Vienna Family Medicine

December 5, 2014Dear [redacted] ***,We are in receipt of the complaint submitted to your office by our patient, [redacted] ***, for services rendered on September 4, The spirometry test conducted during [redacted] ***’s physical exam was performed due to one of his medical conditionsThe test was conducted in order to determine [redacted] ***’s lung function, as part of his physical examThe test would not, and could not, have been performed without [redacted] ***’s knowledge and consent [redacted] ***’s insurance company denied the claim for the spirometry testThe amount [redacted] owes has been adjusted to the amount his insurance company would have been charged per provider contractAfter the adjustment, the balance on [redacted] ***’s account is only $Please do not hesitate to contact our office, if we can be of further assistance.Sincerely,Eileen P Office Manager

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because:I never asked for the test nor was I consultedThe doctor made the decision on his own to have me breathe into a tube for and a half minutesThat was the extent of the 'test.' I even called the clinic before my physical and provided my insurance information to check with them that my scheduled physical was fully covered They misled me into thinking the less than minute 'test' was a party of the covered physical without even discussing it fully
Regards,
*** ***

December 5, 2014Dear [redacted],We are in receipt of the complaint submitted to your office by our patient, [redacted], for services rendered on September 4, 2014. The spirometry test conducted during [redacted]’s physical exam was performed due to one of his medical conditions. The test was...

conducted in order to determine [redacted]’s lung function, as part of his physical exam. The test would not, and could not, have been performed without [redacted]’s knowledge and consent. [redacted]’s insurance company denied the claim for the spirometry test. The amount [redacted] owes has been adjusted to the amount his insurance company would have been charged per provider contract. After the adjustment, the balance on [redacted]’s account is only $48.67. Please do not hesitate to contact our office, if we can be of further assistance.Sincerely,Eileen P
Office Manager

July 26, 2014Dear [redacted],Vienna Family Medicine (VFM) is in receipt of your letter detailing a complaint submitted by one of our patients, [redacted]. After researching [redacted]’s account, as well as her husband’s, we have determined that this office did, in fact, submit the...

charges correctly to the patient’s insurance company. [redacted] indicated during a telephone call on July 15, 2014, that her family has been assigned two different policies with CareFirst through healthcare.gov. [redacted]’s concerns were valid and, unfortunately, she was verbally given misinformation by one of our staff members as to which group number the claims would be submitted under. [redacted]’s claims, as well as her husband’s, were processed without complications. Should you have any further questions or concerns regarding this matter, please do not hesitate to contact thisoffice.Sincerely,Eileen P[redacted] *Office Manager

Review: We have presented insurance cards at the time of service with the correct information but the billing people think they know better and file under a different/wrong group number. The number they are filing against is a duplicate policy created by the health exchange and is being cancelled but it is taking the government 6 months to do this. Meanwhile we have a paid up policy purchased directly from carefirst and that is what our card reflects. I have met with VFM in person and by phone to ensure they have the right information yet they continue to ignore me/bill incorrectly. When they bill to the wrong policy they create hours of work for me and the bills do not get paid. I do not have anymore time to waste on this because every time they claim it is 'fixed', it isn't.Desired Settlement: I want a call that guarantees that all of the services for my husband and me have been billed correctly, that they will continue to be billed correctly, and an apology for the time and stress this has caused me. We pay a lot of money for this insurance and we GAVE THEM THE CORRECT INFORMATION FROM THE START. What right do they have to override the card I give them? I don't think they should get paid at all if they don't use the information provided by the patient for billing.

Business

Response:

July 26, 2014Dear [redacted],Vienna Family Medicine (VFM) is in receipt of your letter detailing a complaint submitted by one of our patients, [redacted]. After researching [redacted]’s account, as well as her husband’s, we have determined that this office did, in fact, submit the charges correctly to the patient’s insurance company. [redacted] indicated during a telephone call on July 15, 2014, that her family has been assigned two different policies with CareFirst through healthcare.gov. [redacted]’s concerns were valid and, unfortunately, she was verbally given misinformation by one of our staff members as to which group number the claims would be submitted under. [redacted]’s claims, as well as her husband’s, were processed without complications. Should you have any further questions or concerns regarding this matter, please do not hesitate to contact thisoffice.Sincerely,Eileen P[redacted]Office Manager

Review: I went into this medical practice in Nov 2012 for a severe ear infection. Several days earlier, I had gone to the emergency room and was treated, but it was not getting better. While at Vienna Family Medicine, I was seen by a nurse practitioner, [redacted], who literally spent 2 minutes with me, if that. She looked into my ear, told me it was so swollen she couldn't see anything, called in a prescription for an anti-inflammatory and sent me on my way. I quite honestly, didn't think I would be billed for the visit since not only did she not do anything to help me, but she also didn't spend any time with me. On March 17, 2013, I received an invoice for a 25-minute visit with a balance (after insurance write-off) of $157.07. I called the office on March 18 to dispute the charge as was told the supervisor would call me back to discuss. She didn't. I called again on April 25 and explained the situation again and was told [redacted], the supervisor, would call me back. She never did. However, the practice kept sending me a statement with an outstanding balance. Finally, on June 20, I went into their office and asked to speak with an office manager. I explained the situation and offered to pay half. She told me she would speak to the billing supervisor about the issue and have her get back to me. This woman finally called me back the next day and told me that they were not willing to accept my offer of a 50% payment. I felt like it was a fair compromise because I was seen my someone, but I received no service from them. She obviously felt differently. This office is in the business of patient care, but I feel as if I received no care from them and wasted my time going in to see someone.Desired Settlement: I have now sent them a payment of $157.07 for the outstanding balance so they don't send me to collections, but I would like a refund of half that amount, or $78.53. In addition, I would like them to mail me a copy of my medical records as I will no longer be going to that practice.