Healthy Foundations Group

Hello Mr. Nunn,

Thank you for taking the time to share your feedback. I understand your concerns and appreciate the opportunity to share the rationale for what, at a glance, may seem to be unusual or inconsiderate. Transparency breeds trust and is something we do our best to foster, particularly with those who are not currently clients of our practice.

First, I'd like to clarify that maintaining a credit card on file is encouraged but not required. We have found that keeping a card on file helps clients keep their accounts current and cuts down on any stress caused by the need for us to reach out regarding outstanding balances.

Regarding insurance billing and claims. Let me start by offering that ours is a standard practice across healthcare settings. It is separated by two categories, in-network billing, and out-of-network courtesy billing. In both instances, insurance companies, from a regulatory standpoint, have 30 days to respond to a claim once submitted.

In-network billing is a straightforward process because the insurance companies will speak directly with us and we’re able to manage a claim. We are contractually obligated to abide by the insurance company’s decision and strictly adhere to that obligation. Once the insurance company responds (generally within 10 days but can take up to 30), we share that response and clients are notified. It is only then that we bill the client; automatically charge the card on file for the amount the insurance company has indicated should be charged.

Out of network billing, which we do, when possible, as a courtesy to help reduce the up-front cost of care, is a bit more complicated. While the same 30-day rule applies, insurers will often not speak to us (because we are not contracted with them) and will frequently send the payment/explanation of benefits directly to the client. One thing we do know is after 30 days, the claim has been processed which is why we switch the billing over to the client at that point. Similar to the In-network process, the client is notified, a bill is sent, and we charge a card if it is on file.

Thank you again for your feedback and the opportunity to address your concern, as well as that of others who have not been seen by our practice.

V/R,
David I. Driver, M.D.
301-970-4010

Dear Ms. Russel,

I appreciate your feedback; it helps me to improve the services we provide. Because of the need to maintain your privacy, I cannot respond publicly to your issue in detail but will do my best to address it broadly in the context of our policy.

The billing process is complex and can be frustrating, particularly when someone is getting conflicting information from a provider and an insurance carrier. We do our best to avoid being triangulated by insurance companies. This is one of the reasons why we share the full financial and insurance submission history in the patient portal and use a third party to validate that our claims are submitted correctly. Additionally, we send weekly statements to keep our clients aware of where their claims and any balances stand, and clients can follow their claims, in detail, in the patient portal. In the event triangulation occurs, we advise clients to file a complaint with their state insurance commission; I have created a tutorial on how to do so that is posted on our website.

We send bills to insurers (both in-network and courtesy billing) using the information we are provided. The timing of when we are given information, the accuracy of it (e.g. which insurance is primary and which is secondary), and the timely filing limitations, and any need to make changes to previously filed claims all have an impact. When a secondary insurance becomes relevant, depending on which policy is primary, and which is secondary, we may have limitations in our ability to provide support.

I took the time to review your account to better understand what has occurred and am happy to talk with you to discuss the various options that are available to you. If this is something you are open to, please reach out to me directly. I remain available indefinitely.

V/R,
David I. Driver, M.D.
301-970-4010