Complaint: [redacted] I am rejecting this response because: Now that all claims have been properly submitted and processed, please provide instructions on how we will receive reimbursement for overpayment of [redacted] expenses and an estimated timeframe to expect reimbursement The attachments [redacted] provided to Revdex.com (Revdex.com) are completed different from the statements [redacted] provided me with (see attached) In the end, I am willing to disregard the statements [redacted] provided to Revdex.com since I spoke with [redacted] (***) and [redacted] today, Jan Both insurances said as of six business days ago (Jan 15), the claims have finally been properly submitted and being that my husband paid $on Jun (see attached receipt), we are still owed a reimbursement from [redacted] [redacted] and [redacted] instructed me to ask [redacted] for reimbursement and if the [redacted] office does not comply, both insurance carriers will contact [redacted] to facilitate [redacted] has come through and done their part so far and I believe they will be able to provide the reimbursement we are rightfully owed Regards, [redacted]
Hello, Please be informed that while we do acknowledge your frustration regarding the processing time, the delay is not out of the ordinary The progression of events has occurred in the exact sequence we originally stated We did inform you that your first insurance has months to pay claims Here we are, almost at the month mark, and we are in the process of getting the final claim paid on the family account from [redacted] Claims are being evaluated in an even shorter time-frame than anticipated by [redacted] , however they will only evaluate claims after [redacted] has made a final decision We ask that you continue to be patient as we can only file to [redacted] once your [redacted] plan has rendered a final decision on paper This "EOB" is then sent to [redacted] along with a claim for secondary claim processing Hopefully we will know more within the next 30-days Please remember that this stage is not in our hands We have submitted all necessary documents, and have confirmation reports attesting to that At this point, we have to wait on your insurances to respond
Complaint: ***
I am rejecting this response because:
Good morning,
I spoke with you on Feb and you instructed me to email you with the final total for reimbursement. At that time, my dental claims were in the final stages of processing. I contacted *** *** on Mar 15 to verify all claims were 100% processed; unfortunately, it was discovered that *** *** left off a fluoride treatment code received on the May visit.
According to *** *** as we currently stand, my family is owed a refund of $127. Once *** *** resubmits May claim with the $fluoride code, we will be owed a refund of $143. The *** *** representative stated the dental office should bill items correctly and tried to reach someone several times this week at the dental office who could assist with resubmitting the claim properly but was unsuccessful.
Therefore, I would like to reinstate complaint #***. Please let me know if anything else is needed.
Thanks in advance
V/r,
***
*** *** ***
***
***
Hello, Please see the attached receipts for all insurance payments received for the family to date You will find the date of payment on the upper right hand portion of the receipt as well as the patient name listed below Claim payments started in June and continued for every month thereafter with the exception of July and November of Family claims are still being received, as this family has a federal plan which requires us to send to both insurance carriers Primary insurance must evaluate first and submit a form which we attach when we send off for Secondary payment Insurance typically takes a minimum of days by law to evaluate If claim payments started in June 2014, that is a good indication that we started submission days prior (May 2014) Also note that a services are grouped by category for faster claims processing That being said, there may not be just one claim for the each date of service Please evaluate our supporting documentation to make a determination on this claim Regards,
Hello, We have spoken to *** via email, phone and in person She is upset about the filing process and currently we are waiting on insurance claims to be received on her account It is not atypical for insurance to take months to finalize payment, but the patient is
unsatisfied I did inform her at this point we need to wait for her insurance to finish paying to properly evaluate her account, as she also reported she might have been overcharged If you would like my most recent email to her please let me know and I will attach it In the email I explained it looked as though she may have been overcharged as well as undercharged I advised to wait on insurance payments for us to make a final review of her case She has dual insurances thru the Federal Employee program and it has been difficult and new for both staff and insurance reps to report the plan details accurately and consistently We advised for her to disregard any bills she may have received thru our automated billing process, and at no time have we asked for payment after the initial set of services were rendered. Mrs*** has come into the office and been loud, disruptive and has tried to ruin our image in front of clients She and her husband have dropped by repeatedly without any appointment and have cause a disruption in our waiting room on several occasions We have politely told her (and her husband) insurance is working on their claims We have not billed her for additional monies nor have we asked for her to make payment on her account even though the account is past our day mark for unpaid insurance claims Please let me know what we can do to settle this It is not typical for us to have clients so combative I have honestly tried my best and do not know what else we need to do to resolve this matter I have been honest with her about the state of office and her account as well as confirmed I will help her, but the patient is still not happy
Complaint: ***I am rejecting this response because:The response does not state how the situation will be fixed Additionally, my claims were not and still have not been submitted to either of my insurances as of December After being pushed aside for half a year, I had to resort to going to the office in person In October, *** *** said my billing issue would be fixed before an appointment we scheduled for November On November, I sent an email requesting review of our previous charges On November, hours, I called to get a status update and make sure nothing else was needed from me *** told me she did not have time for me and her priority was the patients in her office at that moment and not me or my email I decided to drive to the office and be the last patient of the day since they closed at hours I did not say anything to any of the other patients that were in and out of the office I sat patiently and waited until I was called on (I was not called upon until the entire office was clear of all patients)My goal was to try to speak with someone else (or higher) with the hopes that maybe they would be able assist me and get my paperwork going before my scheduled appointment on November or even assure me my situation was being workedAfter discovering ***'s father owns the clinic, I have basically given up on all communication with *** *** and have had to resort to utilizing *** *** *** *** and *** representatives by having them contact *** *** on three-way phone calls since my family's billing issues have not been corrected*** has contacted *** *** times and *** has contacted *** *** times so they could explain the documents that are needed in order to complete my claims In the end, claims need to be submitted correctly Services received on May were never submitted from *** *** to the primary or secondary insuranceBecause the May claims were never submitted by *** ***, the Jun visit can't be completed Request *** *** submit May claim to *** *** *** ***Once that EOB is received, send it to ***Once May claim is complete, ensure proper documents were submitted for Jun visit to *** and *** I'd be more than willing to complete myself; just give me what I need to give them Since there are transmission issues, *** *** *** *** (###-###-####) and/or *** (###-###-####) representative(s) may be contacted and can provide a direct fax line and confirm the transmission they receive is the correct one.I apologize for demanding assistance but this has been a very grueling and prolonged experience I am willing to do whatever it takes to get it processed and resolved. My situation sounded like it was a few pieces of paper away from being fixed It's not even about the money; if it makes it any easier, please donate the payment I am owed to charity. Regards,*** *** ***
As mentioned in a previous response, insurance has up to year to keep claims open Keeping in mind that this client has policies (the second policy will not even consider the claim until they have a primary response), the time-frame for final payments can be 1+ years As we continue to receive payments we will post them to the family account Once all claims have been received, if any refund is due at the time, we can certainly take the proper steps for reimbursement Please understand claims filing is a timely process At this point, everything is in the hands of the insurance companies
Hello, Please be informed that while we do acknowledge your frustration regarding the processing time, the delay is not out of the ordinary. The progression of events has occurred in the exact sequence we originally stated . We did inform you that your first insurance has months to pay claims. Here we are, almost at the month mark, and we are in the process of getting the final claim paid on the family account from *** *** *** *** Claims are being evaluated in an even shorter time-frame than anticipated by ***, however they will only evaluate claims after *** *** has made a final decision. We ask that you continue to be patient as we can only file to *** once your *** *** plan has rendered a final decision on paper. This "EOB" is then sent to *** along with a claim for secondary claim processing. Hopefully we will know more within the next 30-days Please remember that this stage is not in our hands. We have submitted all necessary documents, and have confirmation reports attesting to that. At this point, we have to wait on your insurances to respond
Complaint: ***
I am rejecting this response because: Now that all claims have been properly submitted and processed, please provide instructions on how we
will receive reimbursement for overpayment of *** expenses and an estimated
timeframe to expect reimbursement
The attachments *** ***
provided to Revdex.com (Revdex.com) are completed different from the
statements *** *** provided me with (see attached)
In the end, I am willing to
disregard the statements *** *** provided to Revdex.com since I spoke with ***
*** *** *** (***) and *** today, Jan Both insurances said as of
six business days ago (Jan 15), the claims have finally been properly
submitted and being that my husband paid $on Jun (see attached
receipt), we are still owed a reimbursement from *** *** *** and *** instructed me to ask *** *** for reimbursement and if the *** office
does not comply, both insurance carriers will contact *** *** to facilitate
*** *** has come through and
done their part so far and I believe they will be able to provide the reimbursement
we are rightfully owed
Regards,
*** *** ***
Good afternoon, The response is extremely vague and does not provide me with information, answers or a clear direction of my claim
I understand the *** office can't evaluate the reimbursement amount on my account until everything is paid but did the *** office submit the fluoride claim that was never sent it between May and Mar 15? According to ***, as of Mar 15, everything was 100% processed and there was nothing pending but there was a fluoride charge on May that was never billed If the fluoride charge was submitted after Mar 15, I would like a copy of it so I can provide to my personal claims processor, *** *** at ***, who will expedite my claim
I also understand that claims processing can take up to year or more but my point of contact at *** will process my unique multi-insurance claim within 3-days. Please send any items that show as pending to me so I can send to ***@***.com*** *** has been unsuccessful in reaching someone at *** *** who can complete the steps necessary to complete all claims (as stated above, the only item that is needed is the fluoride charge received on May 14). *** is available and can provide step-by-step instructions to facilitate process. According to my carrier/personal claims processor, *** *** should call *** at ***, ext *** in order to obtain clarification on what is needed. *** will stay on the phone with *** *** and process anything that is not complete. Please provide a few times/dates that will work best and I can arrange a phone conference between *** *** and *** at *** so we can complete any outstanding claims. If it makes it any easier, *** *** can provide me with a time and date to go by the office so we can all figure this out together. It is one piece of paper that is holding everything up that should have been submitted eleven months agoLet's just please get this done V/r, ***
*** *** ***
*** ***@att.net
Hello, As stated previously, we cannot evaluate the account until all claims are paid There are still pending items for the account, so until then we have no new information to report We have billed for all services, but until the insurance pays, they may not recognize the services in their system Please stand by We have stated that claims processing can take up to year with insurance plan This family has multiple insurance carriers which will extend the processing time If anything is needed in the interim it is best for the family to contact their carriers for more information We have facilitated the claim submission Regards,
Complaint: [redacted] I am rejecting this response because: Now that all claims have been properly submitted and processed, please provide instructions on how we will receive reimbursement for overpayment of [redacted] expenses and an estimated timeframe to expect reimbursement The attachments [redacted] provided to Revdex.com (Revdex.com) are completed different from the statements [redacted] provided me with (see attached) In the end, I am willing to disregard the statements [redacted] provided to Revdex.com since I spoke with [redacted] (***) and [redacted] today, Jan Both insurances said as of six business days ago (Jan 15), the claims have finally been properly submitted and being that my husband paid $on Jun (see attached receipt), we are still owed a reimbursement from [redacted] [redacted] and [redacted] instructed me to ask [redacted] for reimbursement and if the [redacted] office does not comply, both insurance carriers will contact [redacted] to facilitate [redacted] has come through and done their part so far and I believe they will be able to provide the reimbursement we are rightfully owed Regards, [redacted]
Hello, Please be informed that while we do acknowledge your frustration regarding the processing time, the delay is not out of the ordinary The progression of events has occurred in the exact sequence we originally stated We did inform you that your first insurance has months to pay claims Here we are, almost at the month mark, and we are in the process of getting the final claim paid on the family account from [redacted] Claims are being evaluated in an even shorter time-frame than anticipated by [redacted] , however they will only evaluate claims after [redacted] has made a final decision We ask that you continue to be patient as we can only file to [redacted] once your [redacted] plan has rendered a final decision on paper This "EOB" is then sent to [redacted] along with a claim for secondary claim processing Hopefully we will know more within the next 30-days Please remember that this stage is not in our hands We have submitted all necessary documents, and have confirmation reports attesting to that At this point, we have to wait on your insurances to respond
Complaint: ***
I am rejecting this response because:
Good morning,
I spoke with you on Feb and you instructed me to email you with the final total for reimbursement. At that time, my dental claims were in the final stages of processing. I contacted *** *** on Mar 15 to verify all claims were 100% processed; unfortunately, it was discovered that *** *** left off a fluoride treatment code received on the May visit.
According to *** *** as we currently stand, my family is owed a refund of $127. Once *** *** resubmits May claim with the $fluoride code, we will be owed a refund of $143. The *** *** representative stated the dental office should bill items correctly and tried to reach someone several times this week at the dental office who could assist with resubmitting the claim properly but was unsuccessful.
Therefore, I would like to reinstate complaint #***. Please let me know if anything else is needed.
Thanks in advance
V/r,
***
*** *** ***
***
***
Hello, Please see the attached receipts for all insurance payments received for the family to date You will find the date of payment on the upper right hand portion of the receipt as well as the patient name listed below Claim payments started in June and continued for every month thereafter with the exception of July and November of Family claims are still being received, as this family has a federal plan which requires us to send to both insurance carriers Primary insurance must evaluate first and submit a form which we attach when we send off for Secondary payment Insurance typically takes a minimum of days by law to evaluate If claim payments started in June 2014, that is a good indication that we started submission days prior (May 2014) Also note that a services are grouped by category for faster claims processing That being said, there may not be just one claim for the each date of service Please evaluate our supporting documentation to make a determination on this claim Regards,
Hello, We have spoken to *** via email, phone and in person She is upset about the filing process and currently we are waiting on insurance claims to be received on her account It is not atypical for insurance to take months to finalize payment, but the patient is
unsatisfied I did inform her at this point we need to wait for her insurance to finish paying to properly evaluate her account, as she also reported she might have been overcharged If you would like my most recent email to her please let me know and I will attach it In the email I explained it looked as though she may have been overcharged as well as undercharged I advised to wait on insurance payments for us to make a final review of her case She has dual insurances thru the Federal Employee program and it has been difficult and new for both staff and insurance reps to report the plan details accurately and consistently We advised for her to disregard any bills she may have received thru our automated billing process, and at no time have we asked for payment after the initial set of services were rendered. Mrs*** has come into the office and been loud, disruptive and has tried to ruin our image in front of clients She and her husband have dropped by repeatedly without any appointment and have cause a disruption in our waiting room on several occasions We have politely told her (and her husband) insurance is working on their claims We have not billed her for additional monies nor have we asked for her to make payment on her account even though the account is past our day mark for unpaid insurance claims Please let me know what we can do to settle this It is not typical for us to have clients so combative I have honestly tried my best and do not know what else we need to do to resolve this matter I have been honest with her about the state of office and her account as well as confirmed I will help her, but the patient is still not happy
Complaint: ***I am rejecting this response because:The response does not state how the situation will be fixed Additionally, my claims were not and still have not been submitted to either of my insurances as of December After being pushed aside for half a year, I had to resort to going to the office in person In October, *** *** said my billing issue would be fixed before an appointment we scheduled for November On November, I sent an email requesting review of our previous charges On November, hours, I called to get a status update and make sure nothing else was needed from me *** told me she did not have time for me and her priority was the patients in her office at that moment and not me or my email I decided to drive to the office and be the last patient of the day since they closed at hours I did not say anything to any of the other patients that were in and out of the office I sat patiently and waited until I was called on (I was not called upon until the entire office was clear of all patients)My goal was to try to speak with someone else (or higher) with the hopes that maybe they would be able assist me and get my paperwork going before my scheduled appointment on November or even assure me my situation was being workedAfter discovering ***'s father owns the clinic, I have basically given up on all communication with *** *** and have had to resort to utilizing *** *** *** *** and *** representatives by having them contact *** *** on three-way phone calls since my family's billing issues have not been corrected*** has contacted *** *** times and *** has contacted *** *** times so they could explain the documents that are needed in order to complete my claims In the end, claims need to be submitted correctly Services received on May were never submitted from *** *** to the primary or secondary insuranceBecause the May claims were never submitted by *** ***, the Jun visit can't be completed Request *** *** submit May claim to *** *** *** ***Once that EOB is received, send it to ***Once May claim is complete, ensure proper documents were submitted for Jun visit to *** and *** I'd be more than willing to complete myself; just give me what I need to give them Since there are transmission issues, *** *** *** *** (###-###-####) and/or *** (###-###-####) representative(s) may be contacted and can provide a direct fax line and confirm the transmission they receive is the correct one.I apologize for demanding assistance but this has been a very grueling and prolonged experience I am willing to do whatever it takes to get it processed and resolved. My situation sounded like it was a few pieces of paper away from being fixed It's not even about the money; if it makes it any easier, please donate the payment I am owed to charity. Regards,*** *** ***
As mentioned in a previous response, insurance has up to year to keep claims open Keeping in mind that this client has policies (the second policy will not even consider the claim until they have a primary response), the time-frame for final payments can be 1+ years As we continue to receive payments we will post them to the family account Once all claims have been received, if any refund is due at the time, we can certainly take the proper steps for reimbursement Please understand claims filing is a timely process At this point, everything is in the hands of the insurance companies
*** *** and staff run the best dental offices in town
Hello, Please be informed that while we do acknowledge your frustration regarding the processing time, the delay is not out of the ordinary. The progression of events has occurred in the exact sequence we originally stated . We did inform you that your first insurance has months to pay claims. Here we are, almost at the month mark, and we are in the process of getting the final claim paid on the family account from *** *** *** *** Claims are being evaluated in an even shorter time-frame than anticipated by ***, however they will only evaluate claims after *** *** has made a final decision. We ask that you continue to be patient as we can only file to *** once your *** *** plan has rendered a final decision on paper. This "EOB" is then sent to *** along with a claim for secondary claim processing. Hopefully we will know more within the next 30-days Please remember that this stage is not in our hands. We have submitted all necessary documents, and have confirmation reports attesting to that. At this point, we have to wait on your insurances to respond
Complaint: ***
I am rejecting this response because: Now that all claims have been properly submitted and processed, please provide instructions on how we
will receive reimbursement for overpayment of *** expenses and an estimated
timeframe to expect reimbursement
The attachments *** ***
provided to Revdex.com (Revdex.com) are completed different from the
statements *** *** provided me with (see attached)
In the end, I am willing to
disregard the statements *** *** provided to Revdex.com since I spoke with ***
*** *** *** (***) and *** today, Jan Both insurances said as of
six business days ago (Jan 15), the claims have finally been properly
submitted and being that my husband paid $on Jun (see attached
receipt), we are still owed a reimbursement from *** *** *** and *** instructed me to ask *** *** for reimbursement and if the *** office
does not comply, both insurance carriers will contact *** *** to facilitate
*** *** has come through and
done their part so far and I believe they will be able to provide the reimbursement
we are rightfully owed
Regards,
*** *** ***
Good afternoon, The response is extremely vague and does not provide me with information, answers or a clear direction of my claim
I understand the *** office can't evaluate the reimbursement amount on my account until everything is paid but did the *** office submit the fluoride claim that was never sent it between May and Mar 15? According to ***, as of Mar 15, everything was 100% processed and there was nothing pending but there was a fluoride charge on May that was never billed If the fluoride charge was submitted after Mar 15, I would like a copy of it so I can provide to my personal claims processor, *** *** at ***, who will expedite my claim
I also understand that claims processing can take up to year or more but my point of contact at *** will process my unique multi-insurance claim within 3-days. Please send any items that show as pending to me so I can send to ***@***.com*** *** has been unsuccessful in reaching someone at *** *** who can complete the steps necessary to complete all claims (as stated above, the only item that is needed is the fluoride charge received on May 14). *** is available and can provide step-by-step instructions to facilitate process. According to my carrier/personal claims processor, *** *** should call *** at ***, ext *** in order to obtain clarification on what is needed. *** will stay on the phone with *** *** and process anything that is not complete. Please provide a few times/dates that will work best and I can arrange a phone conference between *** *** and *** at *** so we can complete any outstanding claims. If it makes it any easier, *** *** can provide me with a time and date to go by the office so we can all figure this out together. It is one piece of paper that is holding everything up that should have been submitted eleven months agoLet's just please get this done V/r, ***
*** *** ***
*** ***@att.net
Hello, As stated previously, we cannot evaluate the account until all claims are paid There are still pending items for the account, so until then we have no new information to report We have billed for all services, but until the insurance pays, they may not recognize the services in their system Please stand by We have stated that claims processing can take up to year with insurance plan This family has multiple insurance carriers which will extend the processing time If anything is needed in the interim it is best for the family to contact their carriers for more information We have facilitated the claim submission Regards,