ComplaintsforMid-South Pulmonary Specialists

• Initial Complaint

  02/26/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My primary care dr referred me for a sleep study and made an appointment for me, but I needed to reschedule. They refused to let me schedule and appointment because they said they do not take my secondary insurance. I see other drs that don't take my secondary and I am just responsible for the copays and deductibles then. But they refused to let me make an appointment. I spoke with ***** (the supervisor in the billing office) and she said she cannot allow me to be seen because my secondary insurance is a government insurance. My secondary insurance is ******************* my primary is Civilian. I tried to explain that I can be seen using just my primary insurance and they still refused to let me be seen.

  Business response

  03/04/2024

  Mid-South Pulmonary & Sleep Specialists strives to provide excellent and expedient care to all of our patients.  Unfortunately,  there are times when we are restrained by insurance guidelines.  Because we are out of network for your secondary policy (TriCare Prime), AND it happens to be a Government issued policy, we are bound by law to file your claims to them.  Your plan will not pay for out of network charges and because of a new law initiated last year (The No Surprises Act) we are not allowed to bill you for expenses that are out of network.  It is my understanding you have a deductible and co-insurance from your primary insurance and this means that the provider would not be paid for anything the primary payer did not pay and since your secondary policy is out of network the physician would not be paid.  Our billing staff did call TriCare Prime and was told the only way to remedy this is for your PCP to issue you an out of network referral, but were told this did not guarantee payment.  While we are out of network with TriCare Prime, we are IN NETWORK with TriCare Standard.  If you are allowed to change your plan from Prime to Standard, we will be more than happy to treat you.  Please feel free to call us if and when your secondary policy changes from Prime to Standard and we will be more than happy to make your an appointment.

  Sincerely,

  Management

• Initial Complaint

  01/30/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I was in the hospital July 2018 for heart issues which required Mid South Pulmonary services. I did not receive a bill in the mail at any time. I did receive a Letter dated 2/9/2022 from ************************ Debt Collector for Mid South Pulmonary. I contacted Mid South Pulmonary on 3/4/22 and spoke with ********* to find out what this bill was. Mid South Pulmonary had my address incorrect. That appears why I never received a bill. All other hospital providers had the address information and I received their bills. I asked ********* if I could pay the amount due $1778.08 to them which I did. Balance is now $0.00. My account was still turned over to ********************** advising I still owe $235.50. I was notified that they are in the process of garnishing my wages. Today I spoke with ********* and she states there is nothing she can do to help. ********* was able to take my $1778.08 and now she cannot help. We have tried contacting Billing Supervisor, *********************** and Administrator, ***************** and have been unable to speak with them.

  Business response

  02/15/2024

  Mid-South Pulmonary & Sleep Specialists strives for excellence and accuracy, unfortunately the address listed on the account was one digit off.  However, monthly statements sent from us were never returned from the Post Office.  Therefore, the account remained unpaid and was turned over to collections, as is our normal process. The amount being disputed by the patient is for Legal Fees from the ***************** and not Mid-South Pulmonary & Sleep Specialists.  We hire and pay the agency to research, contact, and collect outstanding balances from patients on our behalf with the exception of legal fees they (agency) incur.  They bill legal fees separately in order to be reimbursed for their expenses. Below is the activity sent to us by the agency on this account;

  "There were 8 validation letters sent, 2 final demand letters sent, 1 interrogative served, 19 manual calls and several dialer calls, 2 contacts (on several of the calls a person would answer then hang up on the collector).The consumer paid the court costs yesterday 2/13/24."
  

  The agency bills the patient directly for any legal fees that are outstanding and this is the situation in this case. Had the patient called the agency instead of our office they would have been informed of both the outstanding balance and the legal fees. Unfortunately, when the patient called to speak with our billing staff we have no way of knowing the agency has initiated the legal process to obtain payment.  We can only inform them of the outstanding balance due for services rendered by the physicians of Mid-South Pulmonary & Sleep Specialists because the agency's legal fees remain on their system.  It appears as of this writing the patient has paid both balances.  

  We appreciate their willingness to resolve this issue in it's entirety and regret we were not able to resolve sooner.

  Sincerely,

   

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

  Practice Manager

   

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