Tahoe Orthopedics and Sports Medicine Inc.

Review: Tahoe Orthopedics is billing me for services that never took place. I have never been a patient of theirs nor did I receive any of the services that they are billing out to my insurance provider (Blue Shield of California). I believe that Tahoe Orthopedics has my health insurance information because I am on a family policy with my husband who has been a patient at Tahoe Orthopedics this year. However, the services that they are billing for were not incurred either by me or by my husband. Neither my husband nor myself went to their offices, had radiology or surgical procedures on the dates for which Tahoe Orthopedics has submitted to our insurance provider. My husband spoke with someone in the billing department at Tahoe Orthopedics, who said he would take care of this error, but he didn't, because now we are receiving more bills asking for money for services that were never provided to me, ever.

Product_Or_Service: NONE

Order_Number: XXXXXXXXXXXX

Desired Settlement: DesiredSettlementID: Other (requires explanation)

I would like a written acknowledgement from Tahoe Orthopedics and Sports Medicine Inc. stating that they've made a billing error and then I'd like these bills to go away. They would also need to contact Blue Shield of California, and let them know about this billing error, so that the explanation of benefits and requests for money cease and desist ASAP. They need to fix their mistake and I need written proof that all this mess has been cleaned up by those who created it.

Business

Response:

Initial Business Response

This is in response to the complaint on 12/27/13. When the subscriber's husband was seen in our office in May, his insurance card was scanned into another patient's registration that had the same first name as his wife, whose name was on the insurance card. On 12/04/13 I received a call from the insurance looking into whether the patient was seen or not for a visit in May. After looking into it further it was discovered that the insurance card was scanned into the wrong patients account. I then requested a refund from our finance department for DOS 05/14/13. I filled out the Anthem Blue Cross of NV refund form, and wrote a letter to go with it explaining the error that was made, and to please correct the patient's medical record because they were not seen. DOS 09/13/13 had not yet been paid by the insurance. On 12/23/13 her husband brought in another EOB to our customer service department. When I called him to explain the situation he asked that I send his wife a letter explaining the situation, and copies of the letters to go to the insurance. I did so that day. Today on 01/02/14 the payment for DOS 09/13/13 had been posted, so I requested a refund for that DOS from our finance department, and wrote another letter explaining the patient was not seen on this date either. The insurance for DOS 09/13/13 did not have a refund form because it was Blue Shield of CA. The error has been corrected, and I am just waiting for the refund checks to send to the insurance with the letters asking that her medical record be corrected.

Final Consumer Response

(The consumer indicated he/she ACCEPTED the response from the business.)

I accept this response from Tahoe Orthopedics as it sounds great, but, if the problem persists I have absolutely no problem reopening this complaint and following through as need be.