ComplaintsforPathology Laboratories, Inc.

• Initial Complaint

  11/30/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My husband has received services at Pathology Laboratories in Tiffin Ohio on several occasions. Specifically, on the dates of 4/25/22, 10/19/21, and 10/25/21, Pathology Laboratories misbilled the claims under my name (the insurance holder) instead of my husband's name. We notified both Pathology Labs and medical mutual several times to get the bills corrected. As of November 2022, all bills were finally put into the correct patient name which left med mutual reversing the claims and taking back payment for the claims in the improper patient name. As of today, 11/29/2022, Pathology labs has failed to correctly bill medical mutual and continues to attempt to collect from me in the amount of $1650.05 despite notifying Pathology labs of the problem and despite sending pathology labs the explanation of benefits from the rejected claims. Pathology labs have continued to misbill and are uncooperative in correcting their error by submitting correct claims to the insurance company. This has taken over one year to get claims out of my name for medical care that would otherwise be showing on my record and Path labs has still not corrected the full problem.

  Business response

  12/01/2022

  To Whom it May Concern:

  I have reviewed the consumer's complaint in detail and agree with her assessment that PathLabs has failed to bill her accounts and make appropriate adjustments timely.  I am embarrassed by the number of mistakes my billing team has made with these accounts.  First, the Initial Biller selected the wrong relationship code which sent the claim to Medical Mutual with the subscriber as the patient.  This employee has reprimanded and now fully understands the consequences of cutting corners and not properly checking and updating every field.  Secondly, when the customer care call was placed to our Customer Care Team, they failed to follow procedure and escalate the concern to a Medical Billing Specialist who works closely with the insurances and would have immediately submitted a corrected claim.  Instead, the Customer Care Rep attempted to correct this on her own.  Therefore, resulting in lack of corrected claims being submitted and attempts to correct the balance which resulted in multiplying the balance.  This employee has also been reprimanded.  

  In summary, the two accounts that needed a corrected claim filed with MMOH will be sent tomorrow (accessions ********** and **********).  The third accession, has been corrected and is now at a zero balance.  

  I regret that my team's errors have caused you so much distress and can assure you that I will monitor your accounts for resolution.  We appreciate you using PathLabs as your laboratory choice and hope you continue to do so.  In the future, please do not hesitate to reach out to me personally if you encounter billing issues.

  Sincerely,

  ***** ******

  Revenue Cycle Manager

  ********************

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