Ultrasound Associates

Review: I received an ultrasound at their office in November 2011. My insurance paid them. I had many medical issues in 2012 including heart surgery and surgery to remove my thyroid due to cancer. Towards the end of 2012, [redacted] did an internal audit and found that an employer had left my membership active in another medical insurance ([redacted]). [redacted] contacted me and assisted me in finding information about the other insurance. [redacted] also advised that all my clai** would be reverted. They indicated I had to contact all my medical providers. I had to give each provider detailed information of what had happened. The providers had to then return payments to [redacted], submit the clai** to [redacted], once they received the EOB from [redacted] they would then resubmit the claim to [redacted] who would process the claim. If there was a balance, the provider would invoice me and I would take care of settling any pending balance.

I contacted Ultrasound Associates multiple times, both by phone and in writing. Ultrasound Associated refused to process the claim as requested by the insurance companies. They kept harassing me and requesting I sign a waiver where I was made responsible or the entirety of the claim. They have gotten to the point of sending me to collections instead of reprocessing the claim. I have asked multiple times to speak to a manager or the owner of the practice. My requests fall on deaf ears. They have been disrespectful, harsh and unethical on the phone.

I need help. All other providers followed the instructions provided by [redacted] and [redacted]. All other clai** have been processed. I have paid all balances identified after the clai** were paid. I have great credit. I do not with my credit to be affected by the unfairness of the personnel and Ultrasound Associates.

This is the first time I submit a claim. I would really appreciate you help and guidance in finding a resolution for this horrible experience. I have gone through many medical nightmares and would like to move on. Ultrasound Associates, their insensitivity and unwillingness to work with me is really affecting me.Desired Settlement: I want them to retract the claim they send to the collection agency: [redacted] I want them to process the claim through [redacted]. Once [redacted] sends them the EOB, I want them to resubmit the claim to [redacted]. Once [redacted] sends them the EOB, I want them to bill me for any outstanding balance regarding the service they provided.

I would also like to see that the individuals involved on behalf of Ultrasound Associated be retrained in proper customer service practices as well as ethics.

Business

Response:

November 25, 2013

**. [redacted],

This is in response to a letter **. [redacted] sent to the Revdex.com on October 20, 2013.

On November 21, 2011, **. [redacted] had a thyroid sonogram performed at Ultrasound Associates. **. [redacted] gave [redacted] as her insurance carrier and on November 28, 2011, [redacted] was electronically billed and paid on December 9, 2011. The payment was posted and the appropriate discount was taken. On January 7, 2013, [redacted] sent a request for a refund of the entire amount, $463.50. Several calls were placed to [redacted] inquiring about the refund request and retraction of payment on April 23, 2013. I was informed **. [redacted] had maxed out her benefits at time of service and informed later it was because she had [redacted] as her primary insurance. I requested a review and a call back. On April 25, 2013 a statement was generated to **. [redacted]. **. [redacted] sent a [redacted] card May 14, 3013, indicating this was her primary insurance from January 1, 2011 through September 30, 2012.

I spoke to **. [redacted] on May 15, 2013 at which time she informed me she had [redacted] as primary and [redacted] as secondary. I informed her that it was beyond timely filing and she would have to sign a timely submission waiver indicating that if her insurance denied the claim she would be financially responsible. I mailed the waiver on May 15, 2013.

On May 20, 2013, [redacted] from [redacted] called to inquire if I had billed [redacted]. I informed her that I had not received the timely submission waiver from **. [redacted]. She will follow up with me. [redacted] called back on May 31, 2013 and I informed her I had not received the waiver from **. [redacted]. I asked [redacted] would [redacted] put in writing they would pay the claim and she said, “No.” [redacted] informed me [redacted] would only pay as a secondary carrier and not primary.

I received a letter from the patient dated July 15, 2013, attached, which indicates that the claim was over 12 months old and the billing office refused to resubmit the claim. Her insurance told her that under normal circumstances the 12 month statute would apply but her circumstance was different; this was never discussed with [redacted]. She had the [redacted] Rep contact us and request the claim be sent to [redacted]. **. [redacted] did not reference that I am still waiting for the timely submission waiver to be returned.

On July 29, 2013 **. [redacted] called and informed me she was not signing the timely submission waiver. I informed her that I could not bill [redacted] and [redacted] until she did so. According to our contract with [redacted] and [redacted], all claims must be submitted within 12 months. She referenced her letter insisting [redacted] would pay the claim if we resubmitted. I told her I need the waiver for [redacted] and [redacted]. She informed me she was not going to be held financially responsible when she has insurance.

**. [redacted] called again on September 27, 2013 at which time she again refused to sign the waiver. I informed her that her insurance refuses to guarantee payment or put in writing that the claim will be paid. She referenced her letter. She also indicated that her insurance informed us she did not have to sign the waiver, which is not accurate.

In the complaint filed with the Revdex.com she indicates Ultrasound Associates was harassing her when indeed **. [redacted] was the person calling. She indicated that she requested to speak to a manager or the owner. I am the Practice Administrator and I spoke to. **. [redacted]. She was sent to collections on September 24, 2013 for lack of payment and her unwillingness to provide the waiver.

Respectfully, **. [redacted] was informed on May 13, 2013 that the timely submission waiver had to be signed and returned before her insurances were billed. The timely submission waiver was never returned and the patient refused to do so. This could have been avoided if the patient had signed the waiver. The employees of Ultrasound Associates have tried to work with **. [redacted] and [redacted] to get this issue resolved to no avail.

If I can be of any further assistance, please feel free to call me, ###-###-####.

Consumer

Response:

[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]

Review: [redacted]

I am rejecting this response because as I indicated to them multiple times,

[redacted] advised me I was not supposed to sign any waiver. [redacted] said that if I

signed the waiver Ultrasound Associates would just make me fully and soley

responsible for the pending balance without following the correct billing

procedures. I even had an [redacted] representative ([redacted]) contact them and confirm

the process.