Surgical Professions, Inc

Ms *** was seen in the office, as a new patient ,by Dr *** ***, Surgical Professionals Inc
We received charges for this visit on 10/at that time we did not receive any insurance information Patient was entered into the system as a self pay and a
billing statement was sent on 10/ Usually, if the patient has insurance and receives a statement, they contact us right away to make sure we have their insurance information and to inquire on why they received a bill Ms *** did not respond to this first statement Subsequently, the patient was sent additional billing statements on 10/17, 11/21, 12/30, 1/ all with no response from Ms *** On 3/she was sent a statement which had a large fluorescent sticker affixed stating “URGENT NOTICE Previous bills have been sent to you for the above charges Balance is seriously past due Immediate payment must be made If we do not hear from you within days, we will assume you purposely ignored this notice and we will send this account for further collection procedures” Again, no response or communication from Ms ***, nor did we have return mail on any statements sent Ms *** does states “ I already have enough copies of the bills” confirming that she was receiving billing statements Consequently, her account went to the collection agency 5/
We dispute Ms ***s claim about contacting us or the office as well as her claim that we ‘refused’ to send paperwork to her We have neither received any calls or any correspondence from Ms *** regarding any of these billing statements, nor any request for information or records during the months statements were being sent to her Checking with the office they claim that they have no calls documented or correspondence from this patient requesting records, even though Ms *** states she “has requested this information times from the office Any request for records would have to be in writing from the patient or the office would have had to send her a Medical Records Release form for signature before records could be release Therefore, some form of documentation of such a request would be on file
On 5/the account was sent to the collection agency, and they sent out correspondence to her She contacted them stating she had never seen this doctor and wanted proof They provided her with a copy of the patient Rights and Privacy Practices and Authorization of assignment of benefits and release information, with her handwriting and signature
The collection agency shows they placed calls to Ms *** on 6/and 6/ Ms *** did not return the calls However, she did fax a request dated 6/18, the document you have on file, to the collection agency requesting information
I am not sure why we did not get insurance information from the office, or if it was even presented at the time of service However, if Ms *** had responded to the first couple of statements sent and/ or the Urgent Notice, and not waited until the account went to collections, we would have been able to resolve the insurance issue in a timely manner
I have place her account on hold at the collections agency while I further investigate the issue

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 10097981, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
I reject this response because I sent my insurance information several times to these people, I asked them if they had received the referral paperwork from my doctor when I went to my appointment They asked me on the phone if I had insurance and at that time I gave them my *** card number, also when I was at the Visit for this Doctor in Queen Creek, and NOT Gilbert/Mesa. They collected the copay on the card Even stated in the billing If I did not give them the insurance information then how would they know to collect my $dollar Specialist copay. I had requested several times for information regarding the doctors name, the date, what I saw the doctor for, and as you see from the previously attached all I received were bills and no information It sounds to me that someone lost my paperwork, because they should have a copy of my insurance card my emergency referral from the hospital to see a surgeon in with in days, and also the referral from my doctors office All my surgical history, prescription list, hospital paperwork was all given to them at the time of appointment, plus I got the name of this doctor from my insurance companyLike I said if they would of sent this too me a long time ago, I could of re-sent them the information I haveBut they never sent the information and I was not going to send my personal information to just anyone with just a bill that I had no Idea what it was for I called and sent several requests back with a copy of the bill requesting that information Now because of you I finally know who the doctor is PsI have also sent a copy of this to *** for review, for them to investigate also It looks like someone made a big mistake , and now is trying to cover there butt
Thank you *** ***
Regards,
*** ***

Ms [redacted] does not seem to understand that we are NOT the doctor's office.   Acom is a third party billing service, we are not part of the office and have no jurisdiction or authority over their operations. 
It is apparent that her complaint is really with the medical office as supported by her statements about sending "these people" her referral paperwork, medical records, making an appointment, collection of her copay etc, all related to her interaction and contact
with the medical office and NOT our billing office.   Again, though multiple statements and collections notice were sent to Ms [redacted], we received NO contact from her, nor did we receive any request for information.  If she had responded to any one of the statements she received  this matter could have been quickly cleared up.
I provided resolution that is within my scope of authority.   As stated previously I have contacted the collection agency and put the matter on hold.   We have also been in communication with [redacted], who handles this patients insurance, and who has agreed due to the circumstances, that we coul submit a claim at this late date for consideration of payment of Ms [redacted]'s services.     Ms [redacted] would like her balance to be written off, I do not have the authority to do this.   this decision has to come from
the office.   However, since we have billed a claim to her insurance per her request in her initial complaint, we now have to wait to see what the disposition of this claim is going to be with her insurance.    We will notify Ms [redacted] when we receive the outcome of the processing of her claim.

Ms [redacted] was seen in the office,  as a new patient ,by Dr [redacted], Surgical Professionals Inc.    

We received charges for this visit on 10/12 at that time we did not receive any insurance information.   Patient was entered into the system as a self pay and a...

billing statement was sent  on 10/17.  Usually, if the patient has insurance and receives a statement, they contact us right away to make sure we have their insurance information and to inquire on why they received a bill.  Ms [redacted] did not respond to this first statement.    Subsequently, the patient was sent additional billing statements  on 10/17, 11/21, 12/30,  1/31  all with no response from Ms [redacted]    On 3/7 she was sent a statement which had a large fluorescent sticker affixed  stating  “URGENT NOTICE  Previous bills have been sent to you for the above charges.   Balance is seriously past due.   Immediate payment  must be made.   If we do not hear from you within 15 days, we will assume you purposely ignored this notice and we will send this account for further collection procedures”   Again, no response or communication from Ms [redacted], nor did we have return mail on any statements sent.   Ms [redacted] does states “ I already have enough copies of the bills” confirming that she was receiving billing statements     Consequently, her account went to the collection agency 5/30.

 We dispute Ms [redacted]s claim about contacting us or the office as well as her claim that we ‘refused’ to send  paperwork to her.   We have neither received any calls or any correspondence from Ms [redacted] regarding any of these billing statements, nor any request for information or records during the 6 months statements were being sent to her.  Checking with the office they claim that they have no  calls documented or correspondence from this patient requesting records, even though Ms [redacted]  states she “has requested this information 5 times from the office    Any request for records would have to be in writing from the patient or the office would have had to send her a Medical Records Release form for signature before records could be release   Therefore, some form of documentation of such a request would be on file

On 5/30 the account was sent to the collection agency, and they sent out correspondence to her   She contacted them stating she had never seen this doctor and wanted proof.  They provided her with a copy of the patient Rights and Privacy Practices and Authorization of assignment of benefits and release information, with her handwriting and signature.

The collection agency shows they placed calls to Ms [redacted] on  6/16 and 6/18.   Ms [redacted]  did not return the calls.   However, she did fax a request dated 6/18, the document you have on file, to the collection agency requesting information.

I am not sure why we did not get insurance information from the office, or if it was even presented at the time of service    However, if Ms [redacted] had responded to the first couple of statements sent and/ or the Urgent Notice, and not waited until the account went to collections, we would have been able to resolve the insurance issue in a timely manner.

I have place her account on hold at the collections agency while I further investigate the issue

Ms [redacted] does not seem to understand that we are NOT the doctor's office.   Acom is a third party billing service, we are not part of the office and have no jurisdiction or authority over their operations. 

It is apparent that her complaint is really with the medical office as supported by her statements about sending "these people" her referral paperwork, medical records, making an appointment, collection of her copay etc, all related to her interaction and contact

with the medical office and NOT our billing office.   Again, though multiple statements and collections notice were sent to Ms [redacted], we received NO contact from her, nor did we receive any request for information.  If she had responded to any one of the statements she received  this matter could have been quickly cleared up.

I provided resolution that is within my scope of authority.   As stated previously I have contacted the collection agency and put the matter on hold.   We have also been in communication with [redacted], who handles this patients insurance, and who has agreed due to the circumstances, that we coul submit a claim at this late date for consideration of payment of Ms [redacted]'s services.     Ms [redacted] would like her balance to be written off, I do not have the authority to do this.   this decision has to come from

the office.   However, since we have billed a claim to her insurance per her request in her initial complaint, we now have to wait to see what the disposition of this claim is going to be with her insurance.    We will notify Ms [redacted] when we receive the outcome of the processing of her claim.

I have reviewed the response made by the business in reference to complaint ID 10097981, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

I reject this response because I sent my insurance information several times to these people, I asked them if they had received the referral paperwork from my doctor when I went to my appointment.   They asked me on the phone if I had insurance and at that time I gave them my [redacted] card number, also when I was at the Visit for this Doctor in Queen Creek, and NOT Gilbert/Mesa.  They collected the copay on the card.  Even stated in the billing.  If I did not give them the insurance information then how would they know to collect my $40 dollar Specialist copay.  I had requested several times for information regarding the doctors name, the date, what I saw the doctor for, and as you see from the previously attached all I received were bills and no information.  It sounds to me that someone lost my paperwork, because they should have a copy of my insurance card my emergency referral from the hospital to see a surgeon in with in 3 days, and also the referral from my doctors office.  All my surgical history, prescription list, hospital paperwork was all given to them at the time of appointment, plus I got the name of this doctor from my insurance company. Like I said if they would of sent this too me a long time ago, I could of re-sent them the information I have. But they never sent the information and I was not going to send my personal information to just anyone with just a bill that I had no Idea what it was for.  I called and sent several requests back with a copy of the bill requesting that information.  Now because of you I finally know who the doctor is.  Ps. I have also sent a copy of this to [redacted] for review, for them to investigate also.  It looks like someone made a big mistake , and now is trying to cover there butt...

Thank you [redacted] 

Regards,

[redacted]