ComplaintsforOlympic Medical Imaging Consultants

• Initial Complaint

  04/05/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I was in ******************** from ***** November 2023. I had many tests that needed medical imaging to be completed. The work was all done while I was "in the hospital." I have called Olympic Medial Imaging Consultants many times to get them to **** ******** correctly. The ****s need to say the truth - that all the work that was done by this company was "in Hospital" So far I have paid $367.03, which I should not have to pay because ******** will pay for everything after my primary insurance, ********** Blue Shield, has paid. I just received another **** for $118.19 which I should not have to pay and if Olympic Medial coded them correctly, ******** would pay all the ****s 100%. I called ******** today and they have not received any ****s that have been coded correctly. I was told that if the ****s were coded correctly, then they would pay them. I have tried to call them multiple times and most of the time the system kicks me out since I have been on hold for so long. I also emailed them on 24 FEB 24, to which they did not respond. So, this is my last resort.

  Business response

  04/09/2024

  Thank you for reaching out regarding your recent ****ing concerns.  We understand the importance of ensuring accuracy in our ****ing processes and are committed to addressing the issues promptly.

  Our claims were correctly ****ed to ******** as professional services.  We ****ed with a place of service 21 which indicates that services were performed in the hospital.  As we are contracted providers for the hospital our charges must be ****ed on a CMS-1500 claim form with a modifier 26 to indicate that these are professional services.  ******** Part A does not pay for charges that are ****ed on claim forms CMS-1500. 

  Professional services performed while in the hospital are not covered by ******** Part.  A call was made to ******** to verify this information. They will only cover charges ****ed on UB-40 claim forms, which is what is ****ed by the hospital. 

  After conducting a thorough review of your account, we confirmed that there were no ****ing errors.
  In our review we also conclude that there were several communications with our ****ing department regarding these charges.  Please see below for a summary of the communications:

                  January 18, 2024 Patient called in and asked that we **** ******** Part A as secondary and was told that it would not cover the radiology claim but we would do a complimentary ****.
  

                  January 20, 2024 ******** did deny for Part B benefits being inactive.
  

                  February 20, 2024 Patients spouse contacted again, via e-mail, asking us to **** ******** Part A the representative educated [the patients spouse] that the claim is for the reading of the *** and CT, and that we                    **** separately from the facility.  The patients spouse is insistent that this should be covered under Part A because it was part of the hospital stay regardless of what we say.
  

                  February 21, 2024 ************************* received an email from the patient, which was forwarded on to our ****ing department.
  

                  February 28, 2024 ************************* received another email from the patient,which was again forwarded to our ****ing department.
  

                  March 4, 2024 Representative spoke with the patient that they do not have Part B coverage and ******** will not cover the charge.  We ****ed their supplemental insurance and it processed towards a deductible                        and coinsurance. The representative did re-**** but explained it would not change the decision of ******** because they do not have Part B benefits.
  

  We understand that this outcome may not be what you were hoping for, and we apologize for any disappointment it may bring.  Please do not hesitate to contact our ****ing department if you require further clarification or assistance with your account.  You may also want to reach out to ******** for further clarification regarding the different benefits for Part A verses Part B.

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩