Insurance Issues

October 23, 2006

Dear Dr. Akey,

In all the time I have been your patient, I have never received what I believe to be adequate support from your accountant/financial representative.

Recently, I received an invoice for $441.00 with a request for payment for office visits in 2005! Why is she sending out invoices a year old? I don’t understand the issue between Blue Cross and your office, but I suspect that much of the problem is related to the total confusion surrounding what patients were expected to do.

I understand that you have concerns about providing your patients with the best possible help and that taking on more patients to make Blue Cross happy is an ethical issue for you. At the same time, when I came in on numerous occasions, I was given conflicting information by different office staff.

In fact, based on conversations with your office staff, who were very helpful in general, but who seemed as confused as your patients over what was required, I actually submitted approximately 7 or 8 invoices for payment.

Frankly, I wasn’t sure who was supposed to get money from BCBS, and I honestly can’t recall getting any checks related to refunds for office visits from them.

I work really hard and very long hours. I love having you as my primary care physician, but I can’t spend hours trying to figure out what Valerie (?) did and why she can’t get an appropriate response from BCBS. Is there some legal reason why they will not respond to Valerie, or is she refusing to contact them? I have never had a doctor’s office finance person who was not available to discuss invoices and payments in person and who almost never answered the phone when I was able to get a few minutes to call. When it comes to healthcare, getting the billing right is a big deal, and getting courteous service from the billing person is important.

Now Valerie is asking patients to submit year-old invoices for payment. Why can’t she handle this? Is there some reason why she can’t deal with BCBS? She has certainly made a negative impression on me. I feel that she should be required to follow up on whatever mess was made. I’m not sure when the problems you had with BCBS started, but I can’t believe that it should have taken this long to contact me and demand immediate payment. I will have to go back into my records to find out what I paid over a year ago. I was really offended by the fact that she wrote “we will NO LONGER be sending out duplicate statements” when this is the first time I have heard about this in a year.

I will make a call to BCBS, and I will mail them a copy of the statement I just received. It would be nice if I could get copies of the original invoices. Apparently, however, there are no invoice numbers available, so I’m not sure how they can be tracked down. I’m also not sure how quickly I can get a response, but I will try.

I’ll make sure that you get payment one way or another, but I feel that your patients could have been better served by your billing person.

I hope all is well with you. Happy Halloween.

Cordially,

Kathie Gagne