ComplaintsforDr. Mardiro Mihranian, M.D

• Initial Complaint

  08/09/2021

  Complaint Type:

  Service or Repair Issues

  Status:

  Unresolved

  More info

  On Wednesday Oct 9th, 2020 at approximately 12:00 pm, I went to a Dr. Mardi H. Mihranian, M.D., F.A.C.S. office located at ************************************************* for an appointment. The reason for this visit was to have a cyst removed. I was told by the doctors office that they checked with my insurance company (United Healthcare), and that I had to pay $750.00 for my part of the deductible before anything was done. Once paid, services performed, I left happy. The insurance company stated that they have denied the doctors office claims a number of times for coding issues. I was told that the doctors office owes me a total refund, and that I should have never been charged. Two letters have been sent to the doctors office telling them that I should be given a full refund. No reply ever given to me or the insurance company by the doctors office. Copies of the letters, claims made with the insurance company, copy of my receipt and the signed HEPPA Release Form attached.

  Business response

  03/14/2022

  Business Response /* (1000, 9, 2021/09/09) */ The patient presented to our office with a serious and urgent medical problem. After we verified his insurance coverage, we notified him that he has a deductible of $******* which was not satisfied yet (see attached). As a curtesy my office collected $750.00. We have billed his insurance UNITED HEALTH CARE. Per UHC they have requested complete medical records which we have submitted via mail on 08/27/2021. The claim is currently pending for review. The original claim was denied due to missing required documents. Since his case was urgent, I had to perform an urgent surgery with no adverse effect. And had requested him to come back for a follow up to make sure everything is going smoothly. I have included the copies of the claims along with denials from his insurance for your review. Consumer Response /* (3000, 11, 2021/09/13) */ (The consumer indicated he/she DID NOT accept the response from the business.) The 2 new claims submitted by the Doctors office on Wednesday 08/23/2021, have again been denied. United Healthcare informed the doctors office they needed the proper paperwork to complete the claim, and if it was a valid claim. The doctors office stated they sent via the US mail all the required paperwork to United Healthcare on 08/21/2021. As of this date, Monday 09/13/2021 United Healthcare has not received any paperwork from the doctors office. I spoke with United Healthcare just before writing this response on Monday 09/13/2021 and was told that they just spoke to the doctors office, gave them a fax number to have the required paperwork sent to them. The doctors office also told United Healthcare that they would have all the required paperwork faxed before end of business day today Monday 09/13/2021. I am still waiting on a refund from the doctors office of $750.00.

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