Stony Point Surgery Center

Review: My husband, [redacted] had glaucoma surgery at the Stony Point Surgery Center on March 11, 2014. They required us to pay them prior to the surgery, the amount of our deductible and calculated additional portion we would owe them based on our insurance coverage. I discovered on April 13, 2014 that the insurance company had paid them, and they owed us money. Apparently another claim was received by the insurance company first, and the deductible was applied to the first claim filed, which meant that Stony Point Surgery Center had been overpaid.

I called on April 14, 2014 and talked with [redacted] ([redacted]) at [redacted]. She did see where they were overpaid and did owe us a refund. She was very nice and helpful, and told me checks were only issued on a Friday, and she would start the paperwork to request a refund.

As of today, May 1, 2014, I have not received the refund. I called Tuesday evening and left a message, but as of 9:38 a.m. today I have not received a return call with an explanation on why they are holding on to our money and why it should take this long to resolve this.

They wanted assurance that they would receive their money in a timely manner, but don't seem to be concerned about us receiving our money in a timely manner.Desired Settlement: I would like to receive a refund as soon as possible without further delay, as well as an explanation as to why it has taken so long to process this.

Business

Response:

Dear [redacted]:

Please accept this letter as our response to the complaint

filed against our company, which has been assigned complaint number [redacted].

Our patient is upset that we collected their estimated co-pay and deductible

prior to surgery and subsequently took longer than anticipated to refund their

overpayment once another claim settled ahead of ours and partially satisfied

their deductible.

Our industry is shifting its focus to collecting co-pays and

deductibles up front when possible because the responsibility for payment is

increasingly shifting from insurance companies to patients. In today’s

environment with higher coinsurances and even high deductible plans, a an

increase in collections activity and bad debts as a result of this trend and

therefore have increased efforts to collect funds up front. This effort will

continue as part of our fiscal responsibility, but our company constantly

evaluates additional opportunities to assist patients with meeting this increasing

burden.

As for the patient refund in this case, we did not receive

information from the insurance company until 24 days after the date of service,

which can be typical. We are not able to review an account for a refund until we

receive this information from the insurance company. If then took us 13 days to

complete the account review and refund request, and another 22 days to actually

issue the refund to the patient.

We strive to return a patient’s refund within 30 days when

possible and missed that goal by 5 days in this case. We apologize for the

inconvenience this may have caused for the patient. Upon review of this case,

our delay happened at the management level as there are two levels of

management approval before submission to accounts payable. We have realized

that the old-fashioned method of paper approvals is not serving us well and are

currently implementing a new automated system to track the aging of the patient

refunds and more quickly generate a check once approved.

If I can be of further assistance t you or the patient in

this matter, please do not hesitate to call me directly at [redacted].

Sincerely,

Consumer

Response:

I have reviewed the offer made by the business in reference to complaint ID[redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

I appreciate their explanation; however, their representative expressed specifically to me when I talked with her (on a Tuesday or Wednesday), that the refund may be issued that Friday (2-3 days later), or if not, then definitely the next Friday. This is the primary reason that I was so frustrated.

If this is not their procedure, then their representative apparently does not understand their procedures and should not be telling customers things that are not accurate.

Also, they ended up giving me a credit on my credit card - why would that take 22 days to process?

And why did I have to request a refund, when they were obviously overpaid?

I have also made a phone call to Stony Point Surgery Center (a few weeks ago) requesting an itemized statement with the charges and payments they received. I have not received a statement and would like to receive one from them.

Regards,