UCSD Medical Group

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***

The issue is not with how the office visit was coded, but the site of servicePatient was billed for lab workThe Laboratory is owned by the hospitalAccording to patient's benefits anything billed out by a facility such as her lab charges are applied to her yearly deductibleThere is no
fraudulent billing being doneMy staff and myself has explained this many times to the patientShe wants her lab charges to be written off. It would jepordize our contract with her insurance if we waived her deductibleThe hospital has offered her a reasonable payment plan to assit her with her liability.
Please let me know if there is anything else I can do regarding this complaint

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
The statement that I received "four statements" is a bold-face lie. When I contacted the collection agency they claimed a "wrong address" as the reason I had not been contacted - true or false? More importantly, upon receipt of a statement following the initial one, I addressed this matter in writing and did not receive a response, to date. Why not? The letter was posted on December 13, Moreover, I don't buy the line about the services being dictated by eye conditionsI do not have glaucoma! They even repeated the refraction process that was done on the previous visit - which I had paid forWas that necessary? I think not! This could easily be construed as a deliberate act to bill Medicare needlesslyI will continue to pursue a satisfactory resolution of this matter wherever it leads
Be advised that this is the same group that wrongly charged me a $copay which my insurance company advised me to pay and submit a claim for reimbursementFor some unexplained reason & after more than six months, the insurance company sent the $to UCSD Medical Group instead of me. It then took several months for me to receive the $from UCSDIt was only sometime after this fiasco that I received any billing statement(s)As stated previously, I never received any statement of liability from my insurance, so the figures quoted don't mean anything to meI stand firmly that the billing was not justified & in no way timely - which further aroused my suspicionsThank you for your efforts in this matter
Regards,
*** ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***

This notification should be routed to UCSD Medica Group as it is a physician billing matter. The manager is *** ***, ###-###-####

Dear ***, this is *** again , I am not satisfied with how ucsd responed to my complaint I never accepted their response, I don't know what happened to my email since I usually open my email on the phoneSorry next time I will be careful Again, at ucsd Hillcrest I went for well woman clinic visit , definitely never enter hospital on that particular dayThey never explained this prior to my visit over at check in desk, they didn't hand me the receipt when I walked outThey can't charge me hospital lab charge when I was just in the clinicI am in the situation in tight buget, single mom with two kidsI can't pay for the service that wasn't given to metheir billing practice is fraudulent, unethical to innocent peopleI am not the only person , there are more than patients complaining similar to my situation P***se help meThak you , ***
Dear ***, I forgot to clear this in previous email, the well woman visit I went for was done to me includes lab work which is just checking with tounge by the same doc.at the same minuteThey are making story, I dint have any extra lab work , show me the prove that I sign it?? That day was just well woman visit at the clinic , I have no complaints with my insurance, they pay total amount in full for well woman clinic visit, but yes for hopital its comes out of deductible , its like any other insurance Ucsd can not code extra hospital visit where the patients only gets well woman service at the clinic The lab work they are talking about is lie Ucsd ripping money from innocent patients

First of all, no rejection has been made. All I asked was for some additional time to have our compliance office review the physician's chart notes to determine if the charge was substantiated by physicians documentation. The billing office does not make that determination.  I received notification Friday by our Compliance office that the charge was not appropriate and the physician will need to remove the charge.  I have contacted the collection agency and requested the charges be removed and all negative credit rating relating to this charge be removed.
 
[redacted]
Operational Manager
UCSD Medical Group Physicians Business Office

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
UCSD claims they could not identify my case.  I have provided account numbers numerous times via phone, email, and on the Revdex.com complaints.  The responsible individual is attempting to mask her delayed response time and lack of due diligence. I am still waiting for written confirmation that my account balance is $0.  
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
The issue is not whether my insurance plan covers the costs, it is the fact that they don't disclose their costs, and that what they charge AFTER getting you into the facility is unreasonably high when compared to similar services elsewhere.  They do not disclose that they consider their office facility a hospital facility and they charge hospital rates for an office visit.  The administrator who answered mentions "discounts for services" as an option but when I inquired directly with UC San Diego Medical Group they did not offer any discounts, even when I asked about discounts.
Regards,
[redacted]

Mr. [redacted] had services on 3/11/14. Mr. [redacted] was sent four statements requesting payments. Without any response from him UC  San Diego Medical Group assigned his account to collections on 6/28/14. Mr. [redacted] called our office on 7/8/14. We took the insurance...

information from him and submitted a claim. He was instructed to call the collection agency and work with them, as they now owned his account.  
After a complete audit, it was determine that nothing was done unprofessionally. UC San Diego Healthcare  submit claims to insurance and work with insurance to optimize reimbursement.  Without the information there is not much we can do. Mr [redacted] had a number of opportunities to reach out to us and give us his correct insurance information so we could submit a claim. Mr. [redacted]'s Statement indicated clearly that the coverage we had on file was Aetna Managed Choice. That coveraged expired 3/1/14.
The issue relating to our cost of service is a total different matter. We are a teaching hospital and our fees are put into place according to what is reasonable and customary for the area. We offer discounts and payment plans for patient that are without coverage. If Mr. [redacted] had reached out to us we certainly would have worked with him, giving him a much better outcome.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Regards,
[redacted]

Without additional information ie...Medical Record Number or DOB I am unable to identify the patient by the first and last name only. My comment will need to be general.
When a patient is seen in a hospital-licenced location the cost assoicated must comply with specific Medicare federal...

regulations and is the national model for integrated healtcare delivery systems such as UC San Diego Health Systems. At this time we are not able to reach out and provide pricing information to every patient prior to services, but recognize the need to improve patients awareness. Without the ability to look at Ms. [redacted] particular services my guess is her insurance applied the services in an out-patient hospital facility to her yearly deductible OR possibly the insurance considered removal of warts not medically necessary according to her benefits. I do understand that medical care is expensive and strongly recommend patients read their benefits and understand the limitations of their particular insurance. UC San Diego offers many options to assist in paying for medical bills. A reasonable payment plan or discounts on services not covered by insurance are just a few.

The correction was already made. The consult visit was changed to a Follow-up and rebilled. The insurance paid on 11/12/14. Patient has no liability at this time.

I notified UCSD Medical Group of this complaint as I cannot correct the matter.  I work for UCSD Medical Center and this billing matter falls under UCSD Medical Group.  A contact is [redacted], Manager of Customer Relations ###-###-####.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this...

proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.This is not an acceptable response. As requested, my date of birth is [redacted]. Account #[redacted] and listed under [redacted] should be aware of the inquiry as I left multiple emails and voicemails.  I need confirmation that I have zero balance on this account, and she and her staff have not followed up. 
Regards,
[redacted]

Patient received the standard of care for his diagnosis on 11/1/11. Total charge for exam and test was $704.  His insurance paid and indicated the patient was responsbile for a co-insurance liability of $39.30. An eye exam was done at that time, which again, is the standard of care...

to determine if any progress or progression of disease has been made. The $40 eye exam was not a covered benefit of patient's insurance.
Patient received four Statements. We do know his address was correct at the time of billing as it was confirmed during one of his calls. Assignment to collection was 12/14/12 appropriately.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Regards,
[redacted]
The UC Medical Group response is extremely unprofessional, their denial and undocumented phonecalls that I have accomplished to date were ignored.  I plan to pursue this further with their administrative staff.

I will need time to review the chart notes and have our compliance office review for accuracy.

The issue was resolved on July 22. 2014.
I could not identify the patient as she is registered as [redacted], not [redacted] as indicated on her complaint with Revdex.com.

I am sorry the offer of a payment plan was not satisfactory. UCSD is very senitive to the financial needs of our patients. We are willing to extend the payments over many months to assist in the expenses. As stated in an earlier response, the lab work was ordered by her physician as a standard of care. Her insurance applied the services to her yearly deductible per her contract with them. There was no fraud or act of intentional disception. The lab work ordered falls within the guidelines for the care requested.