Upload STFH20240806000501013001.pdf.txt

STFH20240806000501013001.pdf.txt

@@ -0,0 +1,49 @@
+     - « o   s                                    # A P t n d
+     ft.  COMPANY,.                                      V  I ^ I h I  % l ■  ■ U
+
+  Postr Office Box 589 
+  LaGrange, Kentucky 40031-0589 
+  Phone:  1-888-258-8060 ext. 4581 
+  Fax:  502-753-7380 
+  Patricia Murray
+
+  July 26,2024
+                                                      COB REFUND REQUEST
+                                                                     Third Request
+  St. Francis Hospital/The Heart Center 
+  Billing/Refund Dept 
+  PO Box 95000-6560 
+  Philadelphia, PA  19195
+
+
+ RE:  Patient: KAMENEY RAMSAMOOJ            Date of Service: 01/29/2024 - 01/29/2024
+      Patient ID#: 49200807800              Refund Amount: $150.50
+      Patient DOB: 07/25/1965
+
+ATTN: REFUND/BILLING:
+Our Client, Aetna, has paid benefits for services identified above as the Primary Insurer in error. Oxford 
+Health Plan, located at PO Box 29130, HOT SPRINGS, AR 71903, should have paid for these services 
+as primary. *See Claims Detail on reverse
+We  have  previously  sent  a  letter  regarding  this  matter  but  have  not  received  a  refund.  It  is  very 
+important that we are contacted as soon as possible to ensure that the correct primary insurance has been 
+invoiced.  Upon receipt of the notice, please contact Jennifer Waford at (502) 716-6979 to discuss this 
+matter.  Please  respond  or  submit  a  refund  within  30  days  to  resolve  this  matter  and  avoid  further 
+collection efforts.
+Otherwise, please send this letter and a copy of the EOB or EOMB from the primary coverage with your 
+payment so that the overpayment amount can be correctly calculated.  Please forward to:
+The Rawlings Company LLC 
+P.O. Box 589
+LaGrange, KY 40031-0589
+Sincerely,
+Jennifer Waford 
+FILE #3824-4018173, pm2
+
+
+                                                                      AETNA_LDL3_COMM
+
+
+        Aetna is the brand name used for products and services provided by one or more of the Aetna group companies. (Aetna)
+   Aetna performs administrative services, including overpayment recovery and collection, for other health carriers including but not limited to: 
+                Innovation  Health, Texas Health Aetna, Banner Aetna, Sutter Health Aetna, and Aliina Aetna.
+I     Claim #      I*  Service Date  Patient Account    Billed Amount      Paid Amount           OPID
+I  EQJNCX52M00  I     01/29/2024   I  13240090299404  |    $772.00     I      $150.50      |  •  80451456  ~~|