-------- Forwarded message ---------- From: Revdex.com of Metro Washington DC Date: Thu, Aug 28, at 9: AM Subject: Fwd: complaint [redacted] To: [redacted] < [redacted] > ---------- Forwarded message ---------- From: < [redacted] > Date: Thu, Aug 28, at 8:AM Subject: complaint [redacted] To: [email protected] Dear Sirs, I finally contacted the company I complained about.I told the lady that I talked to what my complaint was aboutShe said she would check on it and call me back.She called me back and said they did an audit of my daughters account and instead of her getting $back she would be getting $back! She also told me if it was any consolation that the two people that I dealt with are no longer employed thereYesterday my daughter received the checkThank you for your help Sincerely, [redacted]
May 5, 2014Dear ** [redacted] ,I have reviewed the follow up documentation from ** [redacted] indicating she is rejecting the previous response we provided.When ** [redacted] was originally evaluated in the office on 10/03/she did not complete a payment or check out processHer upcoming services were scheduled by a nurse and she was escorted out of the officeWe do not have a formal checkout process that she is indicating that she completedWhen a new patient schedules an office consultation we cannot quote out of pocket expenses ahead of timeWe do not know the complexity of the office visit ahead completing the examination and therefore send a statement to the patient after the services have been completedIf ** [redacted] would have "called around for prices” as she indicated in her rebuttal letter our front office policy is to quote that evaluations begin at $and go up from there.On 10/15/our billing office quoted ** [redacted] the cost of the surgical services only and informed her they would be due on the day of the procedureThis quote did not include the cost of the consultation.The return visit required to treat a post operative complication on 10/24/is a billable return visit as she required additional services to be completed by the surgeon** [redacted] signed a surgical consent letter acknowledging that a post operative infection may occur which would require additional servicesIt was not stated to ** [redacted] that there would not be a charge for the visitFollowing an emergency visit ** [redacted] would have been discharged by a nurse and escorted out of the officeServices that are not treatment planned in advance cannot be quoted to patients in advance.Our billing office explained the balance to ** [redacted] on 12/11/We did not receive payment or further communication from her and the account was forwarded to the collection agency on March 28th, 2014.Please contact me if you have further questions or require additional documentation.Sincerely,
--------- Forwarded message ---------- From: < [redacted] > Date: Mon, Apr 28, at 11:AM Subject: [redacted] To: [redacted] Good Morning, As per our telephone conversation, I contacted ***'s medical insurance carrier on 04/23/and spoke to ***She stated that the insurance claim is being reprocessed and that it is has not finalized yet, but they have received it I also provided ***'s husband, [redacted] an update on the insurance claim processing as well At this time we are waiting for the insurance carrier to process the claim in order to determine refund Please let me know if you have any further questions or require additional documentation Sincerely, [redacted] , CPC, CDC Practice Administrator, Sudbrink Oral Surgery Associates ###-###-#### xt [redacted] ###-###-#### xt [redacted] ###-###-####(cell)
[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] Complaint: [redacted] I am rejecting this response because: on oct when I had the tooth pulled I paid my bill in full before I went in to have it done.if it was going to be more why would they not have chared me the full amount.so aparently was a concaltation fee.I think this is outrages.I was never told evaluation started at 80.00.I dont think they new what was going on in the office,as they were just opening this office that week .when I call I would not have gone there If it cost that much.I live on a fixed income,I don't have that kind of money.I was told there was on charge for coming back with the infection.I told them Ihave medical inc and couldsee my family doctor,the lady said there would be no charge.I paid with a creadit card because I didn't have the money to pay the Regards, [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]Complaint: [redacted] I am rejecting this response because: I still believe I am owed money by the business [redacted] , the office administrator, provided me with details about the $being withheld previously I received the following in an email message from her on March 19, 2014: "I was able to complete the account review and audit It appears as though [redacted] completed processing of your claim for services provided on 09/19/13, however they did not include the nitrous oxide in the listing of procedures They did provide unexpected coverage for the dental extractions At this time they covered the procedure at 100% without any patient out of pocket expenses with the exception of their exclusion of nitrous oxide administration The claim was sent to [redacted] for possible coverage of the nitrous oxide administration You paid $on 09/20/13, minus the $fee for nitrous oxide, has resulted in a refund due to you of $ This refund was processed on 03/18/directly to your credit card." (I did reply to this email on March 21, with some of the concerns I'll get into below, but got no response.) I believe I am currently owed the $nitrous oxide fee and would like [redacted] to review the account again and issue me a refund if I am truly owed one Here is my reasoning: I learned from [redacted] (my health insurance provider) that the line item listed as "Medical Care" on my explanation of benefits form is for code # [redacted] - Sedation The billed charge for this line item is $- the amount [redacted] says I owe for "nitrous oxide administration." [redacted] covered this item 100% and lists patient responsibility as $ Upon researching this code, it seems as though the substance used to sedate is part of the charge, in addition to the administration (in this case, nitrous oxide) Furthermore, in her response to the Revdex.com complaint, [redacted] says she has resubmitted the claims on my behalf, presumably to [redacted] , but as of Monday, April 7, a representative at [redacted] says no claims have been resubmitted and that it would be unusual for the healthcare provider to justify a claim that is so old (in this case, my surgery took place in September and the EOB was printed and sent out by [redacted] at the end of November 2013) [redacted] also mentions [redacted] , my dental insurance provider, but I have seen nothing from them in the way of an EOB and why would I if my health insurance covered everything 100% as my explanation of benefits would indicate? So again, based on my research, I still believe I am owed the balance of the money I paid up front, or $ It's true that a portion of what I paid up front was refunded to my credit card, and I appreciate that If I believed I really owed this business money for a service (i.esomething was not covered), I would have no problem paying for the service, but again, everything I can find does not indicate that I would like [redacted] to review my account again, with all of this said, and refund the money if it is owed to me, as I believe it is Regards, [redacted]
April 16, 2014 Dear **. [redacted] ,Please accept this letter as a formal response to the complaint filed by **. [redacted] .**. [redacted] had services completed in our office on 10/03/13,10/17/13, and 10/24/13. She paid at the time of service for 10/17/13 only. The remaining two dates... of service remain unpaid and our billing department explained the charges to her during a 12/11/13 telephone conversation. **. [redacted] 's account was referred to a collection agency due to lack of any payment being received.We encourage **. [redacted] to follow up with the collection agency to make payment arrangements.Please contact our office if you have any questions or require additional documentation.
[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]
Complaint: ***
I am rejecting this response because: I paid my bill for 10/03/13-10/17/on 10/17/I paid in full.when I went back with the infection on 10/24/I was told there was no charge and I checked out and was not charged.I would not have gone there for that price,I have no Dental incwhich is the reason I called aroun for pricess befor I made the app
Regards,
*** ***
April 4, Dear ***,Please accept this letter as a formal response to the complaint filed by *** ***.Our office completed an account review for *** *** and determined that an overpayment of $had been made by the patient, which was refunded on
03/18/During the account audit processed a claims error was identified that a portion of the anesthesia services provided were excluded from the processing by her insurance carrierWe have corrected the error and resubmitted claims on her behalf At this time due to the remaining services still being outstanding to the insurance carrier we are unable to issue her an additional refundOnce the insurance carrier completes their reconsideration of the claim, if additional benefits are provided, *** *** will receive an additional refund.Our office completed a courtesy verification of insurance benefits only and did not provide her with a guarantee of paymentsThis was presented to *** *** at the time of registration in the form of our financial policyAttached is a copy of the signed financial agreementIt was again quoted to her verbally at the time our billing office quoted to her the out of pocket expenses.Her allegation that the explanation of benefits received from her insurance company was vague in nature and "sneaky" needs to be addressed directly to her insurance carrierWe do not have control as to how they construct their explanation of benefits.Please contact our office if you have further questions or require additional documentation,
Dear *** ***,Please accept this letter as a formal response to the complaint filed by *** ***, ID #***.Our office has reviewed the complaint filed by *** *** on behalf of his daughter, ***I personally completed the account audit and finalized the insurance payments which resulted in an over payment made by *** of $This amount was refunded to *** on 08/18/with check #***.Our office has closed ***'s account and spoke to her father informing him of the action taken.Please contact our office if you have any further questions or require additional documentation.Sincerely,
Kimberly I. CPC, CDC
Practice Administrator
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
Complaint: [redacted]
I am rejecting this response because: on oct 17 when I had the tooth pulled I paid my bill in full before I went in to have it done.if it was going to be more why would they not have chared me the full amount.so aparently 263.00 was a concaltation fee.I think this is outrages.I was never told evaluation started at 80.00.I dont think they new what was going on in the office,as they were just opening this office that week .when I call I would not have gone there If it cost that much.I live on a fixed income,I don't have that kind of money.I was told there was on charge for coming back with the infection.I told them Ihave medical inc and couldsee my family doctor,the lady said there would be no charge.I paid with a creadit card because I didn't have the money to pay the 263.00.
Regards,
[redacted]
--------- Forwarded message ----------
From: <[redacted]>
Date: Mon, Apr 28, 2014 at 11:37 AM
Subject: [redacted]
To: [redacted]
Good Morning,
As per our telephone conversation, I contacted [redacted]'s medical insurance carrier on 04/23/14 and spoke to [redacted]. She stated that the insurance claim is being reprocessed and that it is has not finalized yet, but they have received it.
I also provided [redacted]'s husband, [redacted] an update on the insurance claim processing as well.
At this time we are waiting for the insurance carrier to process the claim in order to determine refund.
Please let me know if you have any further questions or require additional documentation.
Sincerely,
[redacted], CPC, CDC
Practice Administrator, Sudbrink Oral Surgery Associates
###-###-#### xt [redacted]
###-###-#### xt [redacted]
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]Complaint: [redacted]
I am rejecting this response because: I still believe I am owed money by the business.
[redacted], the office administrator, provided me
with details about the $205 being withheld previously. I received the following in an email message
from her on March 19, 2014:
"I was able to complete the account review and audit.
It appears as though [redacted] completed processing of your claim for services
provided on 09/19/13, however they did not include the nitrous oxide in the
listing of procedures. They did provide unexpected coverage for the dental
extractions.
At this time they covered the procedure at 100% without any
patient out of pocket expenses with the exception of their exclusion of nitrous
oxide administration. The claim was sent to [redacted] for possible
coverage of the nitrous oxide administration.
You paid $470 on 09/20/13, minus the $205 fee for nitrous oxide,
has resulted in a refund due to you of $265. This refund was processed on
03/18/14 directly to your credit card."
(I did reply to this email on
March 21, with some of the concerns I'll get into below, but got no response.)
I believe I am currently owed
the $205 nitrous oxide fee and would like [redacted] to review the account
again and issue me a refund if I am truly owed one.
Here is my reasoning: I
learned from [redacted] (my health insurance provider) that the line item
listed as "Medical Care" on my explanation of benefits form is for
code # [redacted] - Sedation.
The billed charge for this
line item is $205 - the amount [redacted] says I owe for "nitrous oxide
administration." [redacted] covered
this item 100% and lists patient responsibility as $0. Upon researching this code, it seems as
though the substance used to sedate is part of the charge, in addition to the
administration (in this case, nitrous oxide).
Furthermore, in her response
to the Revdex.com complaint, [redacted] says she has resubmitted the claims on my behalf,
presumably to [redacted], but as of Monday, April 7, a representative at
[redacted] says no claims have been resubmitted and that it would be unusual
for the healthcare provider to justify a claim that is so old (in this case, my
surgery took place in September 2013 and the EOB was printed and sent out by
[redacted] at the end of November 2013)
[redacted] also mentions
[redacted], my dental insurance provider, but I have seen nothing from
them in the way of an EOB and why would I if my health insurance covered
everything 100% as my explanation of benefits would indicate?
So again, based on my
research, I still believe I am owed the balance of the money I paid up front,
or $205. It's true that a portion of
what I paid up front was refunded to my credit card, and I appreciate
that. If I believed I really owed this
business money for a service (i.e. something was not covered), I would have no
problem paying for the service, but again, everything I can find does not
indicate that. I would like [redacted]
to review my account again, with all of this said, and refund the money if it
is owed to me, as I believe it is.
Regards,
[redacted]
-------- Forwarded message ----------
From: Revdex.com of Metro Washington DC <[email protected]>
Date: Thu, Aug 28, 2014 at 9:02...
AM
Subject: Fwd: complaint [redacted]
To: [redacted] <[redacted]>
---------- Forwarded message ----------
From: <[redacted]>
Date: Thu, Aug 28, 2014 at 8:36 AM
Subject: complaint [redacted]
To: [email protected]
Dear Sirs,
I finally contacted the company I complained about.I told the lady that I talked to what my complaint was about. She said she would check on it and call me back.She called me back and said they did an audit of my daughters account and instead of her getting $129 back she would be getting $426 back! She also told me if it was any consolation that the two people that I dealt with are no longer employed there. Yesterday my daughter received the check. Thank you for your help.
Sincerely,
[redacted]
May 5, 2014Dear **. [redacted],I have reviewed the follow up documentation from **. [redacted] indicating she is rejecting the previous response we provided.When **. [redacted] was originally evaluated in the office on 10/03/13 she did not complete a payment or check out process. Her upcoming services were scheduled by a nurse and she was escorted out of the office. We do not have a formal checkout process that she is indicating that she completed. When a new patient schedules an office consultation we cannot quote out of pocket expenses ahead of time. We do not know the complexity of the office visit ahead completing the examination and therefore send a statement to the patient after the services have been completed. If **. [redacted] would have "called around for prices” as she indicated in her rebuttal letter our front office policy is to quote that evaluations begin at $80 and go up from there.On 10/15/2013 our billing office quoted **. [redacted] the cost of the surgical services only and informed her they would be due on the day of the procedure. This quote did not include the cost of the consultation.The return visit required to treat a post operative complication on 10/24/2013 is a billable return visit as she required additional services to be completed by the surgeon. **. [redacted] signed a surgical consent letter acknowledging that a post operative infection may occur which would require additional services. It was not stated to **. [redacted] that there would not be a charge for the visit. Following an emergency visit **. [redacted] would have been discharged by a nurse and escorted out of the office. Services that are not treatment planned in advance cannot be quoted to patients in advance.Our billing office explained the balance to **. [redacted] on 12/11/2013. We did not receive payment or further communication from her and the account was forwarded to the collection agency on March 28th, 2014.Please contact me if you have further questions or require additional documentation.Sincerely,
April 16, 2014
Dear **. [redacted],Please accept this letter as a formal response to the complaint filed by **. [redacted].**. [redacted] had services completed in our office on 10/03/13,10/17/13, and 10/24/13. She paid at the time of service for 10/17/13 only. The remaining two dates...
of service remain unpaid and our billing department explained the charges to her during a 12/11/13 telephone conversation. **. [redacted]'s account was referred to a collection agency due to lack of any payment being received.We encourage **. [redacted] to follow up with the collection agency to make payment arrangements.Please contact our office if you have any questions or require additional documentation.
-------- Forwarded message ---------- From: Revdex.com of Metro Washington DC Date: Thu, Aug 28, at 9: AM Subject: Fwd: complaint [redacted] To: [redacted] < [redacted] > ---------- Forwarded message ---------- From: < [redacted] > Date: Thu, Aug 28, at 8:AM Subject: complaint [redacted] To: [email protected] Dear Sirs, I finally contacted the company I complained about.I told the lady that I talked to what my complaint was aboutShe said she would check on it and call me back.She called me back and said they did an audit of my daughters account and instead of her getting $back she would be getting $back! She also told me if it was any consolation that the two people that I dealt with are no longer employed thereYesterday my daughter received the checkThank you for your help Sincerely, [redacted]
May 5, 2014Dear ** [redacted] ,I have reviewed the follow up documentation from ** [redacted] indicating she is rejecting the previous response we provided.When ** [redacted] was originally evaluated in the office on 10/03/she did not complete a payment or check out processHer upcoming services were scheduled by a nurse and she was escorted out of the officeWe do not have a formal checkout process that she is indicating that she completedWhen a new patient schedules an office consultation we cannot quote out of pocket expenses ahead of timeWe do not know the complexity of the office visit ahead completing the examination and therefore send a statement to the patient after the services have been completedIf ** [redacted] would have "called around for prices” as she indicated in her rebuttal letter our front office policy is to quote that evaluations begin at $and go up from there.On 10/15/our billing office quoted ** [redacted] the cost of the surgical services only and informed her they would be due on the day of the procedureThis quote did not include the cost of the consultation.The return visit required to treat a post operative complication on 10/24/is a billable return visit as she required additional services to be completed by the surgeon** [redacted] signed a surgical consent letter acknowledging that a post operative infection may occur which would require additional servicesIt was not stated to ** [redacted] that there would not be a charge for the visitFollowing an emergency visit ** [redacted] would have been discharged by a nurse and escorted out of the officeServices that are not treatment planned in advance cannot be quoted to patients in advance.Our billing office explained the balance to ** [redacted] on 12/11/We did not receive payment or further communication from her and the account was forwarded to the collection agency on March 28th, 2014.Please contact me if you have further questions or require additional documentation.Sincerely,
--------- Forwarded message ---------- From: < [redacted] > Date: Mon, Apr 28, at 11:AM Subject: [redacted] To: [redacted] Good Morning, As per our telephone conversation, I contacted ***'s medical insurance carrier on 04/23/and spoke to ***She stated that the insurance claim is being reprocessed and that it is has not finalized yet, but they have received it I also provided ***'s husband, [redacted] an update on the insurance claim processing as well At this time we are waiting for the insurance carrier to process the claim in order to determine refund Please let me know if you have any further questions or require additional documentation Sincerely, [redacted] , CPC, CDC Practice Administrator, Sudbrink Oral Surgery Associates ###-###-#### xt [redacted] ###-###-#### xt [redacted] ###-###-####(cell)
[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] Complaint: [redacted] I am rejecting this response because: on oct when I had the tooth pulled I paid my bill in full before I went in to have it done.if it was going to be more why would they not have chared me the full amount.so aparently was a concaltation fee.I think this is outrages.I was never told evaluation started at 80.00.I dont think they new what was going on in the office,as they were just opening this office that week .when I call I would not have gone there If it cost that much.I live on a fixed income,I don't have that kind of money.I was told there was on charge for coming back with the infection.I told them Ihave medical inc and couldsee my family doctor,the lady said there would be no charge.I paid with a creadit card because I didn't have the money to pay the Regards, [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]Complaint: [redacted] I am rejecting this response because: I still believe I am owed money by the business [redacted] , the office administrator, provided me with details about the $being withheld previously I received the following in an email message from her on March 19, 2014: "I was able to complete the account review and audit It appears as though [redacted] completed processing of your claim for services provided on 09/19/13, however they did not include the nitrous oxide in the listing of procedures They did provide unexpected coverage for the dental extractions At this time they covered the procedure at 100% without any patient out of pocket expenses with the exception of their exclusion of nitrous oxide administration The claim was sent to [redacted] for possible coverage of the nitrous oxide administration You paid $on 09/20/13, minus the $fee for nitrous oxide, has resulted in a refund due to you of $ This refund was processed on 03/18/directly to your credit card." (I did reply to this email on March 21, with some of the concerns I'll get into below, but got no response.) I believe I am currently owed the $nitrous oxide fee and would like [redacted] to review the account again and issue me a refund if I am truly owed one Here is my reasoning: I learned from [redacted] (my health insurance provider) that the line item listed as "Medical Care" on my explanation of benefits form is for code # [redacted] - Sedation The billed charge for this line item is $- the amount [redacted] says I owe for "nitrous oxide administration." [redacted] covered this item 100% and lists patient responsibility as $ Upon researching this code, it seems as though the substance used to sedate is part of the charge, in addition to the administration (in this case, nitrous oxide) Furthermore, in her response to the Revdex.com complaint, [redacted] says she has resubmitted the claims on my behalf, presumably to [redacted] , but as of Monday, April 7, a representative at [redacted] says no claims have been resubmitted and that it would be unusual for the healthcare provider to justify a claim that is so old (in this case, my surgery took place in September and the EOB was printed and sent out by [redacted] at the end of November 2013) [redacted] also mentions [redacted] , my dental insurance provider, but I have seen nothing from them in the way of an EOB and why would I if my health insurance covered everything 100% as my explanation of benefits would indicate? So again, based on my research, I still believe I am owed the balance of the money I paid up front, or $ It's true that a portion of what I paid up front was refunded to my credit card, and I appreciate that If I believed I really owed this business money for a service (i.esomething was not covered), I would have no problem paying for the service, but again, everything I can find does not indicate that I would like [redacted] to review my account again, with all of this said, and refund the money if it is owed to me, as I believe it is Regards, [redacted]
April 16, 2014 Dear **. [redacted] ,Please accept this letter as a formal response to the complaint filed by **. [redacted] .**. [redacted] had services completed in our office on 10/03/13,10/17/13, and 10/24/13. She paid at the time of service for 10/17/13 only. The remaining two dates... of service remain unpaid and our billing department explained the charges to her during a 12/11/13 telephone conversation. **. [redacted] 's account was referred to a collection agency due to lack of any payment being received.We encourage **. [redacted] to follow up with the collection agency to make payment arrangements.Please contact our office if you have any questions or require additional documentation.
[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]
Complaint: ***
I am rejecting this response because: I paid my bill for 10/03/13-10/17/on 10/17/I paid in full.when I went back with the infection on 10/24/I was told there was no charge and I checked out and was not charged.I would not have gone there for that price,I have no Dental incwhich is the reason I called aroun for pricess befor I made the app
Regards,
*** ***
April 4, Dear ***,Please accept this letter as a formal response to the complaint filed by *** ***.Our office completed an account review for *** *** and determined that an overpayment of $had been made by the patient, which was refunded on
03/18/During the account audit processed a claims error was identified that a portion of the anesthesia services provided were excluded from the processing by her insurance carrierWe have corrected the error and resubmitted claims on her behalf At this time due to the remaining services still being outstanding to the insurance carrier we are unable to issue her an additional refundOnce the insurance carrier completes their reconsideration of the claim, if additional benefits are provided, *** *** will receive an additional refund.Our office completed a courtesy verification of insurance benefits only and did not provide her with a guarantee of paymentsThis was presented to *** *** at the time of registration in the form of our financial policyAttached is a copy of the signed financial agreementIt was again quoted to her verbally at the time our billing office quoted to her the out of pocket expenses.Her allegation that the explanation of benefits received from her insurance company was vague in nature and "sneaky" needs to be addressed directly to her insurance carrierWe do not have control as to how they construct their explanation of benefits.Please contact our office if you have further questions or require additional documentation,
Dear *** ***,Please accept this letter as a formal response to the complaint filed by *** ***, ID #***.Our office has reviewed the complaint filed by *** *** on behalf of his daughter, ***I personally completed the account audit and finalized the insurance payments which resulted in an over payment made by *** of $This amount was refunded to *** on 08/18/with check #***.Our office has closed ***'s account and spoke to her father informing him of the action taken.Please contact our office if you have any further questions or require additional documentation.Sincerely,
Kimberly I. CPC, CDC
Practice Administrator
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
Complaint: [redacted]
I am rejecting this response because: on oct 17 when I had the tooth pulled I paid my bill in full before I went in to have it done.if it was going to be more why would they not have chared me the full amount.so aparently 263.00 was a concaltation fee.I think this is outrages.I was never told evaluation started at 80.00.I dont think they new what was going on in the office,as they were just opening this office that week .when I call I would not have gone there If it cost that much.I live on a fixed income,I don't have that kind of money.I was told there was on charge for coming back with the infection.I told them Ihave medical inc and couldsee my family doctor,the lady said there would be no charge.I paid with a creadit card because I didn't have the money to pay the 263.00.
Regards,
[redacted]
--------- Forwarded message ----------
From: <[redacted]>
Date: Mon, Apr 28, 2014 at 11:37 AM
Subject: [redacted]
To: [redacted]
Good Morning,
As per our telephone conversation, I contacted [redacted]'s medical insurance carrier on 04/23/14 and spoke to [redacted]. She stated that the insurance claim is being reprocessed and that it is has not finalized yet, but they have received it.
I also provided [redacted]'s husband, [redacted] an update on the insurance claim processing as well.
At this time we are waiting for the insurance carrier to process the claim in order to determine refund.
Please let me know if you have any further questions or require additional documentation.
Sincerely,
[redacted], CPC, CDC
Practice Administrator, Sudbrink Oral Surgery Associates
###-###-#### xt [redacted]
###-###-#### xt [redacted]
###-###-####(cell)
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]Complaint: [redacted]
I am rejecting this response because: I still believe I am owed money by the business.
[redacted], the office administrator, provided me
with details about the $205 being withheld previously. I received the following in an email message
from her on March 19, 2014:
"I was able to complete the account review and audit.
It appears as though [redacted] completed processing of your claim for services
provided on 09/19/13, however they did not include the nitrous oxide in the
listing of procedures. They did provide unexpected coverage for the dental
extractions.
At this time they covered the procedure at 100% without any
patient out of pocket expenses with the exception of their exclusion of nitrous
oxide administration. The claim was sent to [redacted] for possible
coverage of the nitrous oxide administration.
You paid $470 on 09/20/13, minus the $205 fee for nitrous oxide,
has resulted in a refund due to you of $265. This refund was processed on
03/18/14 directly to your credit card."
(I did reply to this email on
March 21, with some of the concerns I'll get into below, but got no response.)
I believe I am currently owed
the $205 nitrous oxide fee and would like [redacted] to review the account
again and issue me a refund if I am truly owed one.
Here is my reasoning: I
learned from [redacted] (my health insurance provider) that the line item
listed as "Medical Care" on my explanation of benefits form is for
code # [redacted] - Sedation.
The billed charge for this
line item is $205 - the amount [redacted] says I owe for "nitrous oxide
administration." [redacted] covered
this item 100% and lists patient responsibility as $0. Upon researching this code, it seems as
though the substance used to sedate is part of the charge, in addition to the
administration (in this case, nitrous oxide).
Furthermore, in her response
to the Revdex.com complaint, [redacted] says she has resubmitted the claims on my behalf,
presumably to [redacted], but as of Monday, April 7, a representative at
[redacted] says no claims have been resubmitted and that it would be unusual
for the healthcare provider to justify a claim that is so old (in this case, my
surgery took place in September 2013 and the EOB was printed and sent out by
[redacted] at the end of November 2013)
[redacted] also mentions
[redacted], my dental insurance provider, but I have seen nothing from
them in the way of an EOB and why would I if my health insurance covered
everything 100% as my explanation of benefits would indicate?
So again, based on my
research, I still believe I am owed the balance of the money I paid up front,
or $205. It's true that a portion of
what I paid up front was refunded to my credit card, and I appreciate
that. If I believed I really owed this
business money for a service (i.e. something was not covered), I would have no
problem paying for the service, but again, everything I can find does not
indicate that. I would like [redacted]
to review my account again, with all of this said, and refund the money if it
is owed to me, as I believe it is.
Regards,
[redacted]
-------- Forwarded message ----------
From: Revdex.com of Metro Washington DC <[email protected]>
Date: Thu, Aug 28, 2014 at 9:02...
AM
Subject: Fwd: complaint [redacted]
To: [redacted] <[redacted]>
---------- Forwarded message ----------
From: <[redacted]>
Date: Thu, Aug 28, 2014 at 8:36 AM
Subject: complaint [redacted]
To: [email protected]
Dear Sirs,
I finally contacted the company I complained about.I told the lady that I talked to what my complaint was about. She said she would check on it and call me back.She called me back and said they did an audit of my daughters account and instead of her getting $129 back she would be getting $426 back! She also told me if it was any consolation that the two people that I dealt with are no longer employed there. Yesterday my daughter received the check. Thank you for your help.
Sincerely,
[redacted]
May 5, 2014Dear **. [redacted],I have reviewed the follow up documentation from **. [redacted] indicating she is rejecting the previous response we provided.When **. [redacted] was originally evaluated in the office on 10/03/13 she did not complete a payment or check out process. Her upcoming services were scheduled by a nurse and she was escorted out of the office. We do not have a formal checkout process that she is indicating that she completed. When a new patient schedules an office consultation we cannot quote out of pocket expenses ahead of time. We do not know the complexity of the office visit ahead completing the examination and therefore send a statement to the patient after the services have been completed. If **. [redacted] would have "called around for prices” as she indicated in her rebuttal letter our front office policy is to quote that evaluations begin at $80 and go up from there.On 10/15/2013 our billing office quoted **. [redacted] the cost of the surgical services only and informed her they would be due on the day of the procedure. This quote did not include the cost of the consultation.The return visit required to treat a post operative complication on 10/24/2013 is a billable return visit as she required additional services to be completed by the surgeon. **. [redacted] signed a surgical consent letter acknowledging that a post operative infection may occur which would require additional services. It was not stated to **. [redacted] that there would not be a charge for the visit. Following an emergency visit **. [redacted] would have been discharged by a nurse and escorted out of the office. Services that are not treatment planned in advance cannot be quoted to patients in advance.Our billing office explained the balance to **. [redacted] on 12/11/2013. We did not receive payment or further communication from her and the account was forwarded to the collection agency on March 28th, 2014.Please contact me if you have further questions or require additional documentation.Sincerely,
April 16, 2014
Dear **. [redacted],Please accept this letter as a formal response to the complaint filed by **. [redacted].**. [redacted] had services completed in our office on 10/03/13,10/17/13, and 10/24/13. She paid at the time of service for 10/17/13 only. The remaining two dates...
of service remain unpaid and our billing department explained the charges to her during a 12/11/13 telephone conversation. **. [redacted]'s account was referred to a collection agency due to lack of any payment being received.We encourage **. [redacted] to follow up with the collection agency to make payment arrangements.Please contact our office if you have any questions or require additional documentation.