"Dear doctors: The purpose of this letter is twofold: (1) to discuss Specialty Surgical Center and (2) Tina who handles your insurance. My surgery was January 31, 2012. On that date, and due to my high deductible, Specialty Surgical Center collected the sum of $2,000 from me prior to surgery. In addition to that sum, I have been paying your bills in full. Last week, I received a bill from you for S926.00. I was upset and mystified as to how my deductible still had not been met. Obviously, something was terribly wrong. I called Tina and asked her why my $2,000 had not been taken into consideration. It took several conversations and swapping faxes before Tina cracked the code. The $2,000 that I paid on the date of my surgery is not part of your billing. (Forgive me, my profession is law. That I can do. Insurance simply confounds me). I clearly remember Tina telling me "The problem is with the surgery center. They are either holding up a claim, or they submitted a faulty claim. Call them because they are holding up your deductible." Tina was right! As of May 16th, Specialty Surgical Center still had not submitted a claim. This failure to timely submit a claim (for which they were paid) put me in Deductible Limbo. I advised my healthcare provider of this problem, submitted my proof of payment, and my representative made immediate and continued attempts to contact them using the phone number on the payment slips. She left message after message and never received a return call. Only because she had her surgery at that very facility, and because she knows I live in that area, she called the Westlake Village facility and was able to speak with someone to help me resolve this. As of Monday, May 21st, the claim is finally in the system. That's 111 days after the date of surgery. I find this unacceptable. I also thought you'd appreciate knowing these facts: (l) Specially Surgical Center is remiss in their duties to submit their patients' claims in a timely manner, especially when they have collected their fees in advance and (2) Tina knows her business. I owe her many thanks and I have told her so. I will retire my debt to you upon resolution of this regrettable situation."
Westlake Village, CA