Complaints

• Initial Complaint

  11/13/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I relocated to ****** ******* in August 2024 from ******* *******. When I signed up for *************** Advantage, Humana assigned "QUALITY OF LIFE HEALTH SERVICES" FOR MY PRIMARY CARE PROVIDER. I have ZERO CO-PAY. My follow up appointment was scheduled with *** A on 10/22/2024. Appointments with my PCP are always covered under my ******** ADVANTA*E PLAN. My first appointment with the *** * on 9/18/2024 was billed to me for $265.00,later billed to HUMANA. *** A replaced *** * at QUALITY OF LIFE HEALTH SERVICES. My *************** Advantage is on file with QUALITY OF LIFE HEALTH SERVICES. Unfortunately, I am being billed $179.00 for my 10/22/2024 visit. I called ***************************,accounts receivables ***** I left messages at this number on Nov7,Nov 12. Still waiting for callback in regards to this bill. My 10/22/2024 follow up visit should have been billed to HUMANA. I had no discussion with anyone at QUALITY OF LIFE in regards to paying OUT OF POCKET for services covered by HUMANA. QUALITY OF LIFE HEALTH SERVICES need to check the Management of their LANETT OFFICE. I am not paying the$179.

  

  Business response

  12/09/2024

  During the patient visit, he was informed and agreed to be seen by a Provider who had not been credentialed by Humana Health.  He stated he understood that his visit would be self pay.  The insurance company has been billed again and we are awaiting a response.

  Customer response

  12/10/2024

   
  Complaint: 22550957
  
  I am rejecting this response because:
  
  Sincerely,
  
  ******* ******

  Customer response

  12/10/2024

  ******** QUALITY HEALTH Care is listed on my HUMANA card as my PCP. I was never advised that my 10/22  was Self Pay????

  There is  documented proof of this. I think Humans needs there IN Network system.

  I will refer my Complaint to Humana. Lanett.  AL.  Is a small town. Who is my PCP@******** QUALITY HEALTH, No COPAY Humana Medicare????

  I am not paying $179  when I have Insurance.

  I will escalate this to the  ****************** that Oversees ******** QUALITY HEALTH.

  *******

  .

   

  

  Business response

  01/08/2025

  My name is ****** ****** and I am the AR Manager for Quality of Life Health Services, Inc. I spoke to Mr. ****** on 11/13/24. I apologized to him for his insurance not being attached to the initial claim. I added the insurance to the claim on this day and the claim was billed to Humana. We have since received a denial from Humana due to the physician that he did see at this clinic was not his PCP listed with Humana, and we did not obtain an authorization from his PCP for this visit. We will be adjusting off the balance due to us not obtaining the authorization. Mr. ****** has not received any statements from us stating that he is responsible for the balance of $179.00 since the initial statement before his insurance was billed and processed. That statement is dated 10/29/24. 

  Customer response

  01/09/2025

  Issue Resolved...

• Initial Complaint

  08/03/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Acct# ********* Invo# ************/**/** was my service date at 10 am. *********************** office in *********** is who I paid my fee of $45. I wasn't given a receipt, print out or anything, which that seems to be their procedure because I've never been given a receipt and this is my second visit there. But, it is on camera where I paid. All together, this is the fourth time within my last four visit, that this company has billed me for nonpayment making my credit look bad. I've also called three times, left my contact info without a return call. Please help me solve this problem? Thanks.

  

  Business response

  08/16/2023

  ***** has investigated the complaint made by patient ************************************  Per our records, she did not make a payment for her visit on 5/15/2023. ************ ******** card was scanned into the *** check in kiosk at 2:27 pm. The *** did not collect payment.  She assumed the patient had health insurance.  ******** later rejected the patient's claim because she was not covered for dental service. As a result, the patient is responsible for the nominal fee of $45.00 for her completed visit.  Below is a date of payments received from ************* 
  
  12/20/2021,  Paid 45.00
  1/12/2022, Paid 45.00
  2/17/2022, No payment because *** could not make change
  6/7/2022,  ************ came in and made payment for the 2/17/2022 visit.
  4/18/2023, Paid 45.00
  5/15/2023  No payment made because ******** card was attached
  6/8/2023, Paid 45.00

  Thank You

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