,
VISIT
I CALLED MEDICARE TODAY (9/25/2015) AND THEY INFORMED ME THAT THE ONLY CLAIM THAT
WAS SUBMITTED FOR 3/4/
WAS FROM THE ER DOCTOR SERVICEAND AS I SAID WHEN THE ER DOCTOR SERVICE'S
CLAIM WAS DENIED THEY SENT ME A BILL RIGHT AWAYIt will take business days
for Medicare to send me a summary statement for the period starting in March 4, to the present day September 25, I can mail this
information to you once I receive it as proof that StPeter's never sent in a
claim for that dayDo you want this info?
My husband quit his job in February and we forgot to
remove [redacted] from the Medicare systemI received an [redacted] Claim Recap in
July for x-rays done while at the ER on the June 14, visit and promptly removed [redacted] on July 31,
I CALLED [redacted] TODAY (9/25/2015), THEY INFORMED ME
THAT THE CLAIM FOR X-RAYS ON 6/14/WAS THE ONLY CLAIM THAT WAS SUBMITTED IN
in fact the last claim they had for me was in January 16, 2014, the one year
visit to the doctor to examine my total knee replacementI can mail this
information to you now or wait until I receive the information from Medicare
Do you want this info?
I can send you the bills sent to me by the ER doctor
serviceThe one for 3/4/
was sent in April and I paid it 4/15/
The one for 6/12/was sent
in July and I paid it on 7/31/
THE BILLING PERSONNEL FOR ST PETER'S ER DOCTOR BILLING WAIVED THE LAST TWO
BILLS (6/13/AND 6/14/Do you want these
bills?
I can send you bills sent to me by Dr G[redacted] Visits to Dr
G[redacted] on 6/12/15, 6/15/and 6/18/were paid by me on 7/23/The 6/25/visit was paid on 8/15/and the last visit on 7/8/was adjusted by Medicare on 8/20/and paid by me on 9/22/Do you want these bills?
It is true I called the Financial Advocate personnel of ST
Peter's hospital but not to file for assistanceI would not be eligible for
assistanceNo one at St Peter's Hospital seem to be able to do anything about what
I was saying and kept directing to this departmentI need to talk with someone,
who has real teeth, someone who will really listen and do something about the
lack of timely handling of this ER 3/4/bill, who can give me a financial
break both with a decrease of the $6,plus bill and without accruing
interest while I pay off the remaining amountI also know I don't have $6,
plus lying around to pay the bill in fullI find the hospital's response
unconscionablePerhaps I should move onto a State/Federal agency that helps
when people have issues with hospitals
Sincerely,
Mary R[redacted]
St.
Peter’s Hospital
2475 Broadway *...
Helena
Montana 59601*Ph (406)442-2480* www.stpetes.org
September
20, 2015
RevDex.com
Re: Mary * R[redacted]
#10807478
To
whom it Concerns,
I
am in receipt of the concern filed by Ms R[redacted]. My responses to her concerns *re *s follows:
She
is correct in her statement that if * person only has Part A coverage, Medicare
does not pay for services in the Emergency Room. Medicare recipients get a detailed book
explaining what each portion of coverage will pay for. Emergency room services are clearly defined
in their literature as being covered under Part B benefits.
She
is also correct in stating she did not get a statement right away from our
facility. Our facility does not send out
statements to our customers until there is a self pay portion owing on their
bill. We were getting indications from
Medicare Ms R[redacted] had other primary coverage and we were investigating this to
see if the services could be billed to another insurance. Many of our patients that do not have a certain part of Medicare do carry
alternative insurance. Once it was
found the patient had no additional insurance to bill, a statement was sent out
to her.
Ms
R[redacted] has since reached out to our Financial advocate team and is in the
process of filing for assistance with her outstanding balances. If she is eligible for our program, her
balances will be reduced between 15-100%.
We
are sympathetic to her situation, but it is imperative people understand how their insurance works. If they have questions we do have a team of
people in place to answer questions prior to or after services are done.
Please
let me know if you need any additional information.
Sincerely
Sheri
R[redacted]
Director of Patient Business Services
Phone:
(406) 444-2184
Fax: (406) 444-2169
[redacted]
Enclosure:
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received, your complaint will be closed Administratively Resolved]
Revdex.com,
I have reviewed the response made by the business in reference to complaint ID and have determined that this does not resolve my complaintFor your reference, details of the offer I reviewed appear below
September 25,
Cathy [redacted]
Revdex.com
Complaint ID
Dear Cathy [redacted],
Upon reading the page book sent by Medicare, it is true
that Medicare states that visits to the ER are processed under Part BFour of
my friends who all are on Medicare thought as I did, that the ER facility is
covered under Part AI guess there are a lot of us who don't read the bookNOTE:
IT WOULD BE A VERY INFORMATIVE, EASY AND NOVEL THING TO DO IF ER STAFF,
CHECKING PEOPLE WITH MEDICARE CARDS INTO THE ST PETER'S ER, TOLD THEM ALL
SERVICES ARE COVERED UNDER PART B.
THE FOLLOWING IS MY BIG ISSUEIf I'd found out in April or
May that I was going to be paying $I would have taken my chances with
bacteria getting into my bones and I would have not gone into the ER for
visits in JuneSo w/that, THERE WAS NEVER A CLAIM SUBMITTED TO MEDICARE (OR
[redacted]) BY ST PETER'S ER FACILITY FOR THE MARCH 4,
VISIT
I CALLED MEDICARE TODAY (9/25/2015) AND THEY INFORMED ME THAT THE ONLY CLAIM THAT
WAS SUBMITTED FOR 3/4/
WAS FROM THE ER DOCTOR SERVICEAND AS I SAID WHEN THE ER DOCTOR SERVICE'S
CLAIM WAS DENIED THEY SENT ME A BILL RIGHT AWAYIt will take business days
for Medicare to send me a summary statement for the period starting in March 4, to the present day September 25, I can mail this
information to you once I receive it as proof that StPeter's never sent in a
claim for that dayDo you want this info?
My husband quit his job in February and we forgot to
remove [redacted] from the Medicare systemI received an [redacted] Claim Recap in
July for x-rays done while at the ER on the June 14, visit and promptly removed [redacted] on July 31,
I CALLED [redacted] TODAY (9/25/2015), THEY INFORMED ME
THAT THE CLAIM FOR X-RAYS ON 6/14/WAS THE ONLY CLAIM THAT WAS SUBMITTED IN
in fact the last claim they had for me was in January 16, 2014, the one year
visit to the doctor to examine my total knee replacementI can mail this
information to you now or wait until I receive the information from Medicare
Do you want this info?
I can send you the bills sent to me by the ER doctor
serviceThe one for 3/4/
was sent in April and I paid it 4/15/
The one for 6/12/was sent
in July and I paid it on 7/31/
THE BILLING PERSONNEL FOR ST PETER'S ER DOCTOR BILLING WAIVED THE LAST TWO
BILLS (6/13/AND 6/14/Do you want these
bills?
I can send you bills sent to me by Dr G[redacted] Visits to Dr
G[redacted] on 6/12/15, 6/15/and 6/18/were paid by me on 7/23/The 6/25/visit was paid on 8/15/and the last visit on 7/8/was adjusted by Medicare on 8/20/and paid by me on 9/22/Do you want these bills?
It is true I called the Financial Advocate personnel of ST
Peter's hospital but not to file for assistanceI would not be eligible for
assistanceNo one at St Peter's Hospital seem to be able to do anything about what
I was saying and kept directing to this departmentI need to talk with someone,
who has real teeth, someone who will really listen and do something about the
lack of timely handling of this ER 3/4/bill, who can give me a financial
break both with a decrease of the $6,plus bill and without accruing
interest while I pay off the remaining amountI also know I don't have $6,
plus lying around to pay the bill in fullI find the hospital's response
unconscionablePerhaps I should move onto a State/Federal agency that helps
when people have issues with hospitals
Sincerely,
Mary R[redacted]