Yale Medical Group

Complaint: [redacted]
I am rejecting this response because:
I have not heard from a supervisor and the response does not address my concerns.
Sincerely,
[redacted]

The balance billed to you was removed from the account.
I am contacting the manager of the department for additional information.
I will send additional information.

Complaint: [redacted]
I am rejecting this response because:
I am awaiting [redacted] doing their independent research, getting records from hospital and emergency response (AMR) to see why particular medical code was assigned to patient when he was in perfect stable state.
Sincerely,
[redacted]

The balance for [redacted] has been adjusted.
YNHH is a separate entity. Please contact [redacted] directly.
Thank you for your patience.

Complaint: [redacted]
I am rejecting this response because:Awaiting case investigation by [redacted]
Sincerely,
[redacted]

Complaint: [redacted]
I am rejecting this response because:
Awaiting business response
Sincerely,
[redacted]

The account has been put on hold.
The department supervisor will contact the patient in order to provide the necessary information in order to resolve the inquiry.

Complaint: [redacted]
I am rejecting this response because I have waited til today (Jan 19, 2016) and have not received any written communication from [redacted] on what action has been taken. Message posed on Revdex.com that account has been adjusted is cryptic and does not give any insight on what action has been taken.:
Sincerely,
[redacted]

The account has been placed on hold.
Based on the explanation of benefits received from the patient's carrier the balance due is the deductible balance.
We will contact Cigna to verify the processing of the claim.
[redacted]l and [redacted] are separate entities. [redacted]...

[redacted] Hospital bills for the facility charges. [redacted] bills for the providers.
We are working on researching the issue and will respond back with additional details.

Dear Sirs:
I have contacted the Middlebury Dermatology office regarding the balance due.
Ms. Elizabeth Frechette's account is on hold.  The account has been recalled from collections.
I have contacted the department Administrator for an immediate response.
I...

will respond back to you as soon as I receive an answer.
Susan Roddy
203/785-7145

I am working with the providers office on a response to the issue presented. I will provide a response as soon as possible.

Review: On November 19, 2012, I received medical attention at the [redacted] Yale Medical Emergency Room. I presented my Insurance card upon arrival and the Yale Medical Group staff person contacted my insurance company prior to me being offered services. I belong to a [redacted] in [redacted]. By accepting me for medical treatment, Yale Medical Group was agreeing to the approved compensation per [redacted] payment guidelines known as "Balance Billing". The amount billed was $735.00. The amount paid to the provider, Yale Medical Group, was $132.54. I was informed by my insurance company that I had no further financial obligation to Yale Medical Group, but I have, for months, been receiving invoices for the difference of $602.46 and I've been told by Yale Medical Group that I'm responsible for this payment because I was out of network when I received services in Connecticut. My insurance company, [redacted], has said to me that "Balance Billing" has nothing to do with being out of network and that Yale Medical Group knew when they accepted me that they would be paid to the extent that they have already received payment. I was also told that Yale Medical Group may have had me sign paperwork that made me personally responsible for the difference. I have not seen any such signature. When one is in need of emergency medical services, the patient may feel forced to sign papers to get the medical attention with no explanation as to what is being executed. If that was done, I'd want to see my signature.I was informed by my insurance company that health service providers try to get patients to pay the difference even though, by law, they do not have the right to make such a demand. Yale Medical Group has threatened me with turning this matter over to a collection company. If I thought there was a legitimate financial obligation to Yale Medical Group, I wouldn't be in contact with Revdex.com, but I get the impression that Yale Medical Group is handling this matter in an unethical manner.

Product_Or_Service: Medical Services

Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Other (requires explanation)

First I want to have Yale Medical Group produce documentation that supports their claim. If they cannot produce such documentation, I want a letter from Yale Medical Group acknowledging their mistake and a statement showing I have no balance due.

Business

Response:

Contact Name and Title: [redacted]

Contact Phone: [redacted]

Contact Email: [redacted]

Yale Medical Group has verified with Mr. [redacted]s insurance that [redacted] is not a medicare product. The provider representative, named [redacted], confirmed that [redacted] is not a Medicare product. The call reference number is #[redacted]. The explanation of benefits from [redacted] does not indicate any reference to a Medicare product. Therefore, Yale Medical is non-participating and the insurance is correctly registered as a commercial product. This indicates that Yale Medical Group is non-participating with this plan and no contractual adjustment will be taken. Mr. [redacted] has been offered a budget plan. However, no response or payment has been received as of this date. Mr. [redacted] also stated he had additional documentation to support his claim. This information has not been received by the contact information given to Mr. [redacted].

Review: I received a bill for one medical preventative treatment in the amount of $482.08. it had not hit our explanation of benefits yet, so waited to pay. We received another bill then for $900.44 for the same service one month later. Another month later we received another adjuster bill for $418.08. We went online to pay the final bill and was told there was a zero balance. Five months later we received a bill that was sent to collections for over $500. We received no other notifications other than automated calls that I do not respond to, as I receive multiple automated calls that are phishing scams a day. Once we were informed by the billers third party website our balance was paid, we did not receive any other calls or mail until the collections bill.

I contacted the company to inquire why this bill was sent to collections to give me a full breakdown (as the procedures on the bill are cut off), and there is no listing of any payments made. The representative Camille D[redacted] proceeded to tell me I already had all the information, but they would take $482.08 to clear my balance.

I let her know I would want to confirm the information with my health insurance provider and would like the documentation I requested, at which point she continued to tell me I already had the information but would send other information.Desired Settlement: I am disappointed in the way I was treated as a patient (which I soon plan to change) by [redacted], and the time and frustration that they have caused me to waste. I would like an adjustment on any owed balance, once it is confirmed with my explanation of benefits that it is owed. This is one of many experiences with the billing department where I have had to do more work than them in an effort to clear my balance including times where they lost my payment directly from an [redacted] account. This procedure was more than 6 months ago and I should not be dealing with it now because their clerical systems are simply flawed. Thank you for your time as no one has thanked me for mine.

Business

Response:

The account has been put on hold.

The department supervisor will contact the patient in order to provide the necessary information in order to resolve the inquiry.

Consumer

Response:

Review: [redacted]

I am rejecting this response because:

I have not heard from a supervisor and the response does not address my concerns.

Sincerely,

Review: On Nov. 11, 2013 and Dec. 15, 2013 I had laser treatments for [redacted] at the Yale Dermatology in Middlebury, where I have been a dermatology patient since early 2013. Both times I was charged $319.05, which I paid on the spot. These laser treatments are considered cosmetic and are not covered by my health insurance.Some time after the initial treatment I received a bill in the mail for an additional amount of $55.95. I then got a phone call from a Yale Medical Group representative saying that was in error and to disregard, it which I did.In March I received a collection notice from [redacted] Inc. for $55.95. This noticed informed me that "Unless you notify this office within 30 days after receiving this notice that you dispute the validity of this debt or any portion thereof, this office will assume this debt is valid." Not wanting anyone to assume it was valid, I called the Customer Service office of the billing agency, the Yale Medical Group. I have spoken on two occasions now with a very helpful person, who informed me that they have confirmation of both of my payments of $319.05 and that the additional bill of $55.95 would have to be investigated by a supervisor named [redacted]. I then sent the collection agency notice that I was disputing the bill.Now I am in receipt of another collection notice, re-setting the 30 days from April 14. Again, I want to dispute the bill and again I notified them of same.Desired Settlement: I would like advice on how to proceed, if this is possible.

Business

Response:

Dear Sirs:

I have contacted the Middlebury Dermatology office regarding the balance due.

Ms. Elizabeth Frechette's account is on hold. The account has been recalled from collections.

I have contacted the department Administrator for an immediate response.

I will respond back to you as soon as I receive an answer.

Susan Roddy

203/785-7145

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me. I only wonder if the Collections agency is aware of the Hold, as they recently sent me a new letter asking for payment. Thank you for your attention to this matter, but it is not yet resolved

Sincerely,

Elizabeth Frechette

Review: This company has the worst customer service agents by far. They answer the phone like they hate life and all people on earth. They are very rude and enjoy hanging up in your face when you are trying to explain to them that their billing system is incorrect and the amount due is incorrect. I called this company on several occasions explaining to them that I do not owe them any money because my insurance company paid it in in full. The service insists that I do not know what I am talking about and that I need to contact tri-care north about this issue. I called tri-care north on several occasions and they said they have proof that the bill was paid. I called Yale Medical Group and they again insist they did not get payment. When I did not let the service agent run all over me like a rag doll she hung up. Very rude and childish way to handle business. She kept talking over me instead of listening to me. Not my fault YOUR life sucks. This company needs to get it together and get a better billing system because somebody is cashing these checks and are NOT reporting them to the consumer's account. I would not be surprised if someone is stealing all this money and pointing the blame on the consumer for not "so-called paying their bill"Desired Settlement: Take the proof that tri-care north has faxed regarding the check that they sent has cleared and restore my balance to zero and fire the entire staff because customer service agents are all immature, uneducated, depressed lifeless people who need NOT to work with customers.

Business

Response:

To Whom It May Concern:

I will contact the patient regarding the issue and information presented.

I will send a response once I make contact.

Susan R[redacted]

Review: I recently received a Bill dated 11/26/15 with INVOICE# [redacted] for my son [redacted] who was admitted at [redacted] Emergency on 06/04/2015. My son had swallowed coins for which he underwent X-ray examination and was discharged within less than two hours after it was found that coins are not stucked in lungs but have moved to stomach and is of no longer immediate concern.

Bill that I received shows a balance of $439.0 (after insurance adjustment) with no coverage from insurance company due to high deductible. It also does not provide any details on charges except for the charge code 99285-Emergency department visit. Bill was presented to us six months after the service provided which is highly unusual. This is on top of bill of almost $1300 from [redacted] and $1000 from [redacted] of Connecticut. I have already settled bills with both of those agencies. My Complaint is with regards to following points:

1. At no point during my visit to the hospital or thereafter, [redacted] notified me about [redacted] services and if they are authorized to send me separate bill for services which I only authorized to Hospital and their staff. I do not expect to receive bills from all third party persons working at the hospital in a time frame they choose to do so. I only signed documents authorizing [redacted]. All third party persons working for Hospital are responsible for payment through them and not by customer.

2. I contacted customer service agent on 12/10/2015 but she could not provide any explanation for the charges other than the fact that it is a valid charge. I self-investigated the charge code 99285 and I found following information:

"

Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient’s clinical condition and/or mental status:

•

Comprehensive history

•

Comprehensive examination

•

Medical decision making of HIGH complexity"

It also states:

"only the necessary services for the condition of the patient at the time of the visit can be considered in determining the level/medical necessity of any service."

At the whole time during the emergency visit and before, my son was in stable condition as can obtained from Hospital records. Doctor at the site only performed physical check and determined from X-ray (which has already been paid) that the coin has already passed down to stomach and is of no immediate threat. Hence there was no medical decision required that was of high complexity which the code states. [redacted] has unethically used the highest code (below critical requiring surgery) to make most out of the situation.

I would like to have assistance from Revdex.com to resolve this matter. I could be reached at ###-###-####.

Regards, [redacted]Desired Settlement: Right price for the service offered

Business

Response:

The account has been placed on hold.

Based on the explanation of benefits received from the patient's carrier the balance due is the deductible balance.

We will contact Cigna to verify the processing of the claim.

[redacted]l and [redacted] are separate entities. [redacted] Hospital bills for the facility charges. [redacted] bills for the providers.

We are working on researching the issue and will respond back with additional details.

Consumer

Response:

Review: [redacted]

I am rejecting this response because: