Platte River Family Practice

This patient was seen in our clinic on 2/24/for the very first time ever He signed a financial agreement on that day that states that he is responsible for all balances at time of service We bill insurance as a courtesy then refund if there is an overpayment The patient has the option to pay and bill the insurance themselves He paid $ [redacted] paid all except $of that visit at the end of March Leaving a credit of $ His wife had a balance of $and part of the $credit was applied to her account leaving- $creditHe was seen again on 4/and his credit from the 2/24/visit was applied to this visit ($visit cost- $credit)- no additional moneys were taken by our staff on this visit There was a delay in the billing process with [redacted] , his insurance, and the visit from 4/was not received and processed until weeks ago At that time he had a credit of $ He was issued a check and it was actually sent out in the mail on 8/2/before we even received this notice So the patient received the refund alreadyAs far as the notifications from the patient The dates on the complaint are not consistent without our system He was seen on 2/not- 2/ We have documented times that he called in April, June and JulyHe asked for a refund in April before his 2nd appointment and we discussed that we would apply the credit to the appointment instead of mailing a check to collect again at the visit in a couple weeks and apply part of his check to the wife's balance as well He then contacted our office in about weeks ago, but the insurance had not processed yet We resubmitted once again and finally received the EOB and payment weeks ago (he should be able to see when the EOB was processed in July- but sometimes there is a delay in payment by the time we receive it and get the money deposited in our accounts) When he called at the end of July it was being processed to go out already- and was actually in the mail within business days from his call I understand that insurance billing is frustrating, but I am unsure if this person realizes how fickle insurance billing can be We had been waiting on payment for a while as well We attempt to be as fair and timely as possible- we have a process to resubmit bills that have not been paid within weeks then routinely after that I do not feel that there was an ethical issue about this since sometimes it takes months for us to receive payments from insurance companies We had no plan to keep his extra payment and I am sorry that he feels that way, but until our system shows that the insurance has paid it doesn't trigger a credit for a check to be cut to the patient Bottom Line: the check was already issued and sent before this complaint was logged with the Revdex.com.Please feel free to contact me if there are any questions.Amy G [redacted] Platte River Family Practice [redacted]

This patient was seen in our clinic on 2/24/17 for the very first time ever.  He signed a financial agreement on that day that states that he is responsible for all balances at time of service.  We bill insurance as a courtesy then refund if there is an overpayment.  The...

patient has the option to pay and bill the insurance themselves.  He paid $199.00.  [redacted] paid all except $25 of that visit at the end of March.  Leaving a credit of $174.  His wife had a balance of $71 and part of the $174 credit was applied to her account leaving- $103 credit. He was seen again on 4/28 and his credit from the 2/24/17 visit was applied to this visit ($127 visit cost- $103 credit)- no additional moneys were taken by our staff on this visit.  There was a delay in the billing process with [redacted], his insurance, and the visit from 4/28 was not received and processed until 2 weeks ago.  At that time he had a credit of $78.00.  He was issued a check and it was actually sent out in the mail on 8/2/17 before we even received this notice.  So the patient received the refund already. As far as the notifications from the patient.  The dates on the complaint are not consistent without our system.  He was seen on 2/24 not- 2/13.  We have documented times that he called in April, June and July. He asked for a refund in April before his 2nd appointment and we  discussed that we would apply the credit to the appointment instead of mailing a check to collect again at the visit in a couple weeks and apply part of his check to the wife's balance as well.  He then contacted our office in about 6 weeks ago, but the insurance had not processed yet.  We resubmitted once again and finally received the EOB and payment 2 weeks ago (he should be able to see when the EOB was processed in July- but sometimes there is a delay in payment by the time we receive it and get the money deposited in our accounts).  When he called at the end of July it was being processed to go out already- and was actually in the mail within 2 business days from his call.  I understand that insurance billing is frustrating, but I am unsure if this person realizes how fickle insurance billing can be.  We had been waiting on payment for a while as well.  We attempt to be as fair and timely as possible- we have a process to resubmit bills that have not been paid within 6 weeks then routinely after that.  I do not feel that there was an ethical issue about this since sometimes it takes months for us to receive payments from insurance companies.  We had no plan to keep his extra payment and I am sorry that he feels that way, but until our system shows that the insurance has paid it doesn't trigger a credit for a check to be cut to the patient.  Bottom Line: the check was already issued and sent before this complaint was logged with the Revdex.com.Please feel free to contact me if there are any questions.Amy G[redacted]Platte River Family Practice[redacted]

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Dear [redacted],We are writing in response to the...

complaint ID [redacted].Unfortunately this is a case of blaming and triangulation.  I have received info from [redacted]'s insurance in the form of a generic letter stating that were in liquidation. We have not received any EOBs that relate to the patient.  We cannot confirm that he was even insured on the date of service.  His claim was filed before the deadline submission date and we are waiting for the settlement which is estimated to be Dec 2016. He signed a financial agreement stating that we bill insurance as a courtesy and he is responsible for payment at time of service.  The financial agreement also a states that he is responsible for his account if insurance is not paying.  Please see attached paperwork.  I would be happy to send a refund to patient once we get any paperwork from the insurance company with estimates on coverage, copays and deductibles.  Please call if you have any further questions.Sincerely,Amy G[redacted], FNPC, PartnerPaula C[redacted], RNBC, PartnerPlatte River Family Practice, LLCphone [redacted]Attachments area