Adirondack Park Pet Hospital

This complaint is related to billing from Scripps Memorial hospital and was forwarded to the hopsital Risk Manager for followup

To Whom It May Concern, I reviewed the complaint with the manager who agreed that the incident was erronously codedAsof 9/1/ [redacted] was changing the coding as a screening and not diagnosticFor any further quesitons or concerns regarding this matter please contact [redacted] at 760-901-and she will work with the patient Sincerely, [redacted] ***, Manager of Risk and Patient Relations

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint For your reference, details of the offer I reviewed appear below.They only said they will forward the complaint to the Risk Management person but have not provided the results of the review, nor addressed any of my concerns about having to pay for services at ER when I tried to handle through the Urgent Care I knew ER would be more expensive but that's why I tried to go through Urgent Care Why couldn't the Urgent Care doctor refer me to MRI which is all the ER doctor ended up doing I respectfully request the bill reduced as originally mentioned Regards, [redacted] ***

Good afternoon Ms***, Thank you for the opportunity to respond to Ms [redacted] ’s complaint sent to your office for resolution An audit was conducted of Ms [redacted] ’s account and it was determined that she presented for service and care was appropriateA health benefits ID card was presented at time of visit, but during verification of eligibility, her insurance carrier stated patient was not eligible for servicesA waiver was signed by the patient acknowledging--if her insurance company did not cover the charges—she would be responsible for all out of pocket chargesTherefore, it was determined that the charges are valid and Ms [redacted] is responsible for bill as reflected with the collection agencyDue to the lapse in time, Ms [redacted] must settle the bill with the agency directly We acknowledge her concerns and regret that we cannot be of further assistance regarding this matter We do thank you for bringing this to our attention and affording us the opportunity to address her concerns If I can be of future assistance regarding other issues please do not hesitate to contact me directly [redacted] Patient Relations

Good morning Ms***, Mrs [redacted] ’s concerns were reviewed and determined that her son’s visit and how it was coded by the doctor supports the billing type as defined by the primary insurer health plan, therefore the charge were billed correctly We again acknowledge Mrs [redacted] ’s concerns and regret that we cannot be of further assistance regarding this matter and any charges as it relates to this visit should be settled with the agency directly [redacted] Patient Relations

We investigated Mr [redacted] 's complaints regardng lab charges from 2012, DOS 7-2-Patients account was turned over to collections due to the fact that we received return mail with no forwarding addressThere is no documentation of any insurance on his records

Mr [redacted] indicated that the last time he spoke with Mr [redacted] he requested that Mr [redacted] provide him with proof from his insurance carrier that proved that we didn't bill themMr [redacted] has not provided the additional requested documentsMr [redacted] also offered to remove the accounts from collections if he paid them however Mr [redacted] refused We aplogize for the frustration Mr [redacted] has expierencedHe can contact the Business Office at 888-996-to review his concerns Sincerely, [redacted] ***, Manager of Risk and Patient Relations

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint For your reference, details of the offer I reviewed appear below Regards, [redacted] It seems as if there might be some progress, but I will continue to reject the offer until it is completely resolvedI am disappointed with the lack of customer service in correcting this issueAs I've said before, it makes me wonder how many other incorrect coding goes on at scripps that people may be unaware ofI think the Revdex.com should put a microscope on this business

This matter was reviewed with the Business site managerAfter further review there was a letter mailed to MsLevy (see attached for details)The charges were appropriate and a one time courtesy discount of $was applied to the total outanding billingIf there are any further quesitons please feel free to contact me at [redacted] Sincerely, Wendy Sweet, Risk Manager

To Whom It May Concern: This is in respond to concern received on behalf of your clientThis claim was addressed by the billing department and during the audit process of this account, all charges were found to be billed appropriatelyAs previously mentioned, the care was appropriate and a payment plan agreement with Scripps (established by Business Services) was not followed thru as agreed; therefore the agreement was voided and collection proceeding was initiatedIn the interest of good patient relations, the client's account was pulled from collections and terms of payment plan are being reestablishedIf client does not honor new payment plan agreement with steady payments, collection proceedings will be re-initiated Thank you for the opportunity to respond to inquiry [redacted]

We acknowledge the consumer's concerns and regret that we cannot be of further assistance regarding this matter We do thank you for bringing this to our attention and affording us the opportunity to address your concern

Good afternoon Ms***, Thank you for the opportunity to review Mrs [redacted] s complaintAfter reviewing Mr [redacted] s account, there is no designation of representative on file In the meantime, I will contact Mr [redacted] directly to validate concerns [redacted] Patient Relations

I am responding in regards to a complaint submitted to the Revdex.com against Scripps Mercy Hospital and recorded as ID # [redacted] The following actions have taken place on this account to remedy the issue: I personally have notified Progressive Management Systems (PMS) and have requested that they cancel the account associated with the ID number referenced aboveI have also requested to have any adverse reporting removed from the patient’s credit report as it relates to her visit at Scripps Mercy HospitalI have asked PMS to provide me with a copy of their cancellation letter which I will forward to the patient via email upon receipt As a courtesy to the patient, I have made an adjustment to write-off the full balance of $537.00; which are the facility charges related to her visit at Scripps Mercy HospitalI emailed the patient and advise her of the steps listed above that have been taken on her accountI have also provided the patient with my direct contact information should she have any further questions and/or concernsIf you have any questions or need additional information, please do not hesitate to contact meThank you [redacted] Team Lead, Customer Service & Collections Scripps Patient Financial Services

To Whom it May Concern: This is in response to your client inquiryWe have made several attempts to contact your client at the telephone number listedA letter was sent to your client's attention at the address listed on file responding to their concerns and asking your client to contact the Scripps Mercy Chula Vista office [redacted]

To Whom It May Concern: This is in response to the your client’s concern regarding a duplicate charge for service. We take issues as mentioned very seriously and use the feedback to review our processes; to correct and improve our ability to give excellent patient care and... service. After completing a detailed review of the concerns, it was determined that the charges for copays related to an office visit are actually applied for two different dates of service; therefore are valid and part of our contract with your client's insurance company to collect on the remaining balance which is her financial responsibility. We apologize for your experience and any miscommunication. Again, thank you for bringing this to our attention and for the feedback you have provided us. If I can be of future assistance regarding other issues please do not hesitate to call me directly. ** [redacted]

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint For your reference, details of the offer I reviewed appear below As I have already commented, the visit was a general checkup and the invoice was not, so you have to change the invoice to reflect the correct service You claim you did some review, but you are showing no result and you are not proving to me that my son was provided any service different than a general checkupI was present during the consult so I would knowI would had accepted or rejected a different service and the alternative was not given to meThere is no lab test or study to back up a different service either Furthermore, you passed on the invoice to collection regardless several disputes in progress that I had to reiterate constantly, so you shouldn't have to passed it on to collectionCollection agency shouldn't have had to add charges since I proof the invoice was in dispute The doctor should have received me when I went to talk to him to clarify the issueHe just made me wait for hours The process to dispute your constant mistakes should be clear and you provided contradictory information on what needed to be done next Stop sending back messages that have no informationCorrect your invoice and your mistakes and act professionally

This is our stance, we are sorry that we could not satisfy this patients complaintsMrs [redacted] bills were reviewed by the Business Services department and her bill was waived and adjusted with a zero balanceRisk Managment followed up with Mrs [redacted] and drafted an action plan in resposne to her continued complaintsAt this time there is nothing else we can do to resolve this matterWe are sorry that our solutions did not meet this patients expectations

RevDex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below. Scripps never asked me for my address or insurance information. My doctor's office says they provided it to Scripps. I was referred to Scripps Lab in the same building as my doctor. I gave them the order my doctor gave me. The performed the blood work. I was given the results by my doctor. When my insurance paid him, on these two occasions, I thought everything was taken care of. No one ever suggested that I had responsibility for asking the lab if they had my address and insurance information. How would I have known that?It seems to me that Scripps should have asked my doctor for the correct information when they found that they did not have it. At the very least, they should have asked me for the information when I was there. The lab to which my doctor now sends me asks for my driver's license and insurance card and checks my address before they do any work. This is in addition to the fact that my doctor gives them my information. Had I ever had this experience before being sent to Scripps, maybe I would have thought to ask them if they needed the information. As it was, I didn't know if they were paid through my doctor, or what and I certainly did not know enough to ask about it.Scripps should take responsibility for not having done their job properly and repair the damage done to me by their lack of effective procedures. Regards, [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Regards,
*** *** It is disingenuous of Scripps to claim this has been addressed because my bill has been modifiedThe complaint also involves my husband's bill No one has addressed a single one of the issues I raised regarding his bill.There is no "action plan." Risk Management's only action was to again request the director of Business Services, *** ***, to do something Following is the latest response from Risk Management This is an "action plan?"I’m sorry for your continued dissatisfaction, I’ll follow up with *** *** and her team to call you and review your ongoing issues.Sincerely,Wendy SweetFollowing is the latest email I sent to Risk Management, to which I received the above reply:Thank you for returning my call You are the only person besides Mr*** assistant *** to return a call Not a single person from billing has ever returned a call in ten months, even though many have acknowledged there is a problem with my bill, beginning with *** last MarchAs we agreed, *** *** was to call to figure out the problems with my husband's billAs I expected, no one has since called my husband for permission to talk to me about his bill and no one has called me.I want to document a few of the things we discussedYou said that I received a call in November, after my original letter was delivered, letting me know that *** *** had reduced my bill to zero That was the first I had heard of anything being done with my billI protested that someone is not telling you the truth As I reflected on this, I realized that it is obvious no one ever called First, I have the only messages ever left for me still on my answering machine There are two from *** and two from *** ***, a week after my initial letter (not return phone calls, only calls in response to MrRothenberger's direction)There are none after my actual conversation with ***, when she told me she would figure out my bills Secondly, if I ever received a call telling me my bill is zero, why am I still protesting the inaccurate charges? Obviously, no one ever called to tell me anything There was one issue you did address and this was why my husband was charged for a cholesterol test which is free under the Healthcare Act You said it was because it was not a preventive test You may be correct but you are the first person to have presented a possible reason for this charge I have raised this issue on at least phone calls and no one had any answer except "pay it." Not a single person in billing seemed to know anything about tests that are free by law.We also discussed one of the tests that United Healthcare's audit shows should be $but Scripps is charging over $ When this audit was done months ago, someone at Scripps could have sat down with me to go over the differences and I would have long ago paid what I owe But all my calls resulted in nothing but unreturned phone calls I still have received no answer about why Scripps is charging for something United Healthcare says should be zero.Please do not lose sight of the most basic issue I have had with our bills Our deductible is $2, Instead of charging me $2,then 20% of the balance, the 20% kicked in at some random number over $2,*** acknowledged this months ago This is the issue that *** *** acknowledged, told me he'd figure out and then never returned my call - eight months ago! By now, I have called and visited Scripps over times If a single person could have correctly calculated 20% over $2,I would have long ago paid my bills

To Whom it May Concern:
After completing a formal review regarding the patient's issues, it was determined that the care and the services provided were medically appropriate. In the interest of good patient relations, Business Services has decided to adjust the
charges as it relates to that visit onlyFuture charges for services will be billed accordingly
** ***, Patient Relations