River Falls Fire Department

Benefit Management is the insurance company for this patient The charges for this patient’s bill were $1,The insurance company’s repricer, Stratose, erroneously processed this as an In Network claim, with a contract, and paid $on 8/7/ Because Benefit Management processed it as an In Network claim, their EOB stated that North Fond du Lac EMS must write off the balance ($287.89) as a mandatory adjustment All ambulance claims are processed as Out of Network, there are no agreements or contracts with Benefit Management or Stratose The claim was reprocessed correctly on 11/11/as an Out of Network claim A refund was now due to the insurance company of $ A refund was made to Benefit Management on 11/20/for $ The balance of the claim was now due by the patient The patient paid their portion of the claim on 12/for $ I called and talked to Mr [redacted] on January 20th and explained to him how the insurance company’s repricer, Stratose, had created this error A Revdex.com complaint should not have been filed against North Fond du Lac EMS Regards, [redacted] North Fond du Lac EMS

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Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is some what satisfactory to me. There response still does not answer a few question I have, like why, when I called them they did not tell me The story they are saying now. Yes, I have paid the bill because I did have the service done. I can not prove what the two companies did. I can only hope, that no one else has to go thru the same BS as I did. Was the insurance company at fault, YES. Does EMS have to take some of the blame, YES. Because of the story now being given no one has to answer all the questions I had asked. As I have stated, I was told one thing and now they are telling me another Statement. Do I except the complaint has been solved, only if no one else has to go thru the same problem I had. This is now the end of this complaintRegards,
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Benefit Management is the insurance company for this patient.   The charges for this patient’s bill were $1,140.21. The...

insurance company’s repricer, Stratose, erroneously processed this as an In Network claim, with a contract, and paid $852.32 on 8/7/14.  Because Benefit Management processed it as an In Network claim, their EOB stated that North Fond du Lac EMS must write off the balance ($287.89) as a mandatory adjustment.  All ambulance claims are processed as Out of Network, there are no agreements or contracts with Benefit Management or Stratose.   The claim was reprocessed correctly on 11/11/14 as an Out of Network claim.  A refund was now due to the insurance company of $398.04.  A refund was made to Benefit Management on 11/20/14 for $398.04.  The balance of the claim was now due by the patient.  The patient paid their portion of the claim on 12/26 for $685.93. 
I called and talked to Mr. [redacted] on January 20th and explained to him how the insurance company’s repricer, Stratose, had created this error.  A Revdex.com complaint should not have been filed against North Fond du Lac EMS.
 
Regards,[redacted]North Fond du Lac EMS