Complaints

• Initial Complaint

  02/15/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I went for a study and the company told me that my deductible plus co-pay for my visit on 3/26/2023 would be $525.50 and that the amount would be due at the time services are rendered. I reluctantly paid it since I prefer the see my insurance's explanation of benefit to see the breakdown of payment. I went ahead to pay the amount so that the test can continue. I received multiple EOBs stating that the claim was "rejected" by the insurance due to errors.After months, I received a notice that the claim was paid in full with $0 patient responsibility. I attempted to call their office, with no answer and tried to talk with their insurance person, ***** to see if I can get a refund for $525.50. As of today, I have tried to contact someone there regarding this and no reponse.

  Business response

  02/16/2024

  We could not find a ******************* in our database.  We also searched by phone number.

  We looked at appt list for Tenaya and **** for all of March 2023.  There was no ******************* and no patient had a copay of $525.50.

  3/26/2023 was a Sunday. We are not open on Sunday's .

  Was if for a child with a different first name?

  We welcome additional information to be able to resolve this matter, if it is our issue.

  ************************************

   

   

  Business response

  02/18/2024

  We could not find a ******************* in our database.  We also searched by phone number.

  We looked at appt list for Tenaya and **** for all of March 2023.  There was no ******************* and no patient had a copay of $525.50.

  3/26/2023 was a Sunday. We are not open on Sunday's .

  Was if for a child with a different first name?

  We welcome additional information to be able to resolve this matter, if it is our issue.

  ************************************

• Initial Complaint

  09/10/2022

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Resolved

  More info

  My insurance company paid these people,, *****************************. In February of 2022 they retracted the payment because of not of restrictions as stated ,, they can not bill for same service within a 7 day period, They had paid 2 payments of 181.56 for submitted dates of service May18 and 19,2021... Now in August of 2022 they send me a bill in the amount 181.56 stating its the patient responsibility. If went unpaid I do understand but they were paid, they are contracted with *****************************. My issue is the billing in August is stating my account is over 120 days old,, and was never billed prior ,,, they also waited at least 1 full year after service rendered

  Business response

  09/20/2022

  Business Response /* (1000, 6, 2022/09/14) */ Patient was sent details on 9/13/2022 by one of my staff. We were paid on 6/11/2021 for his sleep study. The insurance didn't resolve our claim to their satisfaction until 6/28/2022, one year later. They took back part of their payment We have no control over how long the insurance company takes to resolve claims. In fact, it is is my understanding that there is no statute of limitations. Patient signed an agreement that he will be responsible for amounts the insurance company won't pay. Unfortunately and again we have no control it took the insurance company 1 year for them to resolve on their end. It turned out that the insurance company wanted the patient to pay for the amount they took back. Again, the patient signed an agreement that he would pay what the insurance company didn't pay. Consumer Response /* (2000, 8, 2022/09/16) */ (The consumer indicated he/she ACCEPTED the response from the business.) Nothing further to be done ,, not happy ,, frustrated,, but not there fault after reviewing their explaination

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