ComplaintsforSean Xie MD
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Complaint Details
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Initial Complaint
10/20/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
I saw *************************** at the *********************** on 7/17/23 in the emergency care unit. Since then *************************** has been improperly billing my insurance provider [ Blueshield of CA ]. They keep denying his claim due to his improper billing [ he keeps using the wrong procedure code for medical consultation ]. He is also attempting to over bill my health insurance provider - trying to bill for more money than for the medical consultation that he provided - thus Blueshield keeps denying the claim. He is now trying to bill me directly with his inflated medical consultation fee and threatening to take me to a collection agency if not paid. My insurance has advised me not to pay this bill - because it needs to first go through their billing department. They also advised me that he should not be sending me threatening bills. This entire situation is being caused by *************************** improperly billing Blueshield of California - and he is now threatening me. please help!Business response
11/07/2023
This patient's insurance denied the claim is NOT because we billed the wrong code. ************* lied so that they do not have to pay for the claim. ************* stated that only one physician can be paid to see the patient. This is laughable. When a patient goes to an emergency room, more than more specialists can be called to see the patient. In this case, we saw the patient as neurosurgery service. There is not another neurosurgeon participated in the care of this patient. We have been using the same code to bill for consultation for the last 20 years, and insurance companies will always find absurd excuses for not paying for the claim. We tried to explain to this patient during her phone call, but she started yelling and screaming and used profanity ('f" word). We understand this patient's frustration, but we only billed the patient for our service after her insurance company unreasonably denied the claim. Rather than discussion reasonably, this patient is rude, not reasonable, refusing to listen, and overall acting very unprofessionally. This claim has been sent to collection service, and we are not directly involved in the collection process any longer.
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Customer Complaints Summary
1 total complaints in the last 3 years.
1 complaints closed in the last 12 months.