IS AUREON CLOSED FOR GOOD?

To file a Better Business Bureau complaint in US or Canada, start at http://www.bbb.org and indicate country (US or Canada). When you enter the name 'Universal Fidelity LP' and zip 77094, it will show you the company's name. It will automatically file the claim with the Houston office, based on the company's location.

 

I too sent my letter of cease and desist, contacted the BBB in TX. They sent the same result as above and I am waiting for the official letter from Universal. The only thing these actions have accomplished is to stop this collection company from further action. This does not mean that Aureon will not attempt to collect from us directly. Many thanks for the people who posted excellent information and form letters. By the way, the addresses on the Universal "bill" is for payment. The address for disputes is findable by going to the bbb link and entering the collection company name, as described above: it is 1445 Langham Creek Dr. Houston, TX 77084
T/P 281-647-4100.

 

The aureon.com website of course no longer exists, but an archived version can be viewed at: http://web.archive.org/web/20110722013944/http://www.aureon.com/ . Not all of the links work, but you can view brochures, management team bios etc from July 2011 backward. This may help provide background for actions.

 

Hey why don't you contact the former CEO of Aureon Rob Shovlin who is now at Bostwick Laboratories and ask him what you should do?

 

You call also call the former Board of Directors of this failed company and ask them what to do

 

to post #109, the prior post: Were you aware of this testing? I'm just curious. I had already left the urologist who sent out my testing to have surgery elsewhere, and two weeks later, he sent out the core. This may not be illegal but it's definitely unethical. It also means that no results from this test were ever used - since I was already having a prostatectomy at another hospital. I would wreck my credit rating prior to paying this bill.

 

Well, in fact maybe you were not obligated to pay. Many urologists had written agreements with Aureon to not balance bill their patients. And yes, we all sign forms saying we are responsible for services not covered. However, this particular service is a gray area because it was out of network for most insurance carriers and Medicare was never going to pay over $3000 for a future predictive risk assessment tests. Plus the fact that obviously Aureon knew that they were not suppose to balance bill because no one received an invoice of any kind before being sent to collections over a YEAR after the company closed their doors.

 

What was the reason BC/BS denied coverage? My insurance company (not BC/BS) denied the claim twice because Aureon did not provide additional information as requested by my insurance company. I don't know if my insurance company would have paid this had Aureon provided the information...it never got that far.

 

BC/BS was paying on some of the codes (for us, $950) until the Blues made the decision that lab work was required to be sent to local labs even for out of network. From what I have read on the internet, this is part of the reason that Aureon Labs closed. If your lab bill was submitted after this decision, then there would be no coverage for these tests.

 

They also closed because their test was a "LOAD of BUNK"!!

 

I hope this isnt the future of "personalized medicine". Niche labs ripping people off with tests that are of no use.

 

Report all of this to your state insurance agency or if you are a medicare patient report it to a medicare fraud hotline if you have medicare insurance. Whoever bought the receivables is just trying to bully you. Hope this helps.

 

As others said might be the case, this issue has not gone away after all. After my original post (#97) I had followup correspondence with Blue Cross about this claim, and they notified me last week by letter that they had declined to pay the original claim from Aureon since the procedures were determined "not to be medically necessary". Then got another letter today stating that Aureon Laboratories Inc. had submitted a request for reconsideration to Blue Cross, and they had again denied claim because the "prostate px test is not a suitable replacement for existing methods for prediction of prostate cancer recurrence." I received a copy of the Aureon reports from my urologist that consistetd of a "histology diagnostic report" plus the "prostate px report", so I don't understand why Blue Cross won't at least pay the claim for the histology report. Next step is to get a copy of the request for reconsideration from BC to see who/where it came from, since Aureon's supposed to be out of business. I'll share here if I find out. I also have 6 months to request my own reconsideration from BC/BS, although don't really expect any success with that route. Also need to get a copy of everything I signed at the urologist's office at the time of the biopsy to see whether they had the authority to submit to a non-network laboratory or for unproven tests. Depending on outcome, will likely also followup with complaint to state insurance commissioner -- they're very pro-consumer in my state so might be of some use in pressuring BC/BS and/or urologist to get this resolved.

 

Many thanks to #117 post. I agree that there must be some responsibility on the part of the urologists, who did not seem to think that their patients would should have been informed re: out-of -network/experimental tests, or that they might have been able to opt out of experimental predictive tests. I have a feeling that there was a bit of a cavalier attitude on the part of the physicians in that Aureon assured them of no financial blow-back onto the patients. I too have thought of obtaining the forms signed at the time of surgery. I would like to think that none of us signed anything that would turn over financial decisions to doctors without some form of informed consent without warning of possible denial of claims. I still believe that forms signed by patients re: financial obligation, is to the physician, not to any entity they decide to use. I will be following here to see the outcome of #117's post. I have yet to receive any confirmation of delivery of my cease and desist letter to the collection co. and I sent it 08/23/12 via certified mail with signature confirmation. I sent it to the address listed from the bbb.

 

When this first happened, I paid an online attorney for advice, thinking that the urologist did not have informed consent. I have copied part of his response.
First, I want to convey that I am on your side in this matter, and that renegade medical providers and obstinate insurance companies are two of my biggest pet peeves. That said, below are the facts, both good and bad. If I have misunderstood any part of the situation, I will be happy to reevaluate my response based on the correct information.
The beginning of your question mentioned a concern about application of this bill to your deductible ...
With regard to a business being "closed," such status does not, in most cases, prevent the collection of debt. This is the case because the entity may either not be fully dissolved, or it has assigned its right to payment to another business, such as a collection agency or debt buyer.
With regard to not receiving bills, you will not be able to rely on the non-receipt as a valid defense to payment. This is the case because, the way the law sees it, an obligation was incurred whether the patient is properly billed, or not. Additionally, allowing a defense on this basis would allow dishonest patients to claim they never received a bill and therefore don’t have to pay, and would also allow a defense if a person moves and does not leave a forwarding address. Obviously, neither applies to you, but that's the rationale the courts apply.
With regard to authorization - similar to the rationale in the last paragraph, the law will imply consent to the bill from the new provider by the fact that your husband presented for treatment with the originating provider. The law is unanimous in all states and extend consent to each and every "spoke" provider with whom the original provider contracts to provide services on behalf of the patient. Authorization is implied and not expressly required.
Quite unfortunately, it is not a medical provider's legal obligation to tell the patient what charges are in network in which charges are not, and this includes contract providers down the chain, such as the one that ended up with your slides. The law places the burden on the person who is insured to do the research, ask questions and find out, if that person has a concern. Therefore, disputing the bill based on not having been provided with this particular information does not trigger an informed consent issue and is neither legally valid, nor will it be accepted by the insurance company. Additionally, signing paperwork to authorize additional "spoke" providers, is unnecessary, as discussed, above.
That said, any provider who over bills, duplicate bills, or obligates the patient to a test not reasonably linked reasonable treatment for a particular condition, or tests conducted in disregard of the patient's express instructions to refrain from testing, and even the express instruction to refrain from particular sub-provider could be legally valid reasons for withholding payment.
AND
If the provider is one that normally bills the insurance, whether in or out of network, and that provider failed to do so within the time provided by the insurance company (usually one year) it cannot thereafter turn around and collect from you an amount that would otherwise have been available through insurance. In such a case, the negligent delay is the fault of the provider and you can be relieved of part or all of the obligation. The way this usually works is that the total bill is offset by the amount that would have been paid by the provider, and you would only be responsible for the amount the insurance company, itself, would have attributed as your portion of the payment.
With regard to your proposed letter, I believe I have touched on each of the facts you mentioned and explained the way the law, and the insurance company/provider will treat each one. I do not have access to the letter that lwpat provided to you, but he's a smart attorney. If lwpat had access to the same information you provided in your most recent question, and provided a letter for you to use, I would trust that the letter will provide you with much benefit.
I would also suggest taking the possibilities conveyed in my letter, and consider the extent to which each applies to you. If you find something applicable, you may want to incorporate it into your main correspondents and will certainly want to use it to maximize the potential benefit in this unfortunate and most frustrating situation.

What we did was the Better Business Bureau as I stated in earlier posts. This seems to be the best way to go. Hope my $30 purchase of advise helps others!

 

I am no lawyer, but from my perspective if you are on medicare the situation is somewhat different. Aureon's policy for providers stated, in writing, "we do not balance bill patients" and also "we do not ask for an ABN to be signed". An ABN (Advance Beneficiary Notice of Noncoverage) is the form that medicare requires that a provider give the patient to sign if he suspects that a procedure he is contemplating may not be covered by medicare. Aureon submitted to medicare a claim for five items, totaling $3,200. Medicare paid for four of those items a total of $996, but declined to pay for one (code 88399)for $1881. The Medicare Summary Notice provided to the beneficiary stated "(a) Medicare does not pay for this item or service" and "(b) It appears that you did not know that we would not pay for this service, so you are not liable. Do not pay your provider for this service". Medicare rules say that if a provider accepts payment for any part of a claim, the provider has to accept the medicare payment as paid in full. So, my position is that the "debt" does not exist, and anybody trying to collect anything is committing fraud.

 

Thanks for posting the legal information above. It was helpful to me.

 

Out of curiosity, has anyone had an adverse issue on their credit report?

 

I ran our last credit report on aug 24th and the only thing that showed was an inquiry that was done in july, two days before they issued the confidential memorandum. I have to wait until next week to run a new report.

Apparently the new owner sent a request for consideration to big blue but i haven't heard anything from UHC.

 

The new owner of Aureon, turned over the accts of patients who had received the prostate px test, etc. to Universal Fidelity, LP, a collection agency, who in turn sent out "confidential memorandums" to patients from years 2010-2011 in an attempt to collect money.