ComplaintsforColumbia Outpatient Sedation LLC

• Initial Complaint

  02/24/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had a colonoscopy and endoscopy done on July 9th 2021 at the Gastro Center of Maryland, 3405 Olandwood Court Suite 102 Olney, MD XXXXX. I confirmed with them before this procedure that my insurance AETNA would cover this procedure to which they stated yes and there website also states the same. After the procedure was done and the insurance paid for what I thought was the procedure I received another bill from Columbia Outpatient Sedation LLC (PO BOX 6267, Hermitage, PA 16148-0923) stating that I owed another 5064.00 because my insurance did not cover this portion of the bill as it was out of network. After trying to get this issue resolved several times with both companies billing offices nothing was resolved and each one pitted the other billing office as whom I should figure the issue out with. After searching online for the LLC I could not find any physical address or any website with any further information. Can someone assist me with this issue? Thank you,*********** **** *****

  Business response

  05/05/2022

  Business Response /* (1000, 9, 2022/03/22) */ *******@integrityhpg.com Attachments Mon, Mar 21, 1:38 PM (1 day ago) to me Hello ****, As I stated on the phone, the patient always signs an anesthesia form to let them know that we may not be contracted with their insurance carrier and it provides their max out of pocket amount. For Columbia Outpatient Sedation it is $425. We subtract anything that the carrier pays and the remaining balance between that amount and 4:25 is patient responsibility. However, we always send what we call a balance bill statement along with a patient involvement letter stating that we are requesting their assistance to have the insurance pay what is usual and customary for the procedure done. That letter clearly states this is not a balance we are wanting them to pay but that we are wanting their insurance to pay. We have to send the balance bill statement with this letter in case the carrier requests a copy of it In order to reprocess the claim. I have attached a sample letter of what they sign at the time they signed their paperwork for the procedure and a copy of the patient involvement letter explaining the process. We did speak to Mr. ***** on several occasions and he kept stating to us that he will speak to his insurance company about this however carrier never reprocessed. My team also offers to do three way calls with the patient and insurance however he has not wanted us to do that either. Please let me know if you have any further questions or need anything further from me. Consumer Response /* (3000, 11, 2022/03/26) */ (The consumer indicated he/she DID NOT accept the response from the business.) This still doesn't' address my overall issue. I was told by the Gastro Center person at the front desk before I got my procedures done that my insurance would cover everything. The anesthesiologist from Columbia Outpatient Sedation had me signing paper work on the table right before he pushed the sedative. Because I was told from the beginning my insurance would cover all I signed to get the procedure done. I should not have to do anything else with my insurance company to get this bill paid for b/c it should have all been submitted by the Gastro Center of MD. My insurance company stated that if Columbia Outpatient Sedation wants to get paid they need to have the Gastro Center submit their portion of the bill on their behalf. Otherwise this will not be paid. I have told this to the billing department for Columbia Outpatient Sedation a number of times.

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