ComplaintsforBowes Imaging Center

• Initial Complaint

  06/14/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I was in a car accident last year(7/17/22) and was given orders for MRIs at Bowes imaging in ********* ******* last August and September 2022. I recently learned last March that my bill was never submitted to my health insurance (secondary insurance) and my car insurance, Farmers , sent notification to Bowes that my policy payment was exhausted. I called Bowes mid March 2023 inquiring on the unpaid bills. I was told they could not submit it at that time because I notified them 10 days past the 6 month contract time frame. I have phone records of my contacts with Bowes . I ,later contacted my health insurance, ********** Blue Shield (TEamCare) , via phone and was told I could fill out a claim on my behalf and mail/fax to them. I did mailed and fax the claims . Last month I received an explanation of medical benefits letter that stated I did not owe the provider Bowes Imaging Center LLC any money . The letter , stated that the provider needed to contact their Network representativePatient is not billable. I called and emailed copies of the letter to Bowes billing department representative ,*****. She called me after receiving it and stated her manager told her they will not contact BCBS. I was informed my insurance sent them a letter the same time they sent mine. I have been told on multiple times that I have 1 yr to submit any medical bill. Bowes is an in-network provider and I was told by BCBS(TEamCare) that I did not need to have my MRI preauthorized in order to have it paid. Bowes is trying to use that I did not get pre authorization prior to my treatment as a reason to not comply in responding to BCBS. Representatives from my insurance on different occasions stated that if Bowes is in network, which they are , it will not hinder me from getting my balance paid. Last week I spent 2 hrs at a local branch of BCBS trying to get help in obtaining missing information that Bowes is refusing to provide them . Can you please help me resolve my issue?

  Business response

  06/30/2023

  We saw this patient on 8/5/2022 and 9/19/2022. When she came to us she never provided a ********** and **** Shield card and only provided ********************** as this was MVA related. We were advised from Farmers that benefits remain on 8/5/22 and we also spoke to ******* with Q law that they were repping her for the accident and to bill the auto insurance. We bill Farmers timely as we are only give 35 days to file a claim. The claim was denied as benefits are exhausted as the patient is only provided 10k and she should have been properly tracking her medical bills. *************** contacted ** on 3/29/23 with the ********** and ********************* information which was exactly 237 days past her first visit with us. Our ********** provider contract only allows us 180 days from service date to file the claim. We are past timely filing and we did not have pre-authorization done for the MRIs as we did not know she had health insurance. If we file this claim to ********** they will make us write off the balance for timely filing error and not having an authorization on file. Therefore, we will not be able to be paid from Q law from her settlement. The ********** rep that called us on 6/8/23 stated she could NOT guarantee that the balance would be patient responsibility so it was a chance we would take to file the claim. If she wanted us to use health insurance she should be aware of how HER insurance plan works as she picked this plan herself. Authorization is required from ********** and they do NOT do retro authorizations. She should also have properly tracked her medical expenses she was receiving and using with ********************* as she was advised from her claims adjuster there is ONLY $10,000 provided.

  Customer response

  07/07/2023

   
  Complaint: 20185243
  
  I am rejecting this response because:
  I do not agree to what Bowes stated in their response to my complaint. I am very much aware how my employer insurance works. Ive been employed at *** for over 30 years.  Over the years I have had situations where I had to submit medical bills to my insurance after service been rendered by a provider and past the 6 months time frame.  I had medical providers that I saw in July 2022 whom just like Bowes were not paid by ***************** due to benefit had exhausted.  Just like how I received a statement from Farmers in March 2023 concerning Bowes not being paid I received similar forms for Global Physician (******** memorial E.R. Doctor) ****************** radiology not being paid too. I contacted ********** Blue Shield local representative and she printed out claim forms for all 3 companies. On more than one occasion I clarified via phone ( TEamCare/BCBS) and in person ( local site at UTC mall) that I have one year from the service date to submit any outstanding medical bill to my health insurance . I will like to clarify the misinformation that Bowes tried to say that I waited over 235 (180 =6 months) days to provide them my insurance information but in reality base on my September 19 2022 service , I missed their so call 6 months by 9 days (called them on 3/28/23)from me contacting them. In my previous complaint I stated I became aware of them not being paid when ******* sent me an exhaust statement towards the end of March 2023. No matter the situation is , I have medical insurance and I am within the time frame for me to turn in their billing statement. Im curious how medical bills that I had service approximately a month prior to Bowes was paid with no issues when it was mailed to BCBS in the same envelope.  I received a call from a Bowes representative on 6/30/23; within our conversation I was informed that I cant submit a bill on behalf of a Provider . That statement was definitely incorrect because I had and currently have doctors/dentists who take my insurance but does not file them.  Once I learn that these bills were not paid I reach out to Bowes (3/28/23) and emailed them all appropriate documents to be filed . On   7/3/23 their rep emailed a duplicate copy of my previous billing statement . I brought that to a local BCBS rep who emailed it their adjuster.  The  issue now is that Bowes needs to contact and submit the proper forms BCBS requested so they can be paid .  My insurance carrier,TEamCare (BCBS represents them in *******), has stated to me on numerous occasions that I am not responsible for any charges from the 2 services dates I had at Bowes Imaging. I was told by TEamCare representative, ******** , that Bowes needs to call the provider phone number ************** for clarification that this particular type of insurance I have does not requires preauthorization for MRI, CT and PET . Thank you BBB for assisting me with my complaint. 
  

  
  Sincerely,
  
  ***************

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