Dr. Maura Henninger

The complainant failed to tell me that her insurance coverage did not begin until two weeks henceforth from her visit to my officeThus, my understanding was that the insurance that she stated she
had was in effect at the time of visitHad she told me it actually began I two weeks, I would certainly have explained to her that the test would not be covered until her insurance began and quoted the price of the test at the larger amountTherefore, the lab charged her at list price, instead of the insurance coverage rateAs a courtesy, the lab is now offering her a 50% discount on the lab due to the confusionThey are not able to offer her the insurance-coverage rate simply because she did not have coverage at that timeThis is not a decision that is up to me and I do not receive any financial remuneration from these testsI've spoken repeatedly with the lab company explaining the discrepancy, as I always advocate fiercely on behalf of my patients when it comes to insurance coverage for testing, but the bottom line is that they cannot charge the insurance coverage amount if the patient did not have coverage at that timeAs I said, *** *** represented to me that her insurance coverage was in effect at the time of the visit and so I had misinformation at that timeThe lab company has courteously agreed to give her an extreme discount on the test of $instead of the $they would typically have chargedMinus the amount that she has already paid, the outstanding balance is $It is my understanding from the biller at *** that *** *** has agreed to pay this amountI believe this is the best result we can hope for in this matter and I sincerely apologize for the confusion caused

The complainant failed to tell me that her insurance coverage did not begin until two weeks henceforth from her visit to my office. Thus, my understanding was that the insurance that she stated she had was in effect at the time of visit. Had she told me it actually began I two weeks, I would...

certainly have explained to her that the test would not be covered until her insurance began and quoted the price of the test at the larger amount. Therefore, the lab charged her at list price, instead of the insurance coverage rate. As a courtesy, the lab is now offering her a 50% discount on the lab due to the confusion. They are not able to offer her the insurance-coverage rate simply because she did not have coverage at that time. This is not a decision that is up to me and I do not receive any financial remuneration from these tests. I've spoken repeatedly with the lab company explaining the discrepancy, as I always advocate fiercely on behalf of my patients when it comes to insurance coverage for testing, but the bottom line is that they cannot charge the insurance coverage amount if the patient did not have coverage at that time. As I said, [redacted] represented to me that her insurance coverage was in effect at the time of the visit and so I had misinformation at that time. The lab company has courteously agreed to give her an extreme discount on the test of $849 instead of the $1462.35 they would typically have charged. Minus the amount that she has already paid, the outstanding balance is $631. It is my understanding from the biller at [redacted] that [redacted] has agreed to pay this amount. I believe this is the best result we can hope for in this matter and I sincerely apologize for the confusion caused.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

I clearly did not start my job yet when I had my appointment. As such, it would have been impossible for me to have insurance coverage and I was clear about that when I went for my appointment at the business. Nothing was explained to me about the exhorbitant fees I would be liable for.[redacted]
 
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

I clearly did not start my job yet when I had my appointment. As such, it would have been impossible for me to have insurance coverage and I was clear about that when I went for my appointment at the business. Nothing was explained to me about the exhorbitant fees I would be liable for.[redacted]
 
 
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

Review: I first consulted with Dr. Maura Henninger in August of 2014 where she prescribed 3 tests: 1 fee paid to her, 2 fees paid to the lab. She stipulated that an additional $300 in fees might be due if my insurance did not cover. I received a subsequent bill for $287 in November from [redacted] and paid that promptly.Now, 9 months later, having not done any more tests - I receive a bill for $1462.35 for a statement date of May **, 2015 which is clearly a mistake. So I refuse to pay. And would like to report this as fraudulent practices.Desired Settlement: Retract this charge.

Business

Response:

The complainant failed to tell me that her insurance coverage did not begin until two weeks henceforth from her visit to my office. Thus, my understanding was that the insurance that she stated she had was in effect at the time of visit. Had she told me it actually began I two weeks, I would certainly have explained to her that the test would not be covered until her insurance began and quoted the price of the test at the larger amount. Therefore, the lab charged her at list price, instead of the insurance coverage rate. As a courtesy, the lab is now offering her a 50% discount on the lab due to the confusion. They are not able to offer her the insurance-coverage rate simply because she did not have coverage at that time. This is not a decision that is up to me and I do not receive any financial remuneration from these tests. I've spoken repeatedly with the lab company explaining the discrepancy, as I always advocate fiercely on behalf of my patients when it comes to insurance coverage for testing, but the bottom line is that they cannot charge the insurance coverage amount if the patient did not have coverage at that time. As I said, [redacted] represented to me that her insurance coverage was in effect at the time of the visit and so I had misinformation at that time. The lab company has courteously agreed to give her an extreme discount on the test of $849 instead of the $1462.35 they would typically have charged. Minus the amount that she has already paid, the outstanding balance is $631. It is my understanding from the biller at [redacted] that [redacted] has agreed to pay this amount. I believe this is the best result we can hope for in this matter and I sincerely apologize for the confusion caused.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

I clearly did not start my job yet when I had my appointment. As such, it would have been impossible for me to have insurance coverage and I was clear about that when I went for my appointment at the business. Nothing was explained to me about the exhorbitant fees I would be liable for.[redacted]

In order for the Revdex.com to appropriately process your response, you MUST answer the question above.

Sincerely,