This is our first official Morris Law Firm blog post, and I wanted it to be about something that we pride ourselves on.
Not only did we get our clients bill paid, but in fact we went further.
In this case we were representing a pharmacy, that is in a very common position among pharmacies as well as MRI facilities and Durable Medical Equipment suppliers.
These types of offices have very little in the way of information about the patient to whom they are providing services or supplying equipment.
This makes them perfect targets for insurance carriers delaying and denying their bills on “verification requests” or “120 day rule” violations.
In AAA case 41-17-1060-7231 our office was able to show that the carrier demanded information from our client which was not in our client’s possession or control.
Specifically the carrier had requested that the pharmacy turn over notes from the prescribing doctor.
The carrier denied the bill after our client informed them that the requested information was not at our clients office.
The interesting wrinkle here is that our firm also represented the doctor who prescribed the medication that the pharmacy dispensed.
We were able to show that when the carrier demanded the documents in question they already had the documents they were requesting.
The prescribing doctor had sent all of their notes to the carrier with their own billing.
The carrier delayed and denied the bill from the pharmacy while they demanded that the pharmacy turn over notes from the prescribing doctor.
In DFS Complaint number CSB-2017-1234735, we submitted proof that the notes from the prescribing doctor were already in the carrier’s file when the insurance carrier tried to delay the pharmacy’s bills by demanding that the pharmacy turn over the prescribing doctors notes.
The letter written to the DFS from the carrier’s attorney states that this was a claims handling error.
It also states that they are reviewing and repaying old files where this may have happened.
Not an admission, or an apology, but I’ll take what I can get.