Adventist Health

Initial Business Response / [redacted] (1000, 13, 2016/01/08) */ Contact Name and Title: [redacted] Manager/Risk Contact Phone: XXX-XXX-XXXX Contact Email: [redacted] @ah.org Thank you for letting us respond to this patient's complaint Patient's daughter called Adventist Health on 11/19/to share concerns regarding father's bill with Quest labs and lack of customer service she and her father received from an LVN when calling to resolve the billConcerns were forwarded to the site manager of the clinic and the director of community care and resolved on 12/22/ LVN's statement; Patient's daughter was very upset and stated that her father's bill needed to be resolved todayLVN explained to her that we were not able to give her any information due to HIPAA and needed father's permission to discuss any informationPatients daughter called back with father and LVN explained what we had done to try and help him (Provider changed diagnosis so that his insurance would cover labs drawn)In addition it was explained to the patient and his daughter that the Quest did not accept our ICD codes and needed ICD codesA new form was faxed to Quest with the ICD code 11/19/2015-Community Care Director left the patient's daughter a detailed message letting her know that we will be following up with her again to gather her feedback regarding her less than satisfactory interaction with staffI also let her know in the meantime if she has any questions to please contact the clinic directly and speak with the site managerIt was our understanding that we are using the properly coded version of icd-10, and unfortunately the quest lab is still using the old icd-versionThe clinic has re-coded the patient's labs in the old version and resubmitted it to quest per their request 12/22/Additional problem arose with insurance not paying for the labs orderedCommunity Care Director spoke with provider who stated that the patient insisted on the labs, even though he did not find them necessaryThe patient persisted, so the provider ordered themAs a result, the patient received a bill because the services were not covered by insurancePatient's daughter was persistent and stated that she was placing formal complaints with our corporate office, the state, the county health department, and the Revdex.comPatient stated that all complaints will be dropped if the issue could be resolved at our levelVP of Community Care approved and submitted a check request to pay patient's bill from Quest, in the amount of $ Community Care Director informed patient's daughter on 12/22/that quest will be receiving payment, and asked her to allow up to weeks for Quest to receive payment

The bills from Adventist Health are incomprehensible and they always seem to end up with some figure that has no relationship to the details of the bill. I am tired of trying to deal with these folks because they seem either incompetent or dishonest. Further, there has been a major
upheaval in this practice and virtually all of the physicians have quit in protest over their financial practices. My physician is leaving on Decso I will try to find a doc6or who has no relationship to these people.
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Initial Business Response /* (1000, 13, 2016/01/08) */
Contact Name and Title: [redacted] Manager/Risk
Contact Phone: XXX-XXX-XXXX
Contact Email: [redacted]@ah.org
Thank you for letting us respond to this patient's complaint.
Patient's daughter called Adventist Health on 11/19/2015 to...

share concerns regarding father's bill with Quest labs and lack of customer service she and her father received from an LVN when calling to resolve the bill. Concerns were forwarded to the site manager of the clinic and the director of community care and resolved on 12/22/2015.
1. LVN's statement; Patient's daughter was very upset and stated that her father's bill needed to be resolved today. LVN explained to her that we were not able to give her any information due to HIPAA and needed father's permission to discuss any information. Patients daughter called back with father and LVN explained what we had done to try and help him (Provider changed diagnosis so that his insurance would cover labs drawn). In addition it was explained to the patient and his daughter that the Quest did not accept our ICD 10 codes and needed ICD 9 codes. A new form was faxed to Quest with the ICD 9 code.
2. 11/19/2015-Community Care Director left the patient's daughter a detailed message letting her know that we will be following up with her again to gather her feedback regarding her less than satisfactory interaction with staff. I also let her know in the meantime if she has any questions to please contact the clinic directly and speak with the site manager. It was our understanding that we are using the properly coded version of icd-10, and unfortunately the quest lab is still using the old icd-9 version. The clinic has re-coded the patient's labs in the old version and resubmitted it to quest per their request.
3. 12/22/2015 Additional problem arose with insurance not paying for the labs ordered. Community Care Director spoke with provider who stated that the patient insisted on the labs, even though he did not find them necessary. The patient persisted, so the provider ordered them. As a result, the patient received a bill because the services were not covered by insurance. Patient's daughter was persistent and stated that she was placing formal complaints with our corporate office, the state, the county health department, and the Revdex.com. Patient stated that all complaints will be dropped if the issue could be resolved at our level. VP of Community Care approved and submitted a check request to pay patient's bill from Quest, in the amount of $903.53
4. Community Care Director informed patient's daughter on 12/22/2015 that quest will be receiving payment, and asked her to allow up to 2 weeks for Quest to receive payment.