In response to your correspondence regarding a complaint rendered by one of our patients, named above-Ms***, we offer our factsMs*** was initially seen in our office on October 16, A day after that appointment, she faxed our office a copy of her insurance card with her
hand written note that this was her health insurance card for services of the previous day(Attachment A) Subsequently, there were other dates of service: 02/14/14, 05/16/2014, and 05/22/*** *** paid referenced services as primary insurance carrier, and held the patient financially responsible for $co-payment, which she paid without incident.Our office received payment retractions from *** *** on January 2, 2015, for dates of service: 10/16/2013, 02/14/2014, 05/16/2014, 05/22/(Attachment B) It is at that time, we had to revert the billing of these dates of services to ***We received *** information from the patient on date of service 05/16/(Attachment C) Our office date stamped the insurance cards at the time of patient check-in, on her date of serviceWe photocopied both cards in the order the patient informed us, which is *** *** primary and *** secondaryIn March 2014, *** aka *** *** (***), sent our office remittances stating the claims for services (dates of service 10/16/2013,02/14/2014, 05/16/2014, 05/22/2014) were previously paid and one remittance stating their real denial “services submitted after this payers responsibility for processing claims ended”(Attachment D) All insurance carriers have a time frame limit defining when provider’s need to submit claims to them for payment consideration and after that time allowance, the claims are deniedDue to *** “timely filing denial” our office appealed the denial with ***, advising them that *** *** had made payment as primary insurer and provided the retraction notices as our evidence(Attachment E)
*** has since made payment of all the dates of services, excluding 10/16/2013, and the outstanding financial balance is $Our last correspondence with *** regarding date of service 10/16/was on 04/24/and the claim is still in process, the claim number is #***, spoke with Lindsey, call reference # ***At the time of *** *** retraction (Jan 2015), we advised the patient of the billing problem and explained the timely filing process with the insurance carriersWe received a voicemail from the patient on 04/01/2015, stating she spoke with insurance carrier and they are re-processing the claim and it will take days, She called again on 06/03/2015, to question the outstanding dates of service and balance of her accountOur Billing Manager, Carol, spoke to the patient and confirmed the outstanding date of service was 10/16/2013, and the outstanding financial balance is $If she called the office on 01/01/2015, as she reported, our office was closed in observation of the New Year's HolidayWe have been DILIGENT in corresponding with the insurance carriers in efforts to have these services paidIn addition, we have advised the patient with monthly statements of her account's historyHer reporting this situationto the Revdex.com is surprising to usOn 04/01/2015, she was told by her insurance that the re-process of claim date 10/16/2013, would take days and the other claims were paid by then, as they were paid on 03/02/Our office acted appropriately with the information provided to us by the patient and the insurance carriersIn this situation, there are four different entities involved, the patient, *** ***, ***/***, and us; it is unreasonable to hold this office solely responsible for the billing mishapWe understand the business transactions of the medical field are intrusive to the medicinal treatments of the patientsHowever, corresponding with insurance carriers makes medical billing unpleasant and confusing to most peopleWe have provided evidence of our actions and hope that our response is helpful in conclusion of this matterSincerely,
NV***Practice Administrator
In response to your correspondence regarding a complaint rendered by one of our patients, named above-Ms***, we offer our factsMs*** was initially seen in our office on October 16, A day after that appointment, she faxed our office a copy of her insurance card with her
hand written note that this was her health insurance card for services of the previous day(Attachment A) Subsequently, there were other dates of service: 02/14/14, 05/16/2014, and 05/22/*** *** paid referenced services as primary insurance carrier, and held the patient financially responsible for $co-payment, which she paid without incident.Our office received payment retractions from *** *** on January 2, 2015, for dates of service: 10/16/2013, 02/14/2014, 05/16/2014, 05/22/(Attachment B) It is at that time, we had to revert the billing of these dates of services to ***We received *** information from the patient on date of service 05/16/(Attachment C) Our office date stamped the insurance cards at the time of patient check-in, on her date of serviceWe photocopied both cards in the order the patient informed us, which is *** *** primary and *** secondaryIn March 2014, *** aka *** *** (***), sent our office remittances stating the claims for services (dates of service 10/16/2013,02/14/2014, 05/16/2014, 05/22/2014) were previously paid and one remittance stating their real denial “services submitted after this payers responsibility for processing claims ended”(Attachment D) All insurance carriers have a time frame limit defining when provider’s need to submit claims to them for payment consideration and after that time allowance, the claims are deniedDue to *** “timely filing denial” our office appealed the denial with ***, advising them that *** *** had made payment as primary insurer and provided the retraction notices as our evidence(Attachment E)
*** has since made payment of all the dates of services, excluding 10/16/2013, and the outstanding financial balance is $Our last correspondence with *** regarding date of service 10/16/was on 04/24/and the claim is still in process, the claim number is #***, spoke with Lindsey, call reference # ***At the time of *** *** retraction (Jan 2015), we advised the patient of the billing problem and explained the timely filing process with the insurance carriersWe received a voicemail from the patient on 04/01/2015, stating she spoke with insurance carrier and they are re-processing the claim and it will take days, She called again on 06/03/2015, to question the outstanding dates of service and balance of her accountOur Billing Manager, Carol, spoke to the patient and confirmed the outstanding date of service was 10/16/2013, and the outstanding financial balance is $If she called the office on 01/01/2015, as she reported, our office was closed in observation of the New Year's HolidayWe have been DILIGENT in corresponding with the insurance carriers in efforts to have these services paidIn addition, we have advised the patient with monthly statements of her account's historyHer reporting this situationto the Revdex.com is surprising to usOn 04/01/2015, she was told by her insurance that the re-process of claim date 10/16/2013, would take days and the other claims were paid by then, as they were paid on 03/02/Our office acted appropriately with the information provided to us by the patient and the insurance carriersIn this situation, there are four different entities involved, the patient, *** ***, ***/***, and us; it is unreasonable to hold this office solely responsible for the billing mishapWe understand the business transactions of the medical field are intrusive to the medicinal treatments of the patientsHowever, corresponding with insurance carriers makes medical billing unpleasant and confusing to most peopleWe have provided evidence of our actions and hope that our response is helpful in conclusion of this matterSincerely,
NV***Practice Administrator