My CCRM IVF Journey

Our successful journey through IVF #2 at one of the world's top fertility clinics

Waived Fees and Credits

Posted by auntiem10 on May 12, 2010

I’ll be honest and say that I haven’t been impressed at all with CCRM’s business office, with the exception of one person: the account manager. I do not want to publish this person’s name on a public forum, but I have been very impressed with the way this person has handled two recent headache-inducing billing mistakes made by the business office.

Recent Billing Situation #1: Remember this post? We had received a $150 bill in the mail from FLC a few weeks ago for the genetic counseling session we had attended as part of our one-day work-up. The business office told me I would have to wait until my regroup with Dr. Surrey and then ask him to waive the fee. I feel that the regroup should be utilized for treatment-related questions, not billing issues, so I was unhappy with this suggestion.

Last week I called the business office to ask about FET costs, and I was (fortunately) transferred to the account manager. I mentioned the FLC billing situation casually, and this person immediately talked to Dr. Surrey. Ten minutes later, Dr. Surrey had agreed to waive the fee!

Recent Billing Situation #2: Last Friday, we received a receipt in the mail, indicating that CCRM had charged $100 to our credit card. I researched the claim online and found that my patient responsibility was $0. My insurance company confirmed that I shouldn’t have been charged.

Basically, the business office had submitted a global billing code for the hysteroscopy + consultation with Dr Surrey, for charges totaling $750. My explanation of benefits showed a network discount applied of $250, reducing the total charges to $500. My insurance company paid CCRM $475, and I had paid a $25 co-pay before the hysteroscopy. These payments = $500, which was the total charges after the network discount.

CCRM’s business office claimed that the network discount should have been only $150 (20%), and that my insurance company had actually denied the office visit portion of the claim ($100). The CCRM account manager was out of the office yesterday, so I spoke with another business office employee when I called to discuss this matter. Although our conversation started out nice and calm, it quickly got heated. I explained to this employee that since the billing code was for a “global” procedure, CCRM could not charge me for only a portion of the claim (information given to me by my insurance company representative). Instead, they needed to issue a refund to me and write off the $100. My request for a refund was unequivocally refused, and I hung up. Last night, I spoke to my insurance company yet again, and this conversation led to them issuing a letter to the CCRM business office demanding that they refund the money and appeal the claim if they are unhappy with the way it was processed. Bottom line: they NEVER should have charged us.

Today CCRM’s account manager returned to work, and the whole debacle was quickly resolved. It turns out that my insurance company was correct all along, and I now have a $100 credit (which I asked the account manager to send me in writing). The mean girl inside of me wants to call the rude business office employee from yesterday and say HA! However, I will refrain. : )

Today I am faxing a letter instructing the business office to REMOVE our credit card information from their records. We want to be billed for everything from now on, effective immediately. I think most of the claims from our ODWU are processed by now, and we are OOP for all treatments, so I don’t think they have much else to charge on our card. But still! In my opinion, their business office leaves something to be desired.

Moral of the story: If you encounter issues with the personnel in the business office, you might want to ask to be transferred to the account manager. This person is extremely kind and wasted no time in getting both situations resolved for us! Also, any time you are billed by the business office, I highly recommend calling your insurance company to verify that you were charged appropriately. As you can see from our situation, they do make mistakes (sometimes to the tune of $250!).

Advertisements

3 Responses to “Waived Fees and Credits”

  1. R said

    Great news that they refunded your money.

  2. JL said

    Need help on this. So I have a 5000 fertility benefit that I have maxed out (lifetime). My husband has one also which is also 5000 unused. I called to verify if the consultation would be covered under my 35 co pay and the business office said no. Anything billed from there will not be covered. and i said well can we do the consult under my husband and she said its fraud since i’m the patient?? So my question is, can we schedule the consult under my husband’s name so he is the patient?

    • auntiem10 said

      I am not sure if you can schedule the consult under your husband’s name! I do know that the only insurance accepted by the Fertility Labs of Colorado is United Healthcare, so I think you would have to pay upfront if you have different insurance. I suggest calling the account manager directly. Can you e-mail me at ccrmjourney@hotmail.com? I can give you the account manager’s name and number, but I don’t want to publish it publicly! My experience has been that I’ve hit a brick wall any time I’ve spoken with the business office, so it is definitely worth looking into a little more before you just pay all of that money upfront.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

 
%d bloggers like this: