Tioga Medical Center LTC

Initial Business Response /* (1000, 5, 2016/01/05) */
I spoke with Sanford Health Plan on 01-04-regarding the way they processed this patients billI was told by the provider relations representative that our bill was filed correctly, it was processed correctly and that the patient owes
$for amounts that were applied to the policy deductible/coinsuranceThe Sanford rep also stated that the patient called them on 12-21-and that the patient was told by Sanford that the bill was submitted correctly and processed correctly by SanfordThe Sanford rep stated that she could not send me the notes from their conversation, however, that she would send an email to me that they bill was processed correctly, etcTMC has not rec'd that correspondence from Sanford as of this writing
TMC is not trying to "screw" anyone over as alleged by the patientWe are an in-network provider for the patient's health insurance Sanford Health PlanWe performed the services requested by the patient and physician, submitted the bill to the patient's insurance and received payment from Sanford, less the deductible/coinsurance owed by the patient
The patient did make a call to us on 12-21-2015, at which time I spoke to him and told him that I would be calling Sanford about his claim that we filed the bill incorrectlyWith the holidays, I was not able to contact his insurance company until 01-04-We don't have other documentation on our file about calls previously made by the patientHe may have called, but our documentation doesn't show that he called
TMC has not done anything incorrectly in this patient's case and appears to be an argument that he needs to take up with his insurance company, Sanford HealthFrom the conversation I had with Sanford Health on 01-04-2016, the bill was submitted correctly and processed correctly by Sanford
Again, TMC is not trying the "screw over the patient" as alleged
I will be writing a letter to the patient about this matter
Initial Consumer Rebuttal /* (2000, 7, 2016/01/15) */
The customer indicated that he/she accepted the business response