The Epilepsy Institute of NC & Dr. Marsha Webb located at 1311 Westbrook Plaza Dr Ste 100, Winston Salem NC, #336-659-8205 blatently billed my insurance for services that were never rendered on a particular date of service. This office has now billed me for three hours of neurological tests performed on my minor child both for dates of service 2/24 and 3/22. I will agree that the tests were performed on the date of service 2/24. The date in dispute is 3/22, which is a date that MY SON WASN'T TESTED AND WAS NOT EVEN PRESENT, and school records back this up. The actual appt in question was for the doctor and myself to go over test results for tests administered on the PREVIOUS 2/24 date of service. Of course, insurance denied the duplicate claim so the doctors office attempted to pursue me for the bill.
When I contacted the billing department (Tom) on 6/5, he basically called me a liar, loud talked, berated and talked over me, flat out refusing to answer ANY of my questions as to why I was being billed for services that were not performed on 3/22. When I tried to explain to him that my son could not have possibly been tested a SECOND time and was not even present that day, his reply was basically OH WELL THAT IS NOT MY PROBLEM, THIS IS WHAT THE DOCTOR PUT IN THE CHART AND YOU ARE RESPONSIBLE FOR IT!!!
After that call ended, I voiced my complaints via every avenue possible... The NC Attorney Generals Office, the NC Department of Insurance Fraud Division, all of the local news stations I could find and my Facebook page. At 8:13 am on 6/6 I left a voicemail for Dr. Marsha Webb herself advising her of my experience with Tom, reminding her that my son was NOT present at the appointment the day they are fraudulently billing me for testing and giving her an opportunity to rectify the situation before it went any further. She immediately called me back at 9:19 am and quickly advised me she would write off the bills if that was to my satisfaction, I asked her to send me documentation supporting this, she agreed and then rushed me off the phone.
Several hours later at 2:11 pm she left me a voicemail that she had talked to TOM and at this point they changed their minds about writing off the bills and I would need to discuss the matter with TOM (I saved this voicemail). Shortly after that at 2:57 pm, I received an irate call from TOM stating that he listened to my "tirade" on the doctors voicemail and he is aware of all my Facebook posts complaining about their business and he has contacted their attorney and IMMEDIATELY hung up on me before I could respond. I immediately called him back and asked him why did he call me just to hang up on me and why has this escalated to this point. His excuse was that I was irate when we initially spoke on 6/5 about the billing and that he felt that I, and I quote, "backed him into a corner and that's how he responds if he feels backed into a corner"..??!! I told him if questioning him about being billed for services that were never rendered is what he considers "backing him into a corner", then that's unacceptable and so is the manner in which he responded to my questions. I advised him of course I am irate because everytime I try to determine what/when I was billed for, he raises his voice and talks over me never allowing me to finish. So he tries to explain again that the bill was for three hours of testing done on my son on 3/22. When I finally got him to listen to the fact that my son was NOT there and I had proof AND that the doctor is aware of this, he then changed his story around and said the charge was for them scoring my sons test results that morning. Again, I pointed out that when I arrived, his office SOMEHOW had misplaced the test results that they had ALREADY PREVIOUSLY SCORED PRIOR TO THE APPT on 3/22 in some random file (they never found that file) AND that I had to wait an additional hour in the lobby while the guy scrambled to re-score the test results so that the doctor and I could finally go over them... And that I am certain the doctor remembers the situation because she was overly apologetic about losing the results, she just didn't know how that happened, and she will get them to re-do the scores quickly cause she knows I have to drive an hour to work... Etc etc... And even sat in the lobby with me for about thirty minutes keeping me company. When I finally DID go into her office to go over my sons test results, I was there for about an hour and when we were done she advised she would compile a complete 8-9 page report and would mail to myself and my son's school to help with his IEP/Section 504 evaluation. So I told him again, NO TESTS were done and why are you now claiming I was charged for re-scoring because your office lost the original test scores??!! He just acted surprised to hear I never got the doctors report and that they had LOST his scores in the first place, but claimed he would investigate what exact services were rendered on 3/22 and what happened when he can get wih the doctor.
Well about 30 minutes after that conversation, I got a call from Mrs. Young at the NC Atty Gen office who offered to call him on three way to attempt to get some of my concerns addressed before she went forward with actually having me file a complaint. When she asked TOM to explain specifically what the bill for 3/22 was for, he AGAIN changed his story and said that the bill was for three hours the doctor spent writing the test result report (a report I have yet to get and its been 3 months). So, that makes THREE different explanations/reasons for what the charges are for on just ONE of the dates of service 3/22. So I asked him to confirm that he is now saying that the $510 bill was for "three hours report writing" that the doctor billed on that same day, He said correct, billed at $170 an hour. I asked if he was talking about the report that they never sent me? He replied well yes but he is working on getting me that report. So I asked has the report even already been done? Well he replied that he couldn't seem to locate it in the file and he hasn't had time to talk to the doctor, etc etc. I replied by telling him now he should understand why I am irate, because you tell me different stories everytime we talk, you lose my sons personal health records that have yet to be found, and you can't even give me a clear answer of what I am being billed for on 3/22. I advised the rep at the Atty Gen office that I really hope that Tom and the Epilepsy Institute takes every step to rectify this and I will give them until Friday 6/8 to call me back before I go forward with filing a complaint.
Interestingly enough, when I got home tonight, I pulled out my itemized statements for all three dates of service, and sure enough it clearly notes that on two separate dates of service (2/24 & 3/22), I was billed for NEUROPHYS TEST BATTERY, when my son was only tested in that office once on 2/24. The date 3/22 is the date in question that my son was not present AND that TOM in billing has changed his story on three times. This itemized statement came directly from the doctors office themselves and is a clear indication that something is amiss here and this could clearly be considered a cause of fraudulent insurance billing.
Melissa Winston-Salem, North Carolina
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