University of Colorado Medicine

Hi [redacted], I reviewed your account and verified that it is closed with the collection agency on our end, however since you are still receiving calls I've contacted them again to ensure that [redacted] account is closed and not reported to the credit bureau. I show that we posted a refund request on...

April 27th so you should've gone out on Friday the 13th. Please let me know if you do not receive the refund check by the end of the week. I show the amount of the check is $10.00 so if you have further questions or concerns, please feel free to contact me directly at [redacted]
[redacted]

The patient has a current balance of $556.20 and the reason why she received another statement for $60.28 is because her remaining balance of $495.92 is currently with our extended business office and that is where payment was posted. Our company policy is to post any payments to the oldest balance...

to try to prevent the account going to collections. When balances have been outstanding for more than 60 days they transfer to our extended business office where they remain for an additional 90 days until going to collections. The balance of $60.28 is still with our main office since it has not exceeded 60 days of no payment. The patient will not be refunded since she still has an outstanding balance. I highly suggest the patient calls to set up a payment plan. Our extended business office called her yesterday trying to discuss payment arrangements but she did not answer.

Hi [redacted], I apologize for the frustration you are experiencing. I talked to [redacted] and we are working together to resolve your account. I've recalled the invoices from collections and nothing has been reported to the credit bureau. I understand that you and [redacted] have been in communication...

today so please let me know if you need anything further from me. Thanks, [redacted]

After further review of the patient's account, I contacted him directly and provided a resolution.

It is the patient's responsibility to know her individual benefits and which doctors are considered in-network. When the patient called to make her appointment she spoke with the representatives at [redacted], not University Physicians. University Physicians only handles the...

claims after the service is rendered. We do not handle anything prior to the patient being seen. The co-pays that the patient paid at the time of service were collected by [redacted] employees and they will not know the patient's benefits either. Again, it is her responsibility to know her individual benefits. Since insurance denied the claim, we will provide the patient with a 40% self-pay discount, however she is responsible for the remaining balance.

Complaint: [redacted]
I am rejecting this response because: I will accept the response from CU once we have achieved full resolution of the outstanding filing with my insurance company and the initial charges. In addition,  I am awaiting a letter from CU to me with a full explanation and confirmation that my account is paid in full.
Sincerely,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Sincerely,
[redacted]

Hi [redacted], I will be more than happy to take a look at your account and resolve the issue, however I'm not finding any matching information to what you are indicating. Can you verify the DOS or the account number BC Services is indicating? Thanks, [redacted]

[redacted], University Physicians Inc. billed the visit on 2/22/16 as a [redacted] which you indicate is how it should've been billed to [redacted] and [redacted]. In regards to the 8/17/16 date of service, UPI billed it as the [redacted] code which you also indicate is correct. If [redacted] has not already...

spoken directly to the insurance team at UPI, I suggest they call them directly at [redacted]. Both departments can work together towards a resolution since the billing our end matches what you indicate should've been billed. Thanks, [redacted]

Initial Business Response /* (1000, 6, 2015/10/15) */
The balance for University Physicians is still outstanding and we have never received a payment or a phone call regarding this account. Our extended business called the phone number listed on the account on 8/2/15,8/21/15,8/25/15,9/3/15 and...

9/24/15 with no response back. [redacted] was paid for the services on this date of service but UPI is a separate entity and we bill for the physician's services verses the hospital who bills for the use of the facility.
Initial Consumer Rebuttal /* (3000, 8, 2015/10/16) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Their billing system is not what I can control. I am not able to return calls easily during the day and I work past 5 pm when everyone else is out of the office. The fact remains I have paid my bills. The other issue regarding my husband's name and the collection agency takes the highest priority.
Final Business Response /* (4000, 18, 2015/10/26) */
To Whom It May Concern,
[redacted]'* account under MRN#[redacted] for University Physicians Inc has been paid in full. His father, [redacted] has not been reported to the credit bureau nor will this debt appear on his credit report.
Thank you,
[redacted]
Patient Relations Lead
University Physicians Inc.
Final Consumer Response /* (2000, 20, 2015/10/27) */
(The consumer indicated he/she ACCEPTED the response from the business.)

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
The business representative,...

[redacted], contacted me and she said that the provided agreed to write off the balance due to the circumstance as described in the dispute. 
Sincerely,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. As long as I am allowed 90 days to pay and it does not get reported to credit bureaus I am okay with their response. Even though I only received the one bill, and a certified letter would have been a simple option for them to notify me of my balance and delinquency. Thank you very much for providing this option for me to resolve the situation, I heard horror stories online of customers not being able to get anywhere with the company when they called.
Sincerely,
[redacted]

Upon review of your account, CU Medicine does show a possible incorrect mailing address on the account for your child. The address information is received via interface from the Children's Hospital of Colorado when the patient is seen. CU Medicine did not receive any return mail...

from the address that the statements were being mailed to. Due to this, CU Medicine was not aware that the address on the account was no longer valid. CU Medicine did attempt to reach you by phone to discuss the balance as well as verify the correct mailing address, however CU Medicine was unable to get in touch with you. CU Medicine shows that there were three calls placed to the phone number on file, which does match the information provided to the dispute. The calls were placed on 07/11/2017, 08/17/2017, and 09/27/2017 and a voicemail was left each time. There was a consent signed at the time of service to be contacted via autodialed calls from CU Medicine as well as by representative. Since CU Medicine was unable to speak with you in regards to the account, it was forwarded to the collection agency.

Initial Business Response /* (1000, 6, 2015/11/18) */
According to the explanation of benefits from the insurance company, the balance for University Physicians is correct because the patient was seen by an out of network provider. Per insurance the physician is not enrolled in the EPO plan, only...

the PPO plan. University Physicians tried to appeal on the patient's behalf but it was denied by insurance. In regards to the reimbursement request, this needs to be re-directed to the hospital since University Physicians only handles accounts after they have gone through insurance. We do not deal with anything in regards to scheduling or prior approval.
Initial Consumer Rebuttal /* (3000, 8, 2015/11/19) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I was told REPEATEDLY by [redacted] schedulers throughout this process that insurance issues were resolved and that I should expect to pay maximum out of pocket expenses. I have fulfilled all my financial obligations for 2015. This is no longer my problem and I will not pay any medical bills from University Physicians.
University Physicians and the insurance company must have had a miscommunication. This issue involves [redacted] schedulers and the insurance company. This no longer involves me since I have paid all my expenses. Perhaps University Physicians should be harassing the insurance company, not me.
If there was any doubt that I would have been expected to pay more than my out of pocket expenses, I would not have had any procedures there.
Stop sending me billing statements.
Final Business Response /* (4000, 23, 2015/12/22) */
Our supervisor, [redacted]z will be communicating with the patient via email regarding her account. This was part of the discussion they had when they spoke on the phone on 12/14/2015.
Final Consumer Response /* (4200, 25, 2016/01/01) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Not yet resolved. Still waiting

Initial Business Response /* (1000, 9, 2015/09/15) */
Hi [redacted],
I'd be more than happy to review your account and assist you, however I can't locate you as a patient in our system. Can you please provide me with the account # (which is located on the top right corner of the statement)?...


Thank you,
[redacted]
Initial Consumer Rebuttal /* (3000, 11, 2015/09/17) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Further information has been requested to review my account. Account number requested: XXXXXXXX
Final Business Response /* (4000, 15, 2015/09/18) */
Hi [redacted],
After reviewing your account, it looks like you are current on your payment plan and this is a payment posting issue. I've reset your payment plan and this should avoid any further issues. If you have any questions or need any further information, please contact me at XXX-XXX-XXXX. I am the patient relations lead for UPI.
Final Consumer Response /* (2000, 17, 2015/09/21) */
(The consumer indicated he/she ACCEPTED the response from the business.)
Thank you for your help with this matter. I hope this case has finally been resolved.

I have personally reached out to the patient to discus his account and we have come to a resolution in regards to his balance. The patient has made an additional payment to resolve the account.

Better Business...

Bureau:
I have reviewed the response made by the business in reference to complaint ID [redacted].So basically after some deeper diving - I found out the 20.00 that was charged to my credit card was for a doctor's visit I had back on May 6th.  It just happened that they charged me on the exact date that I went to the other clinic.  What are the odds.  As far as my grievance pertaining to the concerned co-pay, that can be resolved.  My additional grievance concerning the submitting a diagnosis I wasn't treated for at the clinic to my insurance which started this whole fiasco in the first place, it is still valid.  The clinic and their billing company should be communicating to make sure they submit proper insurance information.  This small little thing that I went to the doctor for, turned into a life waste of many many hours spent calling and getting nowhere.  Hopefully I can put this issue to bed.  Thank you!
[redacted]

Upon further review of your account and CU Medicine shows no record of a copay made on 06/20/2017. After verification with the clinic, they also show no record of taking a payment of $20.00. Can you please provide a copy of your receipt to CU Medicine for research?

I have personally reviewed all of the recorded calls between yourself and the representatives at CU Medicine. I was unable to locate a conversation stating that without insurance coverage the patient balance would be 50% of the billed charges. Unfortunately the payment that was...

made cannot be accepted as payment in full. In regards to your dispute that the pathology was sent to an out of network provider, unfortunately that is out of CU Medicine's control. CU Medicine did perform the services at the request of the referring clinic.

I escalated this to our insurance team who verified that [redacted] provided UPI the wrong denial. After investigation, the balance should not be patient responsibility and UPI will have this corrected. I will place the balance on hold and send the patient a statement showing a zero balance once the account has been corrected.