Thomas Jefferson University Hospital

July 02, 2014
Dear [redacted]:I am writing in response to a complaint that you forwarded from my patient, [redacted]. **. [redacted] has been under my care and I performed an endoscopic surgical procedure as part of her care on June 17, 2013. As planned, **,...

[redacted] was seen at a follow-up visit after that procedure on July 2, 2013. The endoscopic surgical procedure that was performed is assigned no global days for coverage by insurance companies (this includes Medicare, Medicaid, and all commercial insurers). As such, payment for the procedure covers only the procedure and not any subsequent postoperative care. There are no postoperative visits that are covered by the fee for initial surgery and all visits are subsequent to separate obligations by the patient. The great majority of the surgery I perform and have performed for many years comes under these guidelines and my staff routinely advises all patients of their obligations for bills of subsequent visits after the surgery. **. [redacted] was advised of this obligation. The $50 bill for copayment represents **. [redacted] ' s obligation for that first visit after surgery.I would also like to clarify that there are two different entities involved in the bills that **. [redacted] received. My professional services are billed through [redacted] Physicians, which billed for my professional services. Thomas Jefferson University Hospitals was responsible for the billing for all surgical procedures, as well as preoperative testing that occurred in the hospital regarding the surgery.Thank you for your kind consideration in this matter. If you have any questions, please do not hesitate to contact me.Yours truly,

Review: I had an outpatient surgery at Thomas Jefferson University Hospitals on May 17th 2013. I was told while scheduling my surgery, as well as later while being briefed about the surgery that I would have a follow-up visit with the surgeon, which would be FREE as part of the surgery, and that I would not have to pay a co-payment. I had already paid $200 in hospital charges for the surgery (in addition to what my insurance was charged) and the follow-up visit (on July 2, 2013) was supposed to be included as part of this bill. But Jefferson Hospitals has been sending me a $50 bill for co-payment for this follow-up visit for more than a year now. I called them several times to explain that this was billed in error. The first time they agreed, and said they would retract the bill. But a few months later, they started sending me the same bill for the same date of the followup visit gain. When I called them again, they explained that they had forwarded my explanation to the physician's office but the office had decided that I still owed them this payment because of the kind of insurance I had. They promised to request my insurance company ([redacted]) to send me the bill directly, but so far, they have not had anything sent from my insurance company, but instead sent me the same bill again from their hospital billing services. When I called about it and said I wouldn't pay, they said they would send my bill to collection if I didn't pay it, but they have done nothing to resolve their own billing error or offer a proper explanation about the bill. This is not the first time I've had billing issues with [redacted] Physicians. They have also billed me in error previously, but in the previous case, it was corrected by my health insurance company ([redacted]).Desired Settlement: Bill should be adjusted and all charges ($50) for the follow-up visit following the outpatient surgery should be dropped.

Business

Response:

July 02, 2014Dear [redacted]:I am writing in response to a complaint that you forwarded from my patient, [redacted]. **. [redacted] has been under my care and I performed an endoscopic surgical procedure as part of her care on June 17, 2013. As planned, **, [redacted] was seen at a follow-up visit after that procedure on July 2, 2013. The endoscopic surgical procedure that was performed is assigned no global days for coverage by insurance companies (this includes Medicare, Medicaid, and all commercial insurers). As such, payment for the procedure covers only the procedure and not any subsequent postoperative care. There are no postoperative visits that are covered by the fee for initial surgery and all visits are subsequent to separate obligations by the patient. The great majority of the surgery I perform and have performed for many years comes under these guidelines and my staff routinely advises all patients of their obligations for bills of subsequent visits after the surgery. **. [redacted] was advised of this obligation. The $50 bill for copayment represents **. [redacted] ' s obligation for that first visit after surgery.I would also like to clarify that there are two different entities involved in the bills that **. [redacted] received. My professional services are billed through [redacted] Physicians, which billed for my professional services. Thomas Jefferson University Hospitals was responsible for the billing for all surgical procedures, as well as preoperative testing that occurred in the hospital regarding the surgery.Thank you for your kind consideration in this matter. If you have any questions, please do not hesitate to contact me.Yours truly,

Review: During the fall of 2011 I was in a dispute between my insurance company, [redacted], and Jefferson University Hospital. I was rejected by [redacted] for an operation but after I filed an appeal I was approved. Documents showing that I was approved was sent to both myself and to Jefferson Hospital. Once the operation was complete (late-December) I was informed by my orthodontist that the doctors placed the device backwards. Meanwhile cut to 6-or so months from the operation, Jefferson starts sending me bills. I contacted them and informed the representatives that I was approved and they should contact [redacted] told me that Jefferson never sent an invoice for the cost of the operation, while Jefferson said the had. Fast forward 2 years of constant back and forth between [redacted] and Jefferson I start receiving threats from Jefferson. Stating I should pay or it will affect my credit rating. At this time (May 2013) I contacted [redacted] and they informed me that Jefferson has not sent a request for payment. They also informed by to send documents to the Harrisburg and Philadelphia office. On June 20th 2013, [redacted] sent a letter to Jefferson stating that any further attempts to demand money from me will be in violation of Federal and State medicare law. Nevertheless, Jefferson keeps sending me notices and now they are going to turn over my account to a collection agency. I've been trying to get this matter resolved but Jefferson is not willing to do anything. Jefferson is breaking multiple laws and still demands money.Desired Settlement: The business should clear all debt that is allegedly owed and never contact me again. Since multiple laws were being violated by Jefferson I feel that should be compensated for the constant threats and harassment (pain and suffering) that I suffered for over 2 years.