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Total Plan Concepts Reviews (6)

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me and the matter has been resolved. I will resubmit complaint if this issue will not be solved according that response
Sincerely,
*** ***

RevDex.com:
I have reviewed the response made by the business in reference to complaint ID# ***, and have determined that my complaint has NOT been resolved because:'I have attached the bills I received from Quest Diagnosticsdocuments are for the same service, which was done on April and the latest bill I received just recently for the service that was done on October These bills must be paid by my insurance company. Sincerely,
*** ***

Good Morning,We looked into this issue and contacted the provider, *** *** ***'s billing departmentIt seems that they filed the claim with an incorrect tax IDThe tax ID they billed was out of networkThe provider will submit a corrected claim to us Total Plan Concepts with a proper in
network tax IDThe account is currently on hold and the member will not be billed. Thank You,Customer ServiceTotal Plan Concepts***

The attached three bills were all paid with no patient responsibility. Thank You,Customer ServiceTotal Plan Concepts

Good Afternoon, We investigated into this case further with our Authorization Department.  Please see below log of how this case was handled. The Authorization Department  received a request 03/**/17, for a cat scan as an urgent request they therefore approved and finalized the case...

on that same day 03/**/17 based on medical necessity.  Case [redacted]3/**/2017 at 12:09pm Call was received requesting precertification for an “urgent” CT scan. We advised the provider to fax the clinical documentation to review for medical necessity.03/**/2017 at 12:28pm Clinical was received 03/**/2017 at 4:35pm the review was completed by our medical director and approved based on medical necessity.03/**/2017 at 8:33am Approval letter was generated and mailed out to the Provider, Member and facility 03/**/2017 at 1:20pm  Our intake staff Jerife received a call from the member checking on status on the case. The member was advised to have the provider call  for status on the case.  Thank You,Customer ServiceTotal Plan Concepts###-###-####

Good Afternoon, Please provider the exact date of service for this bill from Quest Diagnostics as this member [redacted] currently does not have any Quest claims on file for date of service May 2016.  Thank You,Customer ServiceTotal Plan Concepts###-###-####

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