ComplaintsforHill Physicians Medical Group

• Initial Complaint

  08/03/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I was seen for a doctors appointment on 2/22/2021, this visit was never submitted to my insurance and the doctors office started billing me over a year later. I've called their office multiple times to resolve this, and called my insurance to contact them as well. I am always met with the same answer, the billing manager isn't in, and she will call me back. Needless to say I have never received a call back, this is past timely filing this needs to be written off.

  Business response

  08/10/2023

  Thank you for reaching out to us.  We contacted your doctor for the necessary information related to your visit.  We were able to process the claim and weve asked ******************* to update your account.  Please know that there is a $30 copay that is due, if youve not already paid it.  Sorry for the inconvenience and thank you again for reaching out to us.

• Initial Complaint

  02/26/2023

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  Date(s) of Interaction: 2/2/2023; 2/09/2023; 2/10/2023 I am a speech-language pathologist who had a patient referred to me from their primary care physician for services with documented medical necessity for services. The patient has health insurance through Hill Physicians Medical Group (HPMG) of which I am not within the network. The patient is in great need of speech therapy for occupational purposes and the nearest speech therapist within network is many miles away. The standard procedure is to submit a pre-authorization request to seek approval from the insurance company with diagnostic and procedural codes that are medically necessary. I filled out the prior authorization request that I received via fax from HPMG. I also attached my referral from the doctor with around 10 pages of medical documentation to demonstrate medical necessity for treatment. I received a response from HPMG within a few hours stating that I had missing information (e.g., my national provider ID, tax ID, etc..). However, all of the requested information was on the form. I later typed on the form in case my handwriting was not legible and received the form back with the same explanation. I sent the form again with the requested information on the cover page and on the final page of the authorization request form (even though the information is already on the form). I received the same response. At this point, I forwarded the fax with a letter to their complaints and grievances department and received no such response. HPMG has failed to process my request for prior authorization and the patient's physician continues to request the preauthorization status. The patient also continually calls me because they require services. Patient stated that HPMG called and asked the patient why they wanted to see someone out of network but still has not processed my reauthorization request after three weeks. I attempted to call customer service at the number provided on form but the machine hung up.

  Business response

  03/03/2023

  Thank you for forwarding this complaint.  We would like to resolve the issue, however we're unable to investigate without the member's information.  If it's preferred, please call ***************** MondayFriday, *************, ************ at ************** to provide the member's information.  So sorry for the inconvenience.

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