This is a response to the complaint submitted on March 16, with the ID# First and foremost I would first like to say that all the providers and staff take gr**t pride in what they do here at Ventura County Dermatology, We also take a complaint regarding any aspect of our services very seriouslyThere are many facets to a medical office and billing insurance is just one of themMany offices no longer perform medical billing because of all the paperwork and staff hours it takes to submit even one claim to an insurance companyWe, as a courtesy, still bill insurance companies for our patientsH**lth insurance policies have become incr**singly Inore challenging to understand for patients, medical practices, and even insurance agents, Ultimately, however, it is the patient's responsibility to know their insurance and whether the provider they are seeing is in-network or not and what benefits and coverage they haveThe h**lth insurance policy is a contract between the patient and the insurance carrier, not the office and insurance carrier, We do our best to help guide the patient with their insurance issues but in no way take responsibility for knowing every aspect of their personal policyD***, C [redacted] and J [redacted] W [redacted] are patients at our office, and were seen at different times by providers in our office in MrW [redacted] 's complaint of thr**tening collection letters is not accurateOn 2-12-I did sp**k to MrW [redacted] about his and his son J***'s bill and told him I would look into itI stated that both providers had contracts with Anthem Blue Cross but there are certain sub-contracts that they didn't take, He did express that he had spoken to C [redacted] and L [redacted] on separate occasions about his bill and the need to get it resolvedHis concern was that if it continued to get delayed it would go into collectionsI personally assured him that he would not go to collections because that is a decision that is made by me, the office managerAfter looking into all three of the family's office visits, medical charges and EOB's (explanation of benefits) I found that MrW [redacted] and J***, their son, had seen one of the providers in our office who is out of network with their type of insurance, (Anthem Blue Cross Pathway - PPO - Covered California/ Pathways)I spoke to MrW [redacted] on 03-16-and told MrW [redacted] that his wife C [redacted] saw a provider who was in-network with that type of planThe provider he and J [redacted] saw was out of network with this plan and this is the re [redacted] their insurance did not cover their bill, After providing MrW [redacted] with all the facts about his family's insurance plan and the benefits paid and not paid to the office, he still did not want to pay his bill for the medical services we providedAt that point, I kindly adjusted the remaining balance to zeroAdjusting the balance to zero m**ns that MrW [redacted] and his son paid absolutely nothing for the medical care provided to them at our office, Their balance was adjusted to 'nothing due' during a phone call I had with MrW [redacted] Incidentally, that is the same day that he sent a complaint to the Revdex.comWe adjusted the balance to zero with no knowledge that he was planning to send a complaint to the Revdex.com and we were extremely surprised when we received the documents from the Revdex.comIn MrW [redacted] 's complaint he states that our office told him that DrK [redacted] was an in network provider for his insurance planThis is a true statementHowever, he and J [redacted] did not see DrK [redacted] , they saw another provider in our office who is not in-network for their insurance planHe also states that he received thr**tening collection lettersThis is a allegationWe send out monthly statements to our patients stating what they owe after their insurance has been billedThe second statement says “past due/regular payments are needed to keep account current” The third statement says “final notice if we do not h**r from you within days this account will be turned over to our collection agency”I spoke with MrW [redacted] after lie received the third bill and r**ssured him that he would NOT be sent to collectionsMrW [redacted] did not receive thr**tening collection lettersIn this day and age it is a challenge to keep a small private medical practice open due to the rising overh**ds, incr**sing administrative burdens, changing h**lth insurances, amongst other thingsWe have managed to continue our practice in this community because we try to do our best for our patients and their needsWe strive to go above and beyond to provide excellent service and care to every patient that walks through our doorsWe are a busy medical office and would never try to misl**d a patient in regards to their insurance coverage to get them to use our office over anotherThank you for your timeSincerely, S [redacted] Office Manager
text-decoration: none;">This is a response to the complaint submitted on March 16, 2016 with the ID# 11238.194. First and foremost I would first like to say that all the providers and staff take gr**t pride in what they do here at Ventura County Dermatology, We also take a complaint regarding any aspect of our services very seriously. There are many facets to a medical office and billing insurance is just one of them. Many offices no longer perform medical billing because of all the paperwork and staff hours it takes to submit even one claim to an insurance company. We, as a courtesy, still bill insurance companies for our patients. H**lth insurance policies have become incr**singly Inore challenging to understand for patients, medical practices, and even insurance agents, Ultimately, however, it is the patient's responsibility to know their insurance and whether the provider they are seeing is in-network or not and what benefits and coverage they have. The h**lth insurance policy is a contract between the patient and the insurance carrier, not the office and insurance carrier, We do our best to help guide the patient with their insurance issues but in no way take responsibility for knowing every aspect of their personal policy.
D[redacted], C[redacted] and J[redacted] W[redacted] are patients at our office, and were seen at different times by providers in our office in 2015. Mr. W[redacted]'s complaint of thr**tening collection letters is not accurate. On 2-12-16 I did sp**k to Mr. W[redacted] about his and his son J[redacted]'s bill and told him I would look into it. I stated that both providers had contracts with Anthem Blue Cross but there are certain sub-contracts that they didn't take, He did express that he had spoken to C[redacted] and L** on separate occasions about his bill and the need to get it resolved. His concern was that if it continued to get delayed it would go into collections. I personally assured him that he would not go to collections because that is a decision that is made by me, the office manager.
After looking into all three of the family's office visits, medical charges and EOB's (explanation of benefits) I found that Mr. W[redacted] and J[redacted], their son, had seen one of the providers in our office who is out of network with their type of insurance, (Anthem Blue Cross Pathway - PPO - Covered California/ Pathways). I spoke to Mr. W[redacted] on 03-16-16 and told Mr. W[redacted] that his wife C[redacted] saw a provider who was in-network with that type of plan. The provider he and J[redacted] saw was out of network with this plan and this is the re[redacted] their insurance did not cover their bill, After providing Mr. W[redacted] with all the facts about his family's insurance plan and the benefits paid and not paid to the office, he still did not want to pay his bill for the medical services we provided. At that point, I kindly adjusted the remaining balance to zero. Adjusting the balance to zero m**ns that Mr. W[redacted] and his son paid absolutely nothing for the medical care provided to them at our office, Their balance was adjusted to 'nothing due' during a phone call I had with Mr. W[redacted]. Incidentally, that is the same day that he sent a complaint to the Revdex.com. We adjusted the balance to zero with no knowledge that he was planning to send a complaint to the Revdex.com and we were extremely surprised when we received the documents from the Revdex.com.
In Mr. W[redacted]'s complaint he states that our office told him that Dr. K[redacted] was an in network provider for his insurance plan. This is a true statement. However, he and J[redacted] did not see Dr. K[redacted], they saw another provider in our office who is not in-network for their insurance plan. He also states that he received thr**tening collection letters. This is a false allegation. We send out monthly statements to our patients stating what they owe after their insurance has been billed. The second statement says “past due/regular payments are needed to keep account current” The third statement says “final notice if we do not h**r from you within 10 days this account will be turned over to our collection agency”. I spoke with Mr. W[redacted] after lie received the third bill and r**ssured him that he would NOT be sent to collections. Mr. W[redacted] did not receive thr**tening collection letters.
In this day and age it is a challenge to keep a small private medical practice open due to the rising overh**ds, incr**sing administrative burdens, changing h**lth insurances, amongst other things. We have managed to continue our practice in this community because we try to do our best for our patients and their needs. We strive
to go above and beyond to provide excellent service and care to every patient that walks through our doors. We are a busy medical office and would never try to misl**d a patient in regards to their insurance coverage to get them to use our office over another. Thank you for your time.
Sincerely,
S[redacted]
Office Manager
This is a response to the complaint submitted on March 16, with the ID# First and foremost I would first like to say that all the providers and staff take gr**t pride in what they do here at Ventura County Dermatology, We also take a complaint regarding any aspect of our services very seriouslyThere are many facets to a medical office and billing insurance is just one of themMany offices no longer perform medical billing because of all the paperwork and staff hours it takes to submit even one claim to an insurance companyWe, as a courtesy, still bill insurance companies for our patientsH**lth insurance policies have become incr**singly Inore challenging to understand for patients, medical practices, and even insurance agents, Ultimately, however, it is the patient's responsibility to know their insurance and whether the provider they are seeing is in-network or not and what benefits and coverage they haveThe h**lth insurance policy is a contract between the patient and the insurance carrier, not the office and insurance carrier, We do our best to help guide the patient with their insurance issues but in no way take responsibility for knowing every aspect of their personal policyD***, C [redacted] and J [redacted] W [redacted] are patients at our office, and were seen at different times by providers in our office in MrW [redacted] 's complaint of thr**tening collection letters is not accurateOn 2-12-I did sp**k to MrW [redacted] about his and his son J***'s bill and told him I would look into itI stated that both providers had contracts with Anthem Blue Cross but there are certain sub-contracts that they didn't take, He did express that he had spoken to C [redacted] and L [redacted] on separate occasions about his bill and the need to get it resolvedHis concern was that if it continued to get delayed it would go into collectionsI personally assured him that he would not go to collections because that is a decision that is made by me, the office managerAfter looking into all three of the family's office visits, medical charges and EOB's (explanation of benefits) I found that MrW [redacted] and J***, their son, had seen one of the providers in our office who is out of network with their type of insurance, (Anthem Blue Cross Pathway - PPO - Covered California/ Pathways)I spoke to MrW [redacted] on 03-16-and told MrW [redacted] that his wife C [redacted] saw a provider who was in-network with that type of planThe provider he and J [redacted] saw was out of network with this plan and this is the re [redacted] their insurance did not cover their bill, After providing MrW [redacted] with all the facts about his family's insurance plan and the benefits paid and not paid to the office, he still did not want to pay his bill for the medical services we providedAt that point, I kindly adjusted the remaining balance to zeroAdjusting the balance to zero m**ns that MrW [redacted] and his son paid absolutely nothing for the medical care provided to them at our office, Their balance was adjusted to 'nothing due' during a phone call I had with MrW [redacted] Incidentally, that is the same day that he sent a complaint to the Revdex.comWe adjusted the balance to zero with no knowledge that he was planning to send a complaint to the Revdex.com and we were extremely surprised when we received the documents from the Revdex.comIn MrW [redacted] 's complaint he states that our office told him that DrK [redacted] was an in network provider for his insurance planThis is a true statementHowever, he and J [redacted] did not see DrK [redacted] , they saw another provider in our office who is not in-network for their insurance planHe also states that he received thr**tening collection lettersThis is a allegationWe send out monthly statements to our patients stating what they owe after their insurance has been billedThe second statement says “past due/regular payments are needed to keep account current” The third statement says “final notice if we do not h**r from you within days this account will be turned over to our collection agency”I spoke with MrW [redacted] after lie received the third bill and r**ssured him that he would NOT be sent to collectionsMrW [redacted] did not receive thr**tening collection lettersIn this day and age it is a challenge to keep a small private medical practice open due to the rising overh**ds, incr**sing administrative burdens, changing h**lth insurances, amongst other thingsWe have managed to continue our practice in this community because we try to do our best for our patients and their needsWe strive to go above and beyond to provide excellent service and care to every patient that walks through our doorsWe are a busy medical office and would never try to misl**d a patient in regards to their insurance coverage to get them to use our office over anotherThank you for your timeSincerely, S [redacted] Office Manager
text-decoration: none;">This is a response to the complaint submitted on March 16, 2016 with the ID# 11238.194. First and foremost I would first like to say that all the providers and staff take gr**t pride in what they do here at Ventura County Dermatology, We also take a complaint regarding any aspect of our services very seriously. There are many facets to a medical office and billing insurance is just one of them. Many offices no longer perform medical billing because of all the paperwork and staff hours it takes to submit even one claim to an insurance company. We, as a courtesy, still bill insurance companies for our patients. H**lth insurance policies have become incr**singly Inore challenging to understand for patients, medical practices, and even insurance agents, Ultimately, however, it is the patient's responsibility to know their insurance and whether the provider they are seeing is in-network or not and what benefits and coverage they have. The h**lth insurance policy is a contract between the patient and the insurance carrier, not the office and insurance carrier, We do our best to help guide the patient with their insurance issues but in no way take responsibility for knowing every aspect of their personal policy.
D[redacted], C[redacted] and J[redacted] W[redacted] are patients at our office, and were seen at different times by providers in our office in 2015. Mr. W[redacted]'s complaint of thr**tening collection letters is not accurate. On 2-12-16 I did sp**k to Mr. W[redacted] about his and his son J[redacted]'s bill and told him I would look into it. I stated that both providers had contracts with Anthem Blue Cross but there are certain sub-contracts that they didn't take, He did express that he had spoken to C[redacted] and L** on separate occasions about his bill and the need to get it resolved. His concern was that if it continued to get delayed it would go into collections. I personally assured him that he would not go to collections because that is a decision that is made by me, the office manager.
After looking into all three of the family's office visits, medical charges and EOB's (explanation of benefits) I found that Mr. W[redacted] and J[redacted], their son, had seen one of the providers in our office who is out of network with their type of insurance, (Anthem Blue Cross Pathway - PPO - Covered California/ Pathways). I spoke to Mr. W[redacted] on 03-16-16 and told Mr. W[redacted] that his wife C[redacted] saw a provider who was in-network with that type of plan. The provider he and J[redacted] saw was out of network with this plan and this is the re[redacted] their insurance did not cover their bill, After providing Mr. W[redacted] with all the facts about his family's insurance plan and the benefits paid and not paid to the office, he still did not want to pay his bill for the medical services we provided. At that point, I kindly adjusted the remaining balance to zero. Adjusting the balance to zero m**ns that Mr. W[redacted] and his son paid absolutely nothing for the medical care provided to them at our office, Their balance was adjusted to 'nothing due' during a phone call I had with Mr. W[redacted]. Incidentally, that is the same day that he sent a complaint to the Revdex.com. We adjusted the balance to zero with no knowledge that he was planning to send a complaint to the Revdex.com and we were extremely surprised when we received the documents from the Revdex.com.
In Mr. W[redacted]'s complaint he states that our office told him that Dr. K[redacted] was an in network provider for his insurance plan. This is a true statement. However, he and J[redacted] did not see Dr. K[redacted], they saw another provider in our office who is not in-network for their insurance plan. He also states that he received thr**tening collection letters. This is a false allegation. We send out monthly statements to our patients stating what they owe after their insurance has been billed. The second statement says “past due/regular payments are needed to keep account current” The third statement says “final notice if we do not h**r from you within 10 days this account will be turned over to our collection agency”. I spoke with Mr. W[redacted] after lie received the third bill and r**ssured him that he would NOT be sent to collections. Mr. W[redacted] did not receive thr**tening collection letters.
In this day and age it is a challenge to keep a small private medical practice open due to the rising overh**ds, incr**sing administrative burdens, changing h**lth insurances, amongst other things. We have managed to continue our practice in this community because we try to do our best for our patients and their needs. We strive
to go above and beyond to provide excellent service and care to every patient that walks through our doors. We are a busy medical office and would never try to misl**d a patient in regards to their insurance coverage to get them to use our office over another. Thank you for your time.
Sincerely,
S[redacted]
Office Manager