Tristate Imaging Consultant

February 26, 2015Dear [redacted] ***, This letter is in response to the complaint dated 2/13/against Rittenhouse Square MDI Bryn Mawr facility.Patient has a $insurance deductable plan with a balance of $at the time of studyPatient submitted insurance information for payment.MDI Pricing for this study is $The center asked for 75% of the payment towards the deductibleThe policy of the company is to collect all co-pays, deductibles, and co-insurance is due at time of serviceAs most insurance companies do not always disclose their contracted rates correctly, we estimate based on information from our verification department.At no time do we indicate the amount is exactWe provide a disclosure form to all patients: CO-PAYMENTS CO-INSURANCE DEDUCTIBLES Payment is expected at time of service Co-payments Co-Insurance and Deductible amounts are based on estimates given by your insurance companyAmount could vary, additional monies may be owedSignaturePatient signed the disclosureUpon the review of his EOB contracted insurance price was $Patient paid $at time of service leaving a $balancePlease feel to contact me if any further information is needed Regards,Jussie C

February 26, 2015Dear ** ***,This letter is in response to the complaint dated 2/13/against Rittenhouse Square MDI Bryn Mawr facility regarding additional concernsPatient rejected the response because:As I stated in my original complain, when I called to schedule my appointment with MDI in Bryn Mawr, I told them I had a very high deductible and would be paying for the study out of pocket, so I wanted to know the cost of the testI was told over the phone that it would cost $200.00, but if I was paying out of pocket, they would accept 75% of the $200.00, or $Never did they say they would use the $toward my deductible: rather I was told my $would be payment in full .The patient presented his insurance so we are obligated to submit to his insurance companyThe insurance was verified and determined there was a deductible however, due we are not always privy to the exact amount duePatients may have submitted claims that do not appear during the verification periodThe money quoted was payment towards the high deductible, which was noted in our scheduling system.Our price for this study is $We request payment for all co-pays deductibles or co-insurance at time of service however due to different insurance rates we take 75% up front and bill the remaining to the patient after the EOB is generatedThe insurance company then processes the claim and has the final decision based on the patient’s planPayments are processed according to the individuals planThere is no documentation in our system stating the patient did not want his insurance used for his visitPaperwork was signed by the patients, which stated the amount quoted was an estimatePatient can pick up a copy by submitting a request to the MDI Bryn Mawr,I apologize for the entire misunderstanding on behalf of MDI Bryn MawrInsurance and the terminology can often be misunderstoodOur staff make every attempt to set the expectations for the visit which includes the estimated pricingWe are taking a proactive approach and retraining our front desk staff as to avoid further miscommunication in the futureUnderstanding medical insurance is very difficult and it is never our intention to complicate furtherRegards,
Julie C
VP Operations Tristate Imaging Group

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because:
Dear *** ***,
There was no misunderstanding between me and MDI. We can go back and forth on this as long as Ms. C*** would like to, but the fact remains: I alerted MDI staff I had a high deductible, and they offered me the concession of paying 75% of the $200 they charge to the insurance company for the procedureMsC*** was not on the phone when I called, nor was she at the office when I arrived at MDI in Bryn Mawr, and her portrayal of what transpired sounds like something out of a procedure manual, because it certainly is not what actually transpiredMsC*** readily admits in her recent correspondence that her staff needed to be retrainedI do not agree with her that understanding medical insurance is very difficultWhat occurred in this situation was simple math, and a verbal contract she should honor
Regards,
*** ***

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:
As I stated in my original complaint, when I called to schedule my appointment with MDI in Bryn Mawr, I told them I had a very high deductible and would be paying for the testing out-of-pocket, so I wanted to know the cost of the test. I was told over the phone that it would cost $200, but if I was paying out-of-pocket, they would accept 75% of the $200, or $150. Never did they say they would use the $150 toward my deductible; rather, I was told my $150 would be payment in full!  
When I visited the center for the test, I once again asked if the $150 would be all that I owed, and I was told a resounding YES. I gave them my insurance information because they asked for it, and not under the presumption that they would use it to try to charge me anything additional. Also, I do not recall receiving any disclosure form stating that my $150 was just an estimate. Please show me it if I signed such a disclosure statement.
When a merchant tells you, twice, that this is the price, shouldn't that be the price!
Regards,
[redacted]

February 26, 2015Dear [redacted],
This letter is in response to the complaint dated 2/13/2015 against Rittenhouse Square MDI Bryn Mawr facility.Patient has a $6000 insurance deductable plan with a balance of $5404.37 at the time of study. Patient submitted insurance information...

for payment.MDI Pricing for this study is $200.00 The center asked for 75% of the payment towards the deductible. The policy of the company is to collect all co-pays, deductibles, and co-insurance is due at time of service. As most insurance companies do not always disclose their contracted rates correctly, we estimate based on information from our verification department.At no time do we indicate the amount is exact. We provide a disclosure form to all patients:
CO-PAYMENTS CO-INSURANCE DEDUCTIBLES Payment is expected at time of service Co-payments Co-Insurance and Deductible amounts are based on estimates given by your insurance company. Amount could vary, additional monies may be owed.
SignaturePatient signed the disclosure.
Upon the review of his EOB contracted insurance price was $175.00. Patient paid $150.00 at time of service leaving a $25.00 balance.
Please feel to contact me if any further information is needed .
Regards,Jussie C

Dear [redacted],I was recently handed a complaint from the reference ID listed above and upon investigation found the following information. Medical entities are entitled to collect co-payments and deductibles at the time of service unless otherwise stated in their contracted with the...

insurance company, We use a real time program where insurance companies send us up to date information on their patient health plans.In this instance the information we received from the insurance company was correct. The patient did a deductible at the time of service however patient was also correct in that they were seen by another entity and the deductible had been met. The other entity was posted before Tristate so the patient is owed the deductible amount of $100.00. Payment will be process immediately.The spouse of the patient made the calls on her behalf therefore the billing department was obligated to received permission t speak about the patient's bill. There were numerous calls made to the billing department, no one spoke our billing manager. No patient should be spoken to in a nonprofessional manner and an internal investigation is on-going. Any employee who is found to be disrespectful will receive a warning and undergo a customer service re-education.Regards,Julie C.VP Operations