Public Mediation

Patient Should Not Pay for Medical Office Coding Issues

L. G. vs. Riverfield Family Health Center
United States
Amount Involved: Other terms
    • Status: In Negotiation
      This claim has posted for public comment and negotiation. It will remain posted until resolved to the claimant's satisfaction. Suggest a resolution to help these parties reach a settlement.
    • View response from: Riverfield Family Health Center
    • Claimant Seeks: 1 non-monetary items.
    • Claim #: 1312043
    • Amount Involved: N/A
    • Filed On: Oct 01, 2010
    • Posted On: Oct 16, 2010
    • Complaint(s):
      • Questionable Business Practices
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Statement of Claim
Complaint Involved (1) - View
Claimant says:
"I transferred to Riverfield Family Health in June 2008 as my family doctor after 17 yrs. with another physician (due to location). I made an appt with them for an encounter visit for monitoring of pre-existing conditions (migraines, anxiety/depression, GERD, allergies), blood tests, and renewal of prescriptions. My previous primary gave me an annual EKG because I had beenthe emergency room 3 yrs before with chest pains. When I saw Dr Karpinski at Riverfield she examined me briefly and we discussed my previous conditions. My prescriptions were renewed but there was no blood or urine tests conducted, nor was an EKG run. On Feb 5 2010 when I went for a physical I had to ask for blood test to be drawn and the office told me that it had to be read at Hunterdone Med Ctr even tho my provider only pays for Labcorp. I insisted it go to Labcorp and the nurse reluctantly labelled it so telling me that the dr. would be upset because they were affiliated with HMC. I had to ask for the EKG when in fact, had they read my chart, they would see that I had been receiving regular EKG's as part of my physical since the ER event years before. When I first met Riverfield dr in 2008 I told her that I had been out on 3 leaves of absence at work - 1 in 2005 for 8 weeks, 1 in 2006 for 3 weeks, and 1 in 2008 for 2 weeks - all stress/anxiety. I also asked if she had read my chart fromthe previous doctor and she said yes. Riverfield Health is billing me $282 for my 2010 physical stating that I am only entitled to a physical once every two years according to my plan. That is correct, but my first encounter visit (2008) was not a physical and should not have been billed as one. I have refused to pay the bill, stating that I did not receive the services they are billing for. I have talked to their office manager and billing office - they offered $15 off the bill. I am not paying the bill PERIOD. Riverfield Health is located at 3 Minneakoning Road, Flemington NJ 08822-5726 billing 908-284-1125"
...
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What Claimant Wants Hide
Non-Cash
What By When How Much
1. $0 balance on my account [$282 credit] Oct 30, 2010 N/A
Cash
1. Other – Physical delivery charges Oct 30, 2010 $2.00
Cash total : $2.00
Non-cash: 1 items
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Respondent's Counteroffer Hide
The claimant's settlement terms were rejected with the following explanation:
  • I disagree with the explanation / grounds provided

    "We certainly appreciate the patient's concerns and have reviewed all existing documentation connected to this case. The facts mentioned are not correct. The patient should contact our billing office. We have offered terms she did not explain accurately. We also offer very flexible payment plans for such cases. In addition, we have had certified coders review the documentation to determine if the visits were coded correctly and have found no inconsistencies. "

This claim will remain posted until resolved.

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