Urology Associates, Ltd

January 19., [redacted] Revdex.com Fax # ###-###-#### Re: [redacted] Dear Ms [redacted] , I received in the mail today a final notice of complaint on Mr [redacted] Please note: This is the first notification that we have received regarding this patientMr [redacted] was seen in our clinic on 11-16-by Dr [redacted] ***At that time discussion of treatment and several options were fully outlined for the patient including Axiron 30mgThis is the option that the patient choseOn 11-18-Mr [redacted] contacted our office, and talked to one our Triage Nurses stating that Axiron was not covered by his insurance, by another medication Androgel wasSo we called in that prescription to his pharmacy at his request that very dayThe patient then called back again on 11-21-to our Triage nurse stating that Androgel was also not coveredIt was recommended that he contact member's services of his insurance company directly to see what was covered and call us backHe was told that if no medications were covered by his particular policy-then we could start a prior authorization process together with his pharmacyThis process was then startedMr [redacted] called back again on 11-30-to our Triage nurse, and wanted to know about the status of his Prior Authorization for the Axiron or AndrogelThe nurse informed him that this can take several weeks.,At this point the patient started yelling and swearing at our Triage nurseShe offered to let him speak to her supervisor, but he continued to swear at her, so she discontinued the conversation

Company replied to consumer in writing

I received in the mail today a final notice of complaint on Mr***Please note: This is the first notification that we have received regarding this patient. Mr*** was seen in our clinic on 11-16-by Dr*** ***At that time discussion of treatment and several options were fully outlined for the patient including Axiron 30mgThis is the option that the patient choseOn 11-18-Mr*** contacted our office, and talked to one our Triage Nurses stating that Axiron was not covered by his insurance, by another medication Androgel wasSo we called in that prescription to his pharmacy at his request that very day. The patient then called back again on 11-21-to our Triage nurse stating that Androgel was also not coveredIt was recommended that he contact member's services of his insurance company directly to see what was covered and call us backHe was told that if no medications were covered by his particular policy-then we could start a prior authorization process together with his pharmacyThis process was then started. Mr*** called back again on 11-30-to our Triage nurse, and wanted to know about the status of his Prior Authorization for the Axiron or AndrogelThe nurse informed him that this can take several weeksAt this point the patient started yelling and swearing at our Triage nurseShe offered to let him speak to her supervisor, but he continued to swear at her, so she discontinued the conversation. Patient called back again on 12-27-and was told that the PA was still in process, and patient understood thisHe called back again on 1-3-17, and then again on 1-6-and each time was told that this was still being processed by his insurance company and the pharmacyOn 1-11-we received notification from BlueCross and Blue Shield that the Androgel was approvedThe patient was called immediately on that date and personally told this by the Edina office SupervisorAs you can see by all of the above notes, the patient was very well taken care ofWe did everything within our power to work with his insurance company and the pharmacy to get the medication approved that the patient wantedThe moment that we were notified by BCBS that this had been approved the patient was notified If there is any further information that you need from our clinic please do not, hesitate to contact me Sincerely, Barbara A***, CMPE Administrator Urology Associates, Ltd

I am rejecting this response because: These statements are untrueI did not receive letters or any phone call or messages about my bill. As I stated in complaint, I moved at the end of April and was not made aware I wasn't covered until I called
to do my follin June. Bills were being sent to my previous address they had on fileI was told by my employer before I even went to the doctor that I was covered and that turned out to be not true....not my fault. When I was contacted by collection place, ***, I was made aware that it had been sent to collection as well as other bills from my surgery as none of them were being paid by insurance that was suppose to have covered itThe person I spoke to was named Marlene, not Pam, and she was very professional and helpful and I spoke to her on many occasions to keep her updated on the progress over the months it took to get my employer to pay the billsWhen I was told by Anthony in the business office about the pre pay he was very helpful and professional as well and I asked to speak to a supervisor...she was unavailable but called me back later in the afternoon on a Thursday at 2:18pmIn the message I was told to call her back but she would be in a meeting from 2:to 3:and leaves at and wouldn't be in the office Friday or MondaySo I was given a half hr window to call back or had to wait until the following Tuesday to speak with her. I was quoted a prepay price by Anthony on different occasionsI was told on the Thursday before my scheduled appointment that it was going to be either $or $at the time of my visit...I was then told by him on that following Monday that it would be $280. When I did speak to Barbara I tried explaining the situation and was cut off multiple times and she was extremely rudeWhen I asked to speak to her boss I was told "I am the boss", "she signs her own checks", and "that she answers to nobody"After getting it out of her that she reports to a board; I asked to be contacted by somebody from the board...and of course I cannot speak to anybody from the board before I was hung up on. Again, this billing issue was taken care of as soon as my employer made payment arrangements thru me with the collection agencyThe conversations were all recorded and will show this. I was not able to even make an appointment until the account was paid which I think is completely ridiculous as it is a follappointment to a cancer surgeryI have questions about the way the incision site has healed and need to make sure the cancer did not come back and I'm told I can't because of $2270.40. The fact that I had current coverage now and while trying to make an appointment was never asked or checked by anybody from the appointment desk or the business officeIt didn't seem to matter...only the money they were owed matteredI worked to get somebody else's mistake taken care of as fast as I could while still being told I can't even schedule an appointment....Then when I am allowed to schedule I am given different prepay prices and get to deal with an individual like this Barbara. This policy should be reviewed on a case by case basis and definitely not by somebody with an "I'm the boss" complex or attitude

January 19., 2017 [redacted] Revdex.com Fax # ###-###-#### Re: [redacted] Dear Ms. [redacted], I received in the mail today a final notice of complaint on Mr. [redacted]. Please note: This is the first notification that we have received regarding this patient. Mr....

[redacted] was seen in our clinic on 11-16-16 by Dr. [redacted].. At that time discussion of treatment and several options were fully outlined for the patient including Axiron 30mg. This is the option that the patient chose. On 11-18-16 Mr. [redacted] contacted our office, and talked to one our Triage Nurses stating that Axiron was not covered by his insurance, by another medication Androgel was. So we called in that prescription to his pharmacy at his request that very day. The patient then called back again on 11-21-16 to our Triage nurse stating that Androgel was also not covered. It was recommended that he contact member's services of his insurance company directly to see what was covered and call us back. He was told that if no medications were covered by his particular policy-then we could start a prior authorization process together with his pharmacy. This process was then started. Mr. [redacted] called back again on 11-30-16 to our Triage nurse, and wanted to know about the status of his Prior Authorization for the Axiron or Androgel. The nurse informed him that this can take several weeks.,At this point the patient started yelling and swearing at our Triage nurse. She offered to let him speak to her supervisor, but he continued to swear at her, so she discontinued the conversation.