ComplaintsforSLB Medical Group, LLC

• Initial Complaint

  11/20/2023

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  Used SLB to get some type of reimbursement from my insurance for my midwife care in 2022. SLB has been extremely slow in responding and ignoring emails. We have paid them and they still dont respond to our emails. We are under the impression that the insurance has given SLB our reimbursement money. SLB needs to give us our reimbursement from the insurance or give us our money back that we paid them.

  Business response

  11/20/2023

  First... SLB Billing does NOT receive payments for care provided by the midwives we bill for. The checks either go to the PATIENT or the PROVIDER (***************************). We provided ************************ with the information regarding his claims, that were filed in a timely manner and all of them were processed. I will paste the email that was sent out to the Bloomfields on August 29th. Second... your insurance company told us that the checks were sent to YOU and not the provider. When they send the check to the PATIENT they will not provide us any additional information. BCBS TN won't give us additional information about the check they sent you, but ***** told us the $89.63 check they sent you was cashed back on July 18, 2023. Third... all of your claims have processed. I realize from previous emails that you aren't comprehending that you aren't getting very much back from your insurance companies for what you paid to your midwife, but you did not deliver with the midwife, and therefore we could only, legally, bill for the care you did receive, which was just prenatal and postnatal care. Unfortunately most of what we filed with your insurance company was applied to your deductible. 

  SLB Billing has done the work you paid us for, we coded and filed claims with two different insurance companies for the care your wife and baby recieved with *************************** at ***** Midwifery, and followed up all of those claims until they were appropriately processed and provided you with the information. Again, we did not receive any checks. That's not how it works, the insurance companies only pay either the patient or the provider. We're just an insurance billing company. Additionally, I did answer your email this morning asking if you had received any EOBs or checks, and addressing that perhaps the change of address may have been the issue. I also told you in that email (see below) that because the checks were sent to you, you had to call the insurance company, as they will not give us any additional information regarding checks sent to you.

  Here's the processed claims email we sent you back in August:
  
  SLB BILLING <********************> Tue, Aug 29, 11:22?AM
  
  
  to ********, *****
  
  
  
  
  
  
  
  Good morning!
  
  
  I did the follow up on the claims that were submitted to your insurance companies. This was the information that I was able to obtain, payments and patient responsibilities are in bold and highlighted. 
  
  
  Please let me know if you have any questions!
  
  
  ********* (BCBS TN **************):
  DATES OF SERVICE: 06/01/2022 - 10/10/2022 - NO CLAIM ON FILE PER AUTOMATED
  AMOUNT BILLED: $1,550.00
  DATE PROCESSED: 07/03/2023
  ALLOWED AMOUNT: $489.15
  DED AMOUNT: $0.00
  COIN AMOUNT: $0.00
  PAID AMOUNT: $264.15
  PAID TO: MEMBER - PER ******* (SINCE I COULDN'T FIND CLAIM WITHOUT HELP) 
  CHECK/EFT #: 23194B1000803886
  CLAIM #: EXTG9CJ1TW00
  SPOKE WITH: ************** / AVAILITY
  REFERENCE #: ************ / 4d5b895d-ac7b-46f6-a255-a4f204d68fbf
  
  
  
  -$45.00 COPAY PER COVERED VISIT -- 06/01/2023 NON-COVERED FOR TIMELY FILING
  
  ********* (AETNA):
  DATES OF SERVICE: 11/02/2022 - 12/05/2022
  AMOUNT BILLED: $1,550.00
  DATE PROCESSED: 06/30/2023
  ALLOWED AMOUNT: $649.38
  DED AMOUNT: $500.00
  COIN AMOUNT: $59.75
  PAID AMOUNT: $89.63
  PAID TO: MEMBER
  CHECK/EFT #: 08608-058579523 CASHED 07/18/23
  CLAIM #: E23172324300
  SPOKE WITH: ROXY ************** #: ROXYH08282023 
  
  **** (AETNA):
  DATES OF SERVICE: 12/07/2022 - 12/19/2022
  AMOUNT BILLED: $550.00
  DATE PROCESSED: 06/29/2023
  ALLOWED AMOUNT: $248.93
  DED AMOUNT: $248.93
  COIN AMOUNT: $0.00
  PAID AMOUNT: $0.00
  PAID TO: N/A
  CHECK/EFT ************************ E231723345
  SPOKE WITH: ROXY ************** #: ROXYH08282023 
  
  DATES OF SERVICE: 01/18/2023
  AMOUNT BILLED: $250.00
  DATE PROCESSED: 06/30/2023
  ALLOWED AMOUNT: $107.03
  DED AMOUNT: $107.03
  COIN AMOUNT: $0.00
  PAID AMOUNT: $0.00
  PAID TO: N/A
  CHECK/EFT ************************ E231723180
  SPOKE WITH: ROXY ************** #: ROXYH08282023 
  
  -CALLED 08/28/2023-
  -AETNA AUTOMATED DIDN'T HAVE THESE CLAIMS ON FILE FOR ********* AND ****. I SPOKE WITH ******* TO GET THIS INFO
  
  -AVAILITY AND AUTOMATED FOR BCBS OF TN HAD NO CLAIM FOR *********. I NOTICED THAT THE DATE OF BIRTH ON THE CLAIM WAS **** INSTEAD OF **** THAT AETNA AND BCBS OF TN HAVE ON FILE. 
  
  
  Thank you,
  
  *********************************
  Billing Specialist, SLB Billing

  Here's the email I sent you this morning:
  
  SLB BILLING <********************> 9:02?AM (5 hours ago)
  
  
  to *********, *****
  
  
  
  
  
  
  
  Hi *****... did you ever receive the checks from your insurance company? I am wondering if the issue is that you moved and they don't have your new insurance? Or they just haven't been forwarded to your new address? 
  Unfortunately, because the checks were supposedly sent to you, they will not allow us to have them reissued, it has to be requested by their member (you).
  *****
  
  --
  SLB BILLING
  
  ************ FAX
  
  ********************
  **********************
  
  

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