Westmoreland Dermatology Association

FOREFRONTDERMATOLOGY.May 16, [redacted] Revdex.com Holiday Drive, Suite Pittsburgh, PA 15220RE: Revdex.com Complaint ID [redacted] Dear MsE [redacted] :Forefront Dermatology (“Forefront”) is in receipt of your letter dated May 3, addressed to [redacted] at our office in Greensburg, PennsylvaniaThe complaint describes the experience of a [redacted] Health Plan member who made an appointment at the office and who was subsequently turned away at the time of the appointmentThe appointment was canceled because the patient did not have a valid referral issued by a primary care physician (“PCP”).Forefront understands the frustration expressed in the complaint by the patientOur goal is to treat patients and address their concerns in a timely manner [redacted] ’s rules for the patient’s insurance coverage require that a PCP issue a referral in advance of all specialist visits.Forefront is a specialist provider and had we treated the patient without a valid referral in place, [redacted] would deny our claim [redacted] also prohibits Forefront from collecting any payment from the patient in such a situation.The patient acknowledges in the complaint that the benefit coverage was new (issued 1/1/2017) and that the assigned PCP was no longer accepting new patientsThe burden is on the patient to understand his/her specific insurance plan and adhere to its requirementsForefront staff did advise the patient that a referral was required for the visit.Subsequent to the time of the complaint, the patient selected a PCP in the [redacted] network who issued the necessary referralOne of our providers saw the patient on May 12, 2017.On behalf of Forefront Dermatology, I thank you for the opportunity to respond to the complaint.Sincerely,Jay E**Director of Payor Contracting [redacted] ***

FOREFRONTDERMATOLOGY.May 16, 2017[redacted] Revdex.com 400 Holiday Drive, Suite 220 Pittsburgh, PA 15220RE: Revdex.com Complaint ID 1[redacted]Dear Ms. E[redacted]:Forefront Dermatology (“Forefront”) is in receipt of your letter dated May 3, 2017 addressed to [redacted] at our office in...

Greensburg, Pennsylvania. The complaint describes the experience of a [redacted] Health Plan member who made an appointment at the office and who was subsequently turned away at the time of the appointment. The appointment was canceled because the patient did not have a valid referral issued by a primary care physician (“PCP”).Forefront understands the frustration expressed in the complaint by the patient. Our goal is to treat patients and address their concerns in a timely manner. [redacted]’s rules for the patient’s insurance coverage require that a PCP issue a referral in advance of all specialist visits.Forefront is a specialist provider and had we treated the patient without a valid referral in place, [redacted] would deny our claim. [redacted] also prohibits Forefront from collecting any payment from the patient in such a situation.The patient acknowledges in the complaint that the benefit coverage was new (issued 1/1/2017) and that the assigned PCP was no longer accepting new patients. The burden is on the patient to understand his/her specific insurance plan and adhere to its requirements. Forefront staff did advise the patient that a referral was required for the visit.Subsequent to the time of the complaint, the patient selected a PCP in the [redacted] network who issued the necessary referral. One of our providers saw the patient on May 12, 2017.On behalf of Forefront Dermatology, I thank you for the opportunity to respond to the complaint.Sincerely,Jay E**Director of Payor Contracting[redacted]