First off understand that the problems prevalent with this business appear in my opinion to be companywide. Not just with this one location. They are a modestly large specialty medical practice with offices throughout Arizona. A quick search shows they are owned by Cencora. Online sources claim Cencora is one of the largest pharmaceutical companies in the world with partnership ties to Regeneron. This looks like a vertical monopoly, manufacturing, distributing, and controlling direct to the client services.
Retinal Consultants of Arizona (RCA here after) sees my mother for retinal care. I took over my mother's finances a little over a year ago when my father died. In all that time I have never seen a single bill from RCA. Not a bill. Not a statement. Not even a request to cover a co-pay.
Last week I received a collection notice from a collection agency on behalf of RCA. All I could think is wow. They gave the correct address to the collection agency. I'm sure they could have mailed us a bill.
About 6-8 months ago I stood there face to face with RCA employees and asked about any balances due. They stated they would have somebody with their main office get in touch. I'm not sure which main office that would be, but RCA lists five "Main Offices" on their website. Nobody reached out to me. In my opinion that is highly suspicious.
This week my mom had an appointment. I asked up front for billing, explained she had been sent to collections without ever having seen a bill, and offered them the opportunity to refuse service if their was a legitimate unpaid balance, or they could call their main office and have somebody talk to me. I was told, "There is nobody available to talk with you about this." I was stunned. Now I know they probably can't collect an amount that has been turned over for collections, but to not even be able to tell us why we have not received a bill, or provide billing details is really egregious.
Now, I suspect there are other things going on as well. I can't prove them but the optics are not good. Regeneron has the distribution rights to a medication my mother gets at her visits. Regeneron is in partnership with Cencora. If they play games with billing, don't bill or don't bill properly with Medicare & United Health, & fail to get prior authorizations they might try to collect the full retail price from my mother. Its a very expensive medication. A single dose costs more than twice her monthly take home from Social Security. From the outside it looks like they may be playing fast and loose with Medicare and United health to the financial detriment of their clients. I can't prove it. It just has that look and feel. After talking with the doctor at my mom's most recent visit I am 99.999999% certain they never got a prior authorization for the medication. I don't know if Medicare or United Health has paid them... because I never received a bill from RCA.
During the time period in question there was what appears to be a less than amicable change of venue for RCA's Yuma office. Previously they had been using the facilities of Southwest Eye, and currently they are using the facilities of Aiello Eye Clinic. There may be some games being played there as well regarding billing, and who billed and got paid. It could be contributing to my mother's billing issue. I don't know, but again the optics are not good. During the prescription refill debacle detailed below we got what I perceived as indications of hostility from Southwest Eye.
Now as I looked into RCA, Cencora, and Regeneron I was told by a couple different people that Southwest Eye is also now owned by Cencora. I have not verified that from a 100% trusted sources, but people at RCA were among the sources. In my opinion this has the feel of a corporate shell game designed to make it difficult for small players like my mom or me on her behalf to figure out what they are doing.
After getting nowhere with the staff I spoke to the doctor my mom sees. We got nowhere with him, but he did say multiple times they had heard the same complaint about patients being turned over to collections in spite of never having received a bill. He said it twice. Multiple? It sure sounds suspicious to me that multiple patients have this particular complaint. If they gave the correct address to the collection agency they have the correct address to send a bill. The doctor at first tried to say, "I am just an employee and I have nothing to do with that."
Maybe not just an employee. I ran across a business card and under his name it says PARTNER.
Complaints have been filed. read more