Memorial Herman Hospital / billing department
I have made several attempts to get this account cleared up for the last year. I will attach all the documents that I sent several times as well as several calls to Rachel Ramirez in billing. I feel that she did not do anything to get this rectified and now the account has ended up in collections. I also have spoken with several supervisors in billing as well as Marybel actually called Blue Cross Blue Shield with me on the line. They informed her that the claim was sent in after the allowed time frame so therefore the claim had been denied, and that Memorial Herman owed a refund of 500.00 to the insured as he had already met his 700.00 deductible.
First admit date was 3/22/2016 and a 700.00 payment was made. Admitted again on 4/14/2016 and payment of 500.00 was paid as Memorial Herman could not find the 700.00 payment from March. I spoke with Rachel about this and she was going to look into it, she called back stated she could not locate the 700.00 payment. I sent her a copy of credit card statement showing both payments. She still stated she could not locate the payment. I continue to call and spoke with Cassandra in billing and she was able to locate the payment and stated had been denied. I again sent Rachel a email telling her that Cassandra had located the payment and that the claim had been denied. Rachel again told me she would look into it. Well that never happened I can assume because the claim is now in collections. In speaking with collections they are disputing this as I have sent them the same documents that I sent Rachel a year ago.
Spoke with Blue Cross Blue Shield this afternoon and found out that the April service was billed which showed insured paying 500.00, then they received the March claim showing insured paid 700.00. That is a total of 1200.00 Paid by insured to Memorial Herman which now billing is agreeing that they did receive 1200.00 from insured and the total out of pocket for insured is 700.00 per Blue Cross Blue Shield. So can anyone explain how this claim ended up in collections? A refund of 500 is owed on this account to The insured.
Please help in getting this issue taken care of.