Surgeon Abandoned his Patients - Dr. Eric Pinnar

[Cocoabean 430]

What may be interesting to note is that in the last 14 business days I have received 46 explanation of benefits from 3 insurance companies (1 of which has not been active since 2007 and I had surgery in 2010)....these EOB's state that Dr. Eric Pinnar is billing all my insurance companies for nearly $150k of treatments and procedures and when I looked up the procedure codes some of these procedures are for things I never had! I've got calls into the fraud departments at all insurance providers and a fellow Pinnar patient who has become a friend of mine also has had repeated claims filed for surgery and aftercare that we both paid $17,000 up front for. Fraud at its finest. The "billing department" that was given to my insurances listed a number that was tied to a Synchrony Health which was tied to Dr. Merchia's personal residence in Great Falls, VA where it lists him as selling it in summer of 2011. Shady.

Would be interested to hear what anyone else has to say?????

I am curious, is this the old owner of practice doing the billing or the new owner? As in, is the new owner going back through the records and billing for services provided by the person he bought the practice from, and perhaps the original owner has no knowledge?

I have no vested interest in this issue, but find fraud horrifying.

[debmorgan 0]

Im getting EOB's too. I was a self pay patient that subsequently got insurance and made the mistake of supplying the information to Dr. Pinnars office. They began billing my insurance (before the sale) for office visits even though I had unlimited visits for two years under the self pay agreement.

Fast forward almost three years later, I'm getting EOB's from my former insurance company with charges for office visits at $933 a pop. I received one set for over $20k in services. I was floored. I called the insurance company asking if the office could even do this. It was explained to me that they can file claims up to 1 year after service, it's been nearly three since my surgery.

I've spoken to AWLS "billing" department asking the same questions. I explained my agreement with AWLS and was told they have no record of the agreement and that they will continue submitting claims for these outrageous amounts. I was assured that if I didn't owe their office anything that I wouldn't be responsible for all of these amounts being charged to my former insurance company. If they don't have my self pay agreement, how do they know I don't owe for all of these office visits?

It's my belief that the new owners of AWLS have alienated patients, ruined what was left of the practice, are bleeding cash so badly that they're looking for money from wherever they can find it. This increases my fear that they will indeed try to come after me for the thousands of dollars they're billing the insurance company.

I NEVER ever imagined or anticipated any of this happening when I agreed to let AWLS perform my surgery and band aftercare. The EOB's are just another blow.

[debmorgan 0]

Im getting EOB's too. I was a self pay patient that subsequently got insurance and made the mistake of supplying the information to Dr. Pinnars office. They began billing my insurance (before the sale) for office visits even though I had unlimited visits for two years under the self pay agreement.

Fast forward almost three years later, I'm getting EOB's from my former insurance company with charges for office visits at $933 a pop. I received one set for over $20k in services. I was floored. I called the insurance company asking if the office could even do this. It was explained to me that they can file claims up to 1 year after service, it's been nearly three since my surgery.

I've spoken to AWLS "billing" department asking the same questions. I explained my agreement with AWLS and was told they have no record of the agreement and that they will continue submitting claims for these outrageous amounts. I was assured that if I didn't owe their office anything that I wouldn't be responsible for all of these amounts being charged to my former insurance company. If they don't have my self pay agreement, how do they know I don't owe for all of these office visits?

It's my belief that the new owners of AWLS have alienated patients, ruined what was left of the practice, are bleeding cash so badly that they're looking for money from wherever they can find it. This increases my fear that they will indeed try to come after me for the thousands of dollars they're billing the insurance company.

I NEVER ever imagined or anticipated any of this happening when I agreed to let AWLS perform my surgery and band aftercare. The EOB's and run arounds for medical records are just another blow.

[isit5yet 37]

I really suggest those that have proof of this going on, please contact your state's attorney general office. This is insurance fraud being conducted by the physician's office and is no better than Medicare/Medicaid fraud that is running rampant and unchecked.

[debmorgan 0]

I fully intend to now that I've come across these threads. It's just so shockingly unbelievable. I dreadfully assumed this was happening to every former patient. I hope it ends. I wonder how many complaint it'll take?

[isit5yet 37]

I have no idea, but if anyone attends a local support group, I'd get the word out.

[Back~To~Amy 307]

I work for an insurance company and actually investigate suspected insurance fraud. What you describe is insurance fraud. You need to notify your insurance company. You should also contact the Department of Insurance and report his activites! Sorry you are going through this.

[pmcohenpac 0]

The new owner is the one doing all the billing since the practice was sold on 3/1/11. He/they are billing for all of the patients who were seen since July of 2007. The previous owner is contractually prohibited from having anything to do with the practice since it was sold on 3/1/11. And yes, I think it is sickening what the new ownership has done.

[Bandedin2007 1]

I have also received EOBs going back to 2008 for at least $100K. I was a "fills for life" patient -- I paid a set amount for lifetime visits. I'd be interested in connecting with other former patients who are having similar problems. Maybe if we band together (no pun intended) we'll get better results with the VA Board of Medical Professions, the states attorney, the state insurance commission, one of the media consumer watchdog groups, or someone else willing to help.

[Bandedin2007 1]

I have also received EOBs going back to 2008 for at least $100K. I was a "fills for life" patient -- I paid a set amount for lifetime visits. I'd be interested in connecting with other former patients who are having similar problems. Maybe if we band together (no pun intended) we'll get better results with the VA Board of Medical Professions, the states attorney, the state insurance commission, one of the media consumer watchdog groups, or someone else willing to help.

[Bandedin2007 1]

Deb,

I have also received EOBs going back to 2008 for at least $100K. I was a "fills for life" patient -- I paid a set amount for lifetime visits. I'd be interested in connecting with you and other former patients who are having similar problems. Maybe if we band together (no pun intended) we'll get better results with the VA Board of Medical Professions, the states attorney, the state insurance commission, one of the media consumer watchdog groups, or someone else willing to help. I too am concerned that they're going to turn around and try to bill me (though I suspect they won't since they have to know they're in the wrong, and that would result in lawsuits and legal bills they won't want to deal with).

[debmorgan 0]

Wow. $100k!? Insane! I'm just waiting for the day AWLS sends bills for the amounts not covered by insurance.

I filed my complaints over the weekend to the VADHP, and two insurance companies' fraud departments. I was checking out the VA attorney general site but didn't see the proper classification listed and/or which agency to contact. I'll look further today.

I think you're right though. I think it will take many people with the same complaints before someone perks up to listen.

[Back~To~Amy 307]

http://www.stampoutfraud.com/

The above link is for reporting insurance fraud in Virginia. Y'all might want to go that route.

[debmorgan 0]

I'm really sorry that you're getting the same treatment.

If I do get any bills, I will not pay one cent. Doing so could very well extend the statute of limitations (3-5 years in VA) allowing awls to sue for judgement.

We shouldn't have to be worrying about this now. It's so ridiculous! When does it stop?

[debmorgan 0]

Which entity(s) has been listed on your EOB's as the company filing the AWLS claims?

I just got a reply from VADHP btw. I filed via email.

I realize there are two threads going but I'm gonna post this in the other in case everyone isn't aware.

Which entity(s) has been listed on your EOB's as the company filing the AWLS claims?

I just got a reply from VADHP btw. I filed via email.

I realize there are two threads going but I'm gonna post this in the other in case everyone isn't aware.