Southboro Medical Group

Claim not submitted to my insurance company for appointment that is covered in full, except for copayment which I paid; got sent to debt collection.I went to my Primary Care Physician on [redacted] for a problematic appointment. I have health insurance that covers these appointments; always has. I paid my [redacted] copayment for the appointment. I got contacted a few months later by my pcp's billing office, for an "outstanding balance". I paid approximately [redacted] for lab fees and the balance was still outstanding by over approximately [redacted] This outstanding balance of approximately [redacted] was new news to me. I was instructed to call my health insurance to see what happened with the claim. I contacted the health insurance company and they informed me that they did not have a claim for the date of this appointment. The health insurance company informed me to call my PCP's billing office and ask them to resubmit the claim. I spoke with someone at the billing office who acknowledged that an error was made with claim/coding. I was informed that she would talk to her manager and get back to me in no more than 2 [redacted] days. I did not hear back from her at all and called her back a week and a half later to check on the status of the claim being sent in. I was told that her manager had not returned her calls. When I asked to speak to the manager directly, this request was refused, due to the worker being afraid of "getting in trouble". I stated that I wanted my account flagged because I did not want to get sent to debt collection for something that was not my fault. She said she would "absolutely flag the account" and in the mean time she would work on resolving this problem with her manager, since she could not resubmit a claim without her managers approval. She then blamed her company, saying that "things were confusing now" because of their recent merge with Reliant Medical Group" and that "staff are still being trained". I explained to this staff person that any problems they are having with their merge should not be negatively affecting their patients (which it is).I received a phone call today by [redacted] & [redacted] debt collection agency (approximately 4-5 months after the last time I spoke to the PCP's billing office staff. Before this debt collection representative could explain the reason for her call, I asked her if this was regarding an appointment from December of 2014, and she said, "yes, [redacted] 2014 with Southboro Medical Group". I work full time in a hospital. I work very hard. I pay taxes and I pay a lot of money for my health insurance. My appointment should have been covered in full (except for the copayment that I paid), because they have always been covered in the past. The billing office admitted that they made an error and that they would flag the account, yet I was still sent to debt collection, as if I neglect to make payments of my bills...which is absolutely not true. Because of their error, my credit is now going to be affected. They have failed to find a resolution the problem that they created. I believe that Southboro Medical Group needs to resubmit the claim to my health insurance company (who still has no record of a claim from that appointment date). They should be responsible for timely filing that will result, or, their company should assume responsibility of the amount that is owed. As the patient, I did my part, yet I am being punished with medical bills, despite being covered by, and paying for, health insurance that covers these appointments.Desired SettlementI require Southboro Medical Group to officially assume responsibility for the problem that as been created by correcting my credit report.I require Southboro Medical Group to resubmit the claim to my health insurance company, for the stated date (despite timely filing on their end); ensuring that there is correct coding for the appointment I had. I require Southboro Medical Group to assume responsibility for payment to my insurance company if resubmitting the claim is not possible.I require Southboro Medical Group to contact my health insurance company, [redacted] Care; HMO, for any fees/payments/balances for this claim.Initial [redacted] Response The Manager of Patient Accounts ([redacted]) reviewed and confirmed that services were submitted to the patient's insurance but the claim was applied to patient's deductible. The Manager left the patient a voicemail on [redacted] requesting her to contact us to discuss the explanation of benefits on file from the insurance company, awaiting response from patient.Consumer Response (The consumer indicated he/she DID NOT accept the response from the business.)My benefits cover the service that was provided to me. I do not owe any deductible because the appointment was (and has been on all other visits to the same provider), covered in full, with just a copayment (which was paid). I spoke to the manager ([redacted]) who agreed that all other appointments were covered and she is trying to find out why. [redacted] said she will be working on finding a resolution. I also noted to [redacted] of the poor customer service I received by her staff through this entire 9 month process. I explained to [redacted] that I will not be paying for the service rendered because it is covered. I told her I spoke with Health insurance provider representative, [redacted] explained that this amount is not the patients responsibility, and is instead, the businesses responsibility. Sean said he would be contacting the business on my behalf o settle the issue. I spoke with Sean about 7 days ago, who said he had not yet heard from the Business. I cannot accept the response because it does not resolve the problem.

They send me a bill from last year, and I feel that this was way to long for me to remember. I feel it is unfair practice.claim #73/18/12 office visit payment 25.00 dollars insurance refused to pay for some reason. [redacted]. 99 dollars owed. Claim #83/20/12 office visit payment 25.00 dollars. insurance refused to pay for some reason. [redacted]. 99 dollars owed.and it say please pay $198.00. Desired SettlementI am seeking that I don't pay anything for it because I don't think is my fault and I should not pay for it. Business' Initial Response this is not an optical complaint, we have no record of [redacted] receiving eyeglasses thru us. Could this be for a visual appointment? [redacted], [redacted]Southboro Medical GroupXXX-XXX-XXXXXXX-XXX-XXXX [redacted]Consumer's Final Response (The consumer indicated he/she DID NOT accept the response from the business.)I want to take it to court because I did not get eye glass memo their.Business' Final Response Hi [redacted],The patient appears confused about the eyeglass memo. I guess the original complaint was sent to [redacted] and [redacted] is responding to her message rather than mine, which reads as follows: "I reviewed this acct. Patient did not inform us that their insurance had termed. We billed the insurance provided and were paid in full on 4/6/12 for 3/18/12 & 3/20/12 dates of service. The payer retracted their payment on 10/31/12 but sent a letter on 11/1/12 stating they hadn't retracted the payment yet so the rep didn't actually look at the acct. Rep called the patient's phone number which was disconnected. Balance was transferred to patient on 3/22/13." Again, the patient neglected to inform us that there insurance termed so when we billed them they paid but then retracted there payment 8 months later which is why the patient received the bill late. This balance is the patient's responsibility. Thanks,[redacted]Southboro Medical GroupXXX-XXX-XXXX[redacted]

Requesting for removal of old e-mail and an end to survey e-mails.On or around [redacted] 2014, I kindly requested from the Southboro Medical Group SMG supervisor to stop sending survey e-mails that have the patient's name. This is a privacy violation toward both patients e-mails are attached to this complaint. First off, we never opted to have our personal information sold to a third party, namely Reliant Medical Group. Patients should have the option of opting in to receive surveys or signing a waiver. Second, even if the patient opts in to receive surveys, their name should be NOWHERE in the e-mail, like the one sent yesterday regarding a new system.Desired SettlementRemove both e-mail addresses from Reliant Medical databases. I will no longer be using e-mail due these breaches. If no response is received within 30-days of this filing, I'm weighing the option to file with the Board of Registration in Medicine against Southboro Medical for these privacy breaches.