Westoverhills Primary Care

My complaint is in regard of excessive Test and un disclosure of possible a charge out of the pocket fee for certain TestingDate of service 06/21/Description of tests were
phycho testing by technician for $
Gannual depression screening for $
GInt BH TX Rduc Cvd Rsk Bi An min for $
GAnnual alcohol misuse screen for $
First, I was not alerted of these type of test which are redundant of your Health insurance company already sends you a questionary about alcohol and stress evaluationThis is an excessive Test to extra charge the members or insurance companyI have an outstanding balance with this office of $ $which I don't even have a breakdown of where is coming from By reading the description services on my billing statement I can see these unusual Tests for a PCP office visit

*** *** *** visited Westover Primary Care on June 21, This was initial visit with family doctor to establish patient for medical careAccording toclinic policy, new patients undergo psychiatry screening and alcohol screening tests in the format of questionnairesThese tests are
medically necessary for doctor to have complete picture of the new patient's medical conditionThese are annual tests which may be covered by medical insurance or may be denied; very rarely do they go to patient responsibility.For *** *** ***, United Healthcare insurance didn't approve these tests and therefore they were adjusted by Westover Primary CareProcedure codes 96102, G0442, G0444, G0446, mentioned in the complaint, were never assigned to patient responsibilityCurrent patient balance with Westover Primary Care is $This includes the charges for Office Visit in the amount of $and Hemoglobin blood test in the amount of $that went to patient's deductibleThe tests are not included into patient balance*** *** should have received an Explanation of Benefits from her insurance company showing the deductible amount.Patients' medical records are kept confidential under HIPAAI will be able to provide you with patient's medical and billing documents to support this letter once patient signs authorization formI attached it for your convenience.I called patient on 1/3/and 1/5/to clarify where the balance is coming from and left a voice messagePatient never returned my callsDon't hesitate to contact me with any questions. Westover Primary Care*** ** *** *** ***Please RELEASE my medical information to: Revdex.com Corporate Office Name of Physician, Hospital, or Self Phone# Fax# Address City State ZipPatient Information: *** *** Print Patient Name Date of Birth Phone# Street Address City State ZipPurpose for Records Request:(i.ePersonal use, primary care physician, transferring care, insurance change, for insurance purposes, 2nd opinion, referral)Please specify records to be disclosed by checking the appropriate box o Most Recent Visit Notes o Most Recent Labs ONLY ** *Include HIV/AIDS and Sexual Transmitted Disease Info *** Yes No o Most Recent Imaging o All Records *** Include HIV/AIDS and Sexual Transmitted Disease Info* ** Yes NoPlease note* ** Please allow business days for your request to be processedThere will be a $fee for the release of the first pages, and cents for each page thereafter / No Fee for records that are released to an MD's office or Hospital.t understand that the authorization for disclosure of records as detailed above, unless specifically limited by me in writing, wilt extend to all aspects of treatment providedThese records may include testing for all sexual transmitted diseases, AIDS, and hepatitis, as well as drug, alcohol and/or psychiatric informationOrange Coast Women's Medical Group is hereby released from all legal responsibility of liability for the release of the above disclosure of informationI have the right to withdraw this authorization at any time and that such revocation must be in writingPrint Name:Signature: Datestaff use only:*** *** *** *** *** *** **
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