Team Health

This is in response to your correspondence regarding the complaint submitted by Mr. [redacted] involving a billing issue.   Upon receipt of the complaint, we researched Mr. [redacted]’ concerns and contacted him to update him on how we have resolved the issue and how the oversight on...

our part had occurred.   We have contacted the patient and apologized for the inconvenience, and for the fact that insurance had paid but the insurance disallowed amount was not applied due to system error and he was being balance billed.   We have made certain that this oversight on our part will not occur again.  We have applied the appropriate adjustment and have sent zero balance statement.   The $565.57 payment was paid to Akron billing center (group [redacted]) which is not our billing center. I have provided Mr. [redacted] with the contact information for Akron billing center to follow up on the refund he is requesting.   If there are any concerns or questions, please feel free to reach out to me at any time.

Initial Business Response /* (1000, 5, 2015/06/17) */
[redacted] Associates contract for provider services at all [redacted] hospitals began Feb 2015. The charges for Patient [redacted] date of service March 14, 2015 were paid by United Healthcare April 27, 2015 and the patient...

completed the co payment by Credit Card on June 12, 2015. The emergency room provider charges are billed separately from the facility charges. We have no knowledge of any delinquent invoices for this patient.

Initial Business Response /* (1000, 15, 2015/06/22) */
[redacted] contracted for all [redacted] Emergency Centers effective February 15, 2015. The providers are non par with [redacted] Blue Cross and Blue Shield. The claim for [redacted] , date of service 2/28/2015 was...

appealed back to BCBS. This claim has been paid in full as of 6/10/2015. The current balance is zero wtih no patient responsibility .
Initial Consumer Rebuttal /* (2000, 17, 2015/06/23) */
(The consumer indicated he/she ACCEPTED the response from the business.)
Thank you.

I am rejecting this response because: this is what should have been done in the first place. It determines what their dindings are as to what the final outcome is. I accept their steps but reiterate - I was not in Austin on that date and this is not my bill.

Final Consumer Response /* (2000, 6, 2015/06/23) */
A different manager from the company called me back, and told me that the bill was taken care of, and that I did not need to worry about paying it. I would like to withdraw my complaint, the company resolved the situation.

I have forwarded this complaint to the Sunrise Billing Center  Sunrise Florida for processing.This invoice is not billed in the Akron Ohio Billing Center Marlene C[redacted]

Patient, [redacted] presented to the Emergency Department of Dublin Methodist Hospital on August 16, 2016. The ER provider [redacted] DO documented a level of service [redacted] for total charges of $ 691.00. This Emergency department visit for the evaluation and management of the patient...

requires 3 key components; An expanded problem focused history; An expanded problem focused examination ; and medical decision making of moderate complexity.  The audit review by our coding manager confirms the level of service provided to this patient. The insurance paid $ 403.54, we contractually adjusted $ 186.57.  The balance due from the guarantor, [redacted] is $ 100.89.  I will provide a discount of $ 15% today. The corrected balance is now $ 85.76.In regards[redacted]Client Services ManagerAkron Billing Center[redacted]

Initial Business Response /* (1000, 13, 2016/04/08) */
Contact Name and Title: Dee L[redacted] Pt. Serv Supv
Contact Phone: 865-980-3702
Contact Email: [redacted]
April 8, 2016
Alcoa Billing Company
3429 Regal Drive
Alcoa TN 37701
Case #[redacted]
To whom this may concern,
...

I have reviewed the account and the medical records. I have corrected the guarantor name to match the name that is on the chart. On behalf of the billing center I humbly apologize for any confusion this has caused.
Humbly yours
Djuna L[redacted]
Patient Services Supervisor

Initial Business Response /* (1000, 5, 2015/12/22) */
We are unable to locate this account
Please provide patient name, date of service and Hospital name
Initial Consumer Rebuttal /* (3000, 7, 2015/12/23) */
(The consumer indicated he/she DID NOT accept the response from the...

business.)
Patient name: [redacted]
Acct #: [redacted]
Date of Service: 07/18/2015
Andalusia Regional Hospital

Initial Business Response /* (1000, 5, 2015/09/09) */
Emergency Physician Associates [redacted] has filed this claim for date of service 12/20/2014 to MaGellan Specialty # [redacted]
on behalf of this patient 12/31/2014, 4/2/2015 , 7/16/2015 and again on 9/8/2015. We are awaiting the...

processing of this claim.
We will monitor and report back to the patient as this claim has now escalated.
Initial Consumer Rebuttal /* (2000, 7, 2015/09/11) */
(The consumer indicated he/she ACCEPTED the response from the business.)

Initial Business Response /* (1000, 8, 2016/05/31) */
[redacted], Please provide either a date of service, hospital or account number as I am unable to locate an account for this patient using the information provided.
Initial Consumer Rebuttal /* (3000, 10, 2016/06/01) */
(The consumer...

indicated he/she DID NOT accept the response from the business.)
The date of service was [redacted]. It was an ER visit. The patient was myself, [redacted]. My DOB is [redacted]. ARS is reporting 708.00 to my credit. Services were rendered at Fairview Hospital.
Final Business Response /* (4000, 12, 2016/06/03) */
Thank you for the additional information. The invoice # 89166817-110-6069 has been located for Emergency Professional Services, Grant C[redacted] DO. The level of service provided 99284 and EKG report 93010 totals $ 708.00. The invoice is listed as a self pay with statements issued 1/22/2010, 2/25/2010 and 4/1/2010. The invoice was forwarded to the collection agency ARS on March 22, 2011. This patient also had ER claims for August 2010 which were paid by insurance and the hospitals HCAP program. Did Ms. [redacted] qualify for the Fairview Hospital HCAP program for the charges of [redacted] ? If so, we can close and remove the charges. Please request a copy of this approval letter from Fairview Hospital by Ms. [redacted].
Thank you
Marlene C[redacted]
Client Services Manager

[redacted]Date of Service     11/23/2016Provider (Group) of Service:  [redacted]Place of Service:     [redacted]Provider DO -  [redacted]Total Charges:     $...

1005.00Level of Professional Service CPT     [redacted]Billed to Aetna Insurance 12/7/2016Claim processed by Aetna and applied tot he patients policy deductibleContractual adjustment of $ 632.25 appliedTotal billing to patient is $ 372.75 Consent for treatment signed by patient at time of service registration.

I am requesting Consent for Treatment and all documents presented to the ER Patient Registration.  I will respond with findings as soon as received.

Initial Business Response /* (1000, 5, 2016/06/29) */
We acknowledge that the demographic patient address was in error. We have corrected the address on 1/21/2016 and again on 6/20/2016. We will send written verification of this correction to the patient by letter. We will also call the...

patient per her request to the National Patient Service Center.

Initial Business Response /* (1000, 6, 2015/08/27) */
Appeal to [redacted] has been submitted
Initial Consumer Rebuttal /* (2000, 8, 2015/09/13) */
(The consumer indicated he/she ACCEPTED the response from the business.)
I accept, as long as company does not come back after me for money if appeal is...

denied

Revdex.com:
While I do accept the adjusted total of the bill I still feel unsatisfied with the final outcome. I am sorry that this situation ever had to escalate to this level. I feel this whole thing could have been resolved months ago if the people at HCFS Health Care Financial Services (aka Team Health) had been willing to work with me and answer my questions rather than give me the run around and repeatedly telling me that I needed to speak with someone at the hospital where I was treated. On more than one occasion when I spoke with people at HCFS I offered to pay 50% of what they were attempting to charge as I felt that it was a more realistic and fair amount. This was refused and I was told that I would have to pay the full amount of the statement and there would be no adjustments. Ms. C[redacted] is correct in her statement that I spoke with Dr. Gene K[redacted] however, I was not referred to him until this had been going back and forth for several months already. At the time that I did speak with Dr. K[redacted], which was in late July or early August, he informed me that he would send a recommendation to HCFS to reduce my bill due to my dissatisfaction with my treatment and how things had been handled since. After this recommendation was sent I received two more bills that still had no price adjustment. It was at that time that I decided to involve the Revdex.com. At no time during any of this have I ever been informed as to why services rendered were coded at the level in question. As previously stated, I will accept the reduced statement amount and have scheduled payment in full now that I have received the corrected bill. That said, I believe this company needs to do some serious thinking of how they conduct their business. I hope to never have to deal with this company again in the future.  I have reviewed the response made by the business in reference to complaint ID 11723877, and find that this resolution is satisfactory to me.

Initial Business Response /* (1000, 5, 2015/08/05) */
wE CURRENTLY HAVE CHARGES FOR [redacted] FOR DATE OF SERVICE 5/23/2015 FOR PROFESSIONAL FEES DUE THE EMERGENCY PROVIDER, FERGUSON AT SOUTHWEST HOSPITAL. INSURNANCE , MEDICAL MUTAL WAS FILED AND PAID JULY 11, 2015
THE PATIENT RESPONSIBILITY...

PER MEDICAL MUTUAL IS $ 115.48
A STATEMENT WAS MAILED TO THE PATIENT FOR INVOICE [redacted]
TODAY I CALLED THE PATIENT AND LEFT A VOICE MESSAGE
THE CALL BACK NUMBER FOR THE TH AKRON BILLING CENTER IS 330-664-6101 OR 330-664-6102
Initial Consumer Rebuttal /* (3000, 8, 2015/08/06) */
I called Southwest Hospital billing to see if the PA had a different phone number. They directed me to the medical records dept. The medical records dept. could not find the name [redacted] in their records. They directed me to the ER desk. They were not familiar with the name either. Now I'm not sure if this is even our correct bill.

Initial Business Response /* (1000, 5, 2016/05/24) */
Please assist me as I'm not locating any invoice for a "[redacted]" for [redacted]
I do have charges for a [redacted] DOS [redacted] I will need confirmation of patient's DOB and last "4" digits of the SSN. OR Request that this...

patient call the Billing Center at [redacted]
Thank you
Marlene C[redacted]
Client Servics Manager

[redacted]DOS 7/4/20177/30/20178/23/20179/18/201711/18/201610/22/201610/23/201610/6/20169/23/2...⇄ itemized statement have been mail to this patientIn regardsMarlene C[redacted]

[redacted]Date of Service 12/30/2015Longview Regional  Medical Center      The level of service provided was reviewed by our Coding Department and confirmed per the chart documentation. The dispute was then forwarded to the Facility Medical Director Gene Kelly...

MD at Longview Regional Medical Center.Dr. Kelly conferenced with the patient.  We have applied a courtesy discount of 65% A corrected statement was mailed to this patientIn regardsMarlene C[redacted]Client Services ManagerTH Akron Billing Center