Therapeutic Solutions

I am rejecting this response because: 1) I never stated I had Medicare. I have *** *** for medical insurance. 2) I used the Medicare allowance as a benchmark for the service. I downloaded their file for and looked up the clinical diagnostic laboratory fee allowed for Urinalysis. (***)3) I was advised that I needed to submit to their drug test/ urinalysis policy if I wanted to be a patient there. 4) On the day of service, I was advised the fee was nominal. I do not believe this fee falls in the nominal range. Had I been advised of the true cost of the procedure - which I requested -- I would not have agreed to the test.5) I worked for years as the Administrator in a drug/alcohol program which regularly ran tox screens for residents. The actual cost of the test was never in this range, and I personally approved the invoices for the agency. I have been working two jobs for several months, and was not able to pick up mail being held at the post office during business hours. I finally picked up my mail on 11/and responded as quickly as possible. Whether or not *** *** *** applied the amounts to my deductible is irrelevant. The relevant point is that they billed an excessive amount for services provided. I continue to protest the amounts charged, and appreciate the help of the Revdex.com.*** ***

This patient was seen in our office 7/5/17 for an initial evaluation. When a patient is first seen, our physicians do a urine toxicology screen in order to properly prescribe any possible medications if need be.  This information lets them know what other possible medications the patient may or...

may not be on, so that the new medication does not conflict with what the patient is already taking. This patients insurance is [redacted] not Medicare (as stated in her complaint).  I am unsure where she received the information about "an item reimbursed by Medicare at $15-20?" For Medicare patients, Medicare pays labs in full. Her claims were processed correctly by [redacted] according to her insurance allowed fee schedule, since we are a contracted provider. Patient had not met her deductible amount at the time of service, so the amount that her insurance would have paid, went to patient responsibility. For CPT code [redacted] her insurance allowed $30.86, put to patient deductible. For CPT code [redacted] her insurance allowed $270.05 and put to patient deductible. For CPT code [redacted] her insurance allowed $6.10, put to patient deductible. This total amount put towards patient deductible is $307.01 The additional amount of $125.00 was for a No Show fee for not showing up to her appointment on 9/6/17. This totals the amount of $432.01 of what we were billing her for. This amount was then sent to the credit bureau because of no response from the patient in 4 months. Unsure where she is coming up with the dispute amount of $542.49?  She was never billed this amount. Patient went thru our normal collection process: received 2 statements, received a 15 day warning letter 9/27/17, asking to please call our office regarding balance due, patient was sent to pre-collections 10/12/17 for 30 days, again asking to contact the provider to discuss balance due, then patient went to straight collections 11/10/17, since we never heard from the patient. I have no record of a call placed to our office on 12/4/17 from the patient. We have no control of [redacted]'s allowable amount for these codes and as a contracted provider we adjusted off the non allowed amount.  We merely billed the patient for exactly how her insurance processed her claims, since she had not met her total deductible amount when these claims were received. Please see attachments showing a print out of the CPT codes billed and what was posted to patient responsibility.  Also attached is the 2 explanation of benefits (EOB's) from her insurance company on how they processed her claims. If you have any questions, please let me know.