Weill Cornell Medical College

Revdex.com: I have reviewed the response made by the business in reference to complaint ID# [redacted] , and have determined that my complaint has NOT been resolved because: Weill Cornell’s response is not acceptable and does not resolve this issueThis was not a combination visit, as Weill Cornell claimsI went in for a physicalDuring the course of the physical, I conversed with my doctor (at his questioning) about one of the “covered issues” that Weill Cornell mentioned in its response to my complaintIn the course of discussing the “covered issue,” I mentioned experiencing what I believed to be some interrelated symptoms of itThe doctor briefly offered casual adviceThis advice was given while the doctor did other things, such as press against my stomach and type on the computerWhile there is no universal definition of an annual physical, a reasonable expectation of such a visit is that a patient will answer a doctor’s questions about “covered issues” and converse with the doctor about related symptoms and concernsThe website Web MD, for instance, mentions as part of its definition of an annual physical that your doctor will [redacted] ***.” Another popular website [redacted] states that [redacted] ” The matters I raised were part of a larger conversation with my doctor about a “covered issue.” What I received from the doctor was some casual advice about some very minor issues, which a reasonable person would expect to be covered as part of a routine physicalI believe that Weill Cornell is taking advantage of the ACA’s preventative care provision and charging customers like me unnecessarily for brief conversations that a reasonable person would consider “preventative care.” In order for the Revdex.com to appropriately process your response, you MUST answer the question above Sincerely, [redacted]

I received the correspondence from the Revdex.com ID No [redacted] for patient [redacted] This is a detailed response and resolution of [redacted] ’s dispute[redacted] had services rendered on at WCM department of Infectious Disease by [redacted] The patient did pay his co-pay at the visit and a claim was submitted to his insurance carrier GHI for adjudicationGHI processed these claims as Out of Network in errorThis caused the patient to receive an incorrect billing statementOur Customer Service team received a call from the patient on expressing dissatisfaction with the bill he received [redacted] was advised by the Customer Service Representative, the claim would be sent back to GHI for reprocessingThe claim was reprocessed by GHI and two payments were sent to the patient.1) Date of service a payment was issued to subscriber in the amount of $A call was placed to GHI notifying them that these claims were still processed incorrectlyGHI stated they are having a technical issue on their side and this was escalated for a fast track resolutionI spoke with [redacted] and explained the billing issues regarding his accountHe was advised the account will be placed on hold and we will monitor it closelyIf he has any questions he should call the billing manager directlyWith regards to [redacted] date of service that was mentioned in the complaintThe charge was recalled from the collection agency Arcadia [redacted] is working with the Billing Manager to resolve this issue alsoPatient and Billing Manager are in agreement on how this billing issue is being handled

To Whom It May Concern:I received the complaint ID [redacted] . The patient mailed in correspondence to our customer service center disputing one of the procedures billed on 82016, 92016 and telephone contact on 102016... respectively before any response from [redacted] . October **, 2016 one of our account administrator spoke with [redacted] , to which he indicated a procedure listed on the statement was not performed. We immediately sent an email inquiry to the provider’s office regarding the dispute. On November *, 2016, the provider’s office responded to our inquiry to advise the procedure was not done and the charge would be voided. A call was placed to [redacted] , voice message left, advising of the outcome and the current balance due. Subsequently, the account was captured in our aging automated process and sent to our external collection agency after the maximum billing cycle was met. We did not receive an inquiry from our vendor as the payment made to our collection vendor was the accurate amount due. We deeply apologize for any inconveniences caused to [redacted] .

Dear *** *** - I received the complaint ID ***The patient mailed in correspondence to our customer service center disputing his copay for the physician visit on August *, A call center representative called the patient and explained that the issues he discussed with the physician
were not covered as a preventative visit and a sick visit was billed in addition*** *** indicated that he would be filing a complaint with the Revdex.com if we did not stop billing him for the copayI have attached a copy of the notice that is distributed to all patients who visit Weill Cornell Medicine for a preventative care visitThe issues *** *** discussed with his physician are not listed on the notice he signed on the date of serviceThe sick visit was billed appropriately and *** *** owed Weill Cornell Medicine $for the August *, visit. Annual Preventive Consent Form (Non-Medicare)Dear Patient.Weill Cornell Physician Network believes in providing the upmost carein addi tion to world class serviceWe also believe it is important to communicate and educate our patients about services rendered by our providers.Due to the Afordable Care Act (ACA), patients are now entitled to one annual preventive visit also known as well visitThe is an office visit for a routine physical exam or yearly health maintenance examAnnual physical exams provide preventative care with the following services covered under this type of visit:** *** *** *** *** *** *** *** ** *** *** *** *** *** ***
** *** *** *** *** ***
** *** *** ** *** *** *** *** *** *** *** ** *** ***
** *** *** ***
** *** *** *** *** ** *** *** ** ** *** ***
** *** *** ***Medication refills, or other ailments, injuries, or illneses addressed during an annual physical exam are not covered by the annual physical and are considered components of a sick visitThese services will billed to your insurance and based on your policy you may be responsible for copayments, co-insurance or deductible paymentsPlease check with your insurance conpany to confirm your coverage for all types of doctor visits.SICK VISITThis is an office for an acute problem or flaof a chronic problemThis could also be an office visit to follow up on chronic problems (*** *** *** *** ***).Page of 2***Annual Prceventive Consent Form SICK/WELL VISITThis is a conbination visit of a routine physical exam where an acute or chronic issue is addressed as wellFor example, if you come in today for a well visit and you have an acute or chronic issue you would like addressed by your physician, it is considered a combination visit and must be billed differently than a well visit or a sick visit. WHY IT IS BILLED DIFFERENTLYIt is billed differently to account for the additional work, expertise and time required for a combination visit (additional lab work, x-ray, referrals and/or prescription medications)It involves additional documentation as well. HOW THIS AFFECTS MEAlthough many insurance companies acknowledge the sick/well visit combination, some of them still require the patient to pay a co-pay or have additional costs applied to his/her annual deductible. We realize this can be confusing and if you have any questions or concerns after reviewing this material, please ask. Patii:nt 's Signaturl!

To Whom It May Concern:
I received the complaint ID...

[redacted]. The patient mailed in correspondence to our customer service center disputing one of the procedures billed on 8/*/2016. Three billing statements were sent to [redacted] on 8/**/2016, 9/*/2016, 10/*/2016 and telephone contact on 10/**/2016 respectively before any response from [redacted]. October **, 2016 one of our account administrator spoke with [redacted], to which he indicated a procedure listed on the statement was not performed. We immediately sent an email inquiry to the provider’s office regarding the dispute. On November *, 2016, the provider’s office responded to our inquiry to advise the procedure was not done and the charge would be voided. A call was placed to [redacted], voice message left, advising of the outcome and the current balance due. Subsequently, the account was captured in our aging automated process and sent to our external collection agency after the maximum billing cycle was met. We did not receive an inquiry from our vendor as the payment made to our collection vendor was the accurate amount due. We deeply apologize for any inconveniences caused to [redacted].

I received the correspondence from the Revdex.com ID No. [redacted] for patient [redacted] [redacted]. This is a detailed response and resolution of [redacted]’s dispute.[redacted] had services rendered on 10/*/16 and 10/**/16 at WCM department of Infectious Disease by [redacted]. The...

patient did pay his co-pay at the 10/**/16 visit and a claim was submitted to his insurance carrier GHI for adjudication. GHI processed these claims as Out of Network in error. This caused the patient to receive an incorrect billing statement. Our Customer Service team received a call from the patient on 07/**/17 expressing dissatisfaction with the bill he received. [redacted] was advised by the Customer Service Representative, the claim would be sent back to GHI for reprocessing. The claim was reprocessed by GHI and two payments were sent to the patient.1) Date of service 10/*/16 a payment was issued to the subscriber in the amount of $36.00.2) Date of service 10/**/16 a payment was issued to subscriber in the amount of $72.00. A call was placed to GHI notifying them that these claims were still processed incorrectly. GHI stated they are having a technical issue on their side and this was escalated for a fast track resolution. I spoke with [redacted] and explained the billing issues regarding his account. He was advised the account will be placed on hold and we will monitor it closely. If he has any questions he should call the billing manager directly. With regards to [redacted] date of service 06/**/16 that was mentioned in the complaint. The charge was recalled from the collection agency Arcadia. [redacted] is working with the Billing Manager to resolve this issue also. Patient and Billing Manager are in agreement on how this billing issue is being handled.

To Whom It May Concern:I received the complaint ID [redacted]. The patient mailed in correspondence to our customer service center disputing one of the procedures billed on 8/*/2016. Three billing statements were sent to [redacted] on 8/**/2016, 9/*/2016, 10/*/2016 and telephone contact on 10/**/2016...

respectively before any response from [redacted]. October **, 2016 one of our account administrator spoke with [redacted], to which he indicated a procedure listed on the statement was not performed. We immediately sent an email inquiry to the provider’s office regarding the dispute. On November *, 2016, the provider’s office responded to our inquiry to advise the procedure was not done and the charge would be voided. A call was placed to [redacted], voice message left, advising of the outcome and the current balance due. Subsequently, the account was captured in our aging automated process and sent to our external collection agency after the maximum billing cycle was met. We did not receive an inquiry from our vendor as the payment made to our collection vendor was the accurate amount due. We deeply apologize for any inconveniences caused to [redacted].

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

Weill Cornell’s response is not acceptable and does not resolve this issue. This was not a combination visit, as Weill Cornell claims. I went in for a physical. During the course of the physical, I conversed with my doctor (at his questioning) about one of the 17 “covered issues” that Weill Cornell mentioned in its response to my complaint. In the course of discussing the “covered issue,” I mentioned experiencing what I believed to be some interrelated symptoms of it. The doctor briefly offered casual advice. This advice was given while the doctor did other things, such as press against my stomach and type on the computer. While there is no universal definition of an annual physical, a reasonable expectation of such a visit is that a patient will answer a doctor’s questions about “covered issues” and converse with the doctor about related symptoms and concerns. The website Web MD, for instance, mentions as part of its definition of an annual physical that your doctor will [redacted].” Another popular website [redacted] states that [redacted]” The matters I raised were part of a larger conversation with my doctor about a “covered issue.” What I received from the doctor was some casual advice about some very minor issues, which a reasonable person would expect to be covered as part of a routine physical. I believe that Weill Cornell is taking advantage of the ACA’s preventative care provision and charging customers like me unnecessarily for brief conversations that a reasonable person would consider “preventative care.” 
  
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]