The Neurology Center of Southern California

Initial Business Response /* (1000, 11, 2015/08/31) */
This is in response to correspondence received on August 261 2015 regarding case# [redacted]. Please note that this is the first and only notice that we have on file regarding this complaint. Professional Emergency Physicians is a separate company...

from Parkview Hospital and bills separately.
This patients charges were billed to the family's insurance carrier on February 17, 2015. We received their explanation of benefits on March 18, 2015 stating that this charge had been applied to the patient's yearly deductible. The first statement was dated April 13, 2015; second statement was dated May 11, 2015 and the final notice dated June 15, 2015.
We have on record that the patient's mother called our office on June 29, 2015 and was upset with the amount they were being billed for the emergency room physician's services. The patient's mother insisted that their daughter was not seen by one of our physicians or physician's assistance on the date of service in question We told the patient's mother that we would pull all the emergency room records and have our head coder review the charge for accuracy.
On July 7, 2015 we received the claim back from our coding department stating that based on the medical records the patient was seen by [redacted], ** for a medical screening and the our charge was appropriate. After confirming that our charges were correct we called the patient's mother back to discuss the review. She asked what her rights were in appealing this decision and we instructed her to send in a written letter of complaint to the medical director, We also advised her to contact Parkview Hospital to obtain a copy of the medical records for this ER visit. To date we have no record of receiving any written correspondence from the patient's parents, nor was any documentation included in this complaint.
On August 10, 2015 the patient's mother called our office again and paid the entire amount due; $455.00 with a credit card. At the present time I'm showing we have a zero balance due. According to the responsible patty's complaint they are asking for a written policy that states the parent/guardian is responsible for medical care regardless if it's communicated or unknown to them; we have on file a copy of the signed "authorization to treat and financial responsibility signed by Mrs. [redacted]
At this time we do not feel that the patient is entitled to a refund, services were rendered to patient in the presence of her parents according to the physician's assistants documentation. If the parents still do not feel that their daughter was examined by a Professional Emergency Physicians staff member, we again suggest that they contact Parkview Hospital and ask for a copy of her medical records as they are the property of the hospital.
If you should have any additional questions regarding this matter please feel free to contact our office.
Initial Consumer Rebuttal /* (3000, 15, 2015/09/02) */
(The consumer indicated he/she DID NOT accept the response from the business.)
In response to Professional Emergency Physicians via Revdex.com case #XXXXXXX:
I don't want to continue repeating myself... but with exception of the young man who took my insurance information- NO medical professional came in the room or spoke with us while we were there. When we left no one gave us any paperwork, we didn't check out, and no one stopped us. As I said before I never received an itemized statement. My first bill came on 05/15 and I originally thought this was for the room only, which is a substantial amount. This is my primary dispute.
Also, as previously stated, the CSR and I went back and forth with no resolution. I continued to explain that no one came to see us and no one spoke with us. She adamantly insisted her computer says otherwise. Basically, we were going in circles. I finally I asked to speak with a supervisor and she advised two things: #1 - I get a copy of the medical records and #2 - I write a detailed letter to the Medical Director. I did both of these.
#1 -Be advised: the CSR did tell me I had a signed "authorization to treat and financial responsibility," but when I asked her for a copy she refused. She said I had to get a copy of the medical records. She gave me a number to call for medical records, XXX-XXXX. I called, followed the prompts, and sent request out via fax on 07/07/15. I got notice in the mail dated 07/07/15 requesting I fill out another form, which I did. I received response (9 pages that included my original request) dated 08/13/15 that said, "Unfortunately, the requested information is not available due to: the patient has not been a patient at Parkview Hospital on the dates you have submitted." (I updated the Revdex.com claim with this new information on 08/22).
#2 -I wrote Dr. [redacted], Medical Director, and mailed the letter on 07/10/15. I waited for almost 4 weeks and never received a response. At this point, I feel I had exhausted all my options so I chose to try to get through to the company via the Revdex.com (here) instead.
The last paragraph the response dated 08/31/15: "...services were rendered to the patient in the presence of her parents according to the physician's assistants documentation.... If the parents still do not feel that their child was examined by a Professional Emergency Physicians staff member, we again suggest that they contact Parkview Hospital and ask for a copy of the medical records as they are property of the hospital." I reiterate: that NO medical professional came in the room or spoke with us while we were there. I did request the medical records and the conclusion was my child was not seen. (see above, and attachments).
In conclusion, I was forced to pay a bill in full for medical care my minor child did not receive. I only paid it because I did not want this to adversely affect my credit rating.
If the hospital refuses to refund me a portion of this bill I need to see the policy where it clearly states I'm responsible for medical care regardless if it is communicated or known to the parent/guardian even though they are present. I also request the written policy where it states the medical professionals are not obligated or required to communicate with the parent/guardian if they are present.
*Note: I am going to try to send some attachments to go with this: the letter I wrote as well as the notice I got for obtaining the medical records. All attachments are PDF copies with all personal information blocked out for the privacy of my child. I do have copies without information blocked out if they are needed*