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Enzo Clinical Labs has investigated this complaint and has found the following information:Enzo received a valid requisition for testing from the physician and provide the testing results in good faith of getting paidEnzo filed a claims to United Healthcare for date of service for charges totaling $557.50United Healthcare processed the claim and Enzo received an EOB from UHC that determined the total patient responsibility was $51.00All tests performed fall under preventative care testing, however, the tests for which deductibles were applied to require an alternate diagnosis code which was not initially provided by the physician The amount related to these tests is the balance in question -$51.00.Enzo is working with the physician’s office to obtain additional dx codes to cover the codes in question under UHC preventative guidelinesResolution: New York State Insurance Law requires Enzo to bill patient responsibility as indicated by the insurance carrier Enzo has accurately billed the patient responsibility based on a valid requisition for testing by the physicianEnzo has contacted the physician’s office and has received additional diagnosis codesEnzo will submit a corrected claim with new dx codes providedEnzo has left a message for MsCastro-Tanco to advise that we are resubmitting claim and she should discard the invoice she received
March **, 2016*** *** ***
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*** ** ***Dear Revdex.com:Enzo Clinical Labs holds patient satisfaction as a top priority We look to resolve this case in a timely and satisfactory manner I am disappointed that the patient did not have a
positive patient experience I have confirmed the following information as indicated in the complaint: Enzo billed the patient’s insurance information as provided by her physician’s office The insurance carrier denied as no coverage on the date of service It is not Enzo’s standard practice to call patients for insurance information We contact a patient via mail three times before sending to our collection agency. *** *** was mailed to the address indicated in the complaint two bills on 12/**/and 01/**/ On 02/**/a pre-collection letter was sent notifying the patient that unless they contact us the account would be sent to a collection agency. On 03/**/Enzo referred *** ***’s account to our collection agency *** ***, aka VW and they began their collection effort On 03/**/VW contacted the patient via mail On 03/**/the patient contact VW via telephone The account is noted by the VW collector as call being terminated due debtor behavior On 03/**/debtor left voicemail with VW requesting a call back On 03/**/Enzo received notification of the Revdex.com complaint and initiated an investigation and closed the collection account with VW.Resolution: We have closed the collection case with *** *** and resubmitted the claim to *** ***’s current insurance carrier There is no patient responsibility as determined by the insurance carrier Neither Enzo nor VW acting on behalf of Enzo has made any report regarding this balance to any credit agencyIn addition the balances billed are correctThey reflect all tests completed as ordered by the patient’s physician.If you have any questions, please call me at ###-###-#### or directly at ***Thank you for your attention to this matter.Sincerely,Ann M*** *** ***
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Enzo Clinical Labs has investigated this complaint and has found the following information:Enzo received a valid requisition for testing from the physician and provide the testing results in good faith of getting paid. Enzo filed a claims to United Healthcare for date of service 11/**/16 for...
charges totaling $557.50United Healthcare processed the claim and Enzo received an EOB from UHC that determined the total patient responsibility was $51.00All tests performed fall under preventative care testing, however, the tests for which deductibles were applied to require an alternate diagnosis code which was not initially provided by the physician. The amount related to these tests is the balance in question -$51.00.Enzo is working with the physician’s office to obtain additional dx codes to cover the codes in question under UHC preventative guidelines. Resolution: New York State Insurance Law requires Enzo to bill patient responsibility as indicated by the insurance carrier. Enzo has accurately billed the patient responsibility based on a valid requisition for testing by the physician. Enzo has contacted the physician’s office and has received additional diagnosis codes. Enzo will submit a corrected claim with new dx codes provided. Enzo has left a message for Ms. Castro-Tanco to advise that we are resubmitting claim and she should discard the invoice she received.