Alvarado Hospital Medical Center

Please see the attached letter that will be mailed to Mr***
Mr*** claims that the physicains did not infomr him that they were not contracted with his insurance. All patients that arrive to the ER are protected under EMTALA. EMTALA states that you must treat a patient
regardless of having the means to pay. Alvarado does not even collect insurance information until after the physicain has seen the patient. The Physicain would likely never have a need to know what type of insurance the patient has.
I have provided him my phone number and I would be more than happy to discuss any of his issues that he feels are unresolved.
Best regards,
*** ***
***

Review: I continually receive pre recorded phone calls from Alvarado Hospital for [redacted]. I press 4 that the person does not live here anymore. I have called the hospital and business office and they said they would remove my phone number. I even told them I would give them [redacted]s phone number but they did not want it and said my number would be removed. I continually get harassed and called from Alvarado. [redacted] ([redacted]) [redacted] evidently gave them my phone number instead of his own. I have been receiving these calls for a few years now and I have had it with Alvarado Hospital. I assume this is a collection problem because he was evicted for not paying rent.Desired Settlement: They have a responsibility to stop harassing and calling me. If this does not stop I will seek legal action.

Business

Response:

December 13, 2013

Case# [redacted]

Consumer Information:

[redacted],

Thank you for forwarding this complaint information to me. I have contacted our business office and have confirmed that Mr. [redacted]’s phone number has been removed from Mr. [redacted]’s account. [redacted] in the business office contacted both of our outside agencies to make sure the number has been removed.

I spoke to Mr. [redacted] to reassure him that this problem has been taken care of. He was very appreciative, I told him to please call me if he has any other issues.

Best regards,

###-###-####

Patient Experience

Alvarado Hospital

Review: I am indigent. I have no health insurance. I am a temporary resident of CA, living with my son and working as a housekeeper. On March 12, I severely sprained my ankle but waited several days to seek medical attention because I have no insurance. After days of unbearable pain, I went to the Alvarado Hospital Medical Center Emergency Room with the intention of seeing if my ankle was broken. I entered the small waiting room, signed my name and address at the front desk and took a seat. After about 10 minutes, I had to go to the front desk to tell the receptionist that there was a man lying in the middle of the waiting room floor in obvious distress. I waited another five minutes or so, during which time several ambulances came to the ER. I made the decision that my ankle was not the most important thing happening, so I went back to the front desk and told the nurse I was going to leave. That I would come back the next day. I was never seen by a professional. Never checked on or asked "So, what is the matter." I did not, at any time, leave the waiting room area. Last week, I received a bill from Alvarado Hospital Medical Center for the amount of $187. When I called to dispute the charge, since I had received NO SERVICES at the ER, I was asked "don't you have insurance?" When I complained about the fact that I was ever charged when I received no help at the ER, I was told, 'That is our policy." I told the CSR that I am indigent and have no coverage and, again, was told, "This is our Policy."Desired Settlement: I would like the AHMC to cancel all charges to me. Also, the "policy" they have of charging an enormous amount of money when there have been no services offered or received is criminal and must stop. "Don't you have insurance?" As though the insurance company should pay for my not receiving any services. What has happened to this country?

Business

Response:

I am awaiting confirmation from the business office. But it is noted in your chart that you were triaged but left with out being seen, it has been my understanding that the $187.00 charge would be dropped. I will confirm tomorrow. please feel free to contact me at [redacted].

Review: On 24 November and again on 30 December 2015 my wife was admitted to the emergency room at Alavardo Hospital for treatment. The emergency room personnel were provided with my wife's ID and medical insurance information. As a result of her admittance, my wife received treatment from the emergency room attending physician. The emergency room physician never informed us that the emergency room physicians do not contract with our Blur Cross Blue Shield plan. As a result, two months later my received three bills from Alvarado hospital for approximately $ 880 each for payment of emergency room services. On the bill it states " ER Physicians do not contract with out of state [redacted] plans.. Your insurance will mail a payment for this claim to you. You are responsible for full balance". So not only did the ER Physician not disclose he does not contract with [redacted] but they want to pay $2,400 and hope my insurance company mails my a payment to cover some of the balance. Also the physician assigned to my wife after the emergency room did not disclose that he was a non-participating provider, resulting in an out of pocket cost of $ 220. I consider this practice as deceptive business practices and possibly medical insurance fraud. Also I don't understand the statement that ER Physicians don't contract with out of state [redacted] plans. As far as I know my insurance plan is Blue Cross Blue Shield of California. I am requesting all my out of pocket cost be refunded.Desired Settlement: I am requesting all of my out of pocket cost be refunded and Alvarado hospital stop this deceptive practice.

Business

Response:

Please see the attached letter that will be mailed to Mr. [redacted]

Mr. [redacted] claims that the physicains did not infomr him that they were not contracted with his insurance. All patients that arrive to the ER are protected under EMTALA. EMTALA states that you must treat a patient regardless of having the means to pay. Alvarado does not even collect insurance information until after the physicain has seen the patient. The Physicain would likely never have a need to know what type of insurance the patient has.

I have provided him my phone number and I would be more than happy to discuss any of his issues that he feels are unresolved.

Best regards,

Review: Hi,

Last year in February, I was admitted into the Alvarado Hospital ER due to pain in my abdomen and kidney area. They continued to do a CT scan, and when the doctor came back, she let me know that the radiologist saw I had pneumonia and ovarian cysts. I then asked about the pain in my kidney area and she said the radiologist didn't see anything. She said if the pain continues, to come back in two days. Well two days later the pain got so bad I was throwing up, crying and rolling on the floor in a fetal position. I was unable to drive due to the pain so my Mom drove into town and took me in on Monday 2/18/13 which happened to be a holiday & the ER was packed. I waited for over 4 hours in excruciating pain & the nurse came into the waiting room & said they couldn't do another CT scan due to too much radiation, therefore they needed to do an ultra sound instead. Once the ultra sound was completed I continued to wait another hour until they could get me in a bed. When the doctor came in, he said, "did they tell you that you had Kidney stones on your last visit?", I responded with "no but that explains why I'm in so much pain." And he then continued with, "The radiologist rechecked your CT scan and found them". He never even mentioned the ultra sound.

Now, a year later, after paying for my first visit in full, they are continuing to call me anywhere from 2-6 times a day every other day, I'm not over exaggerating either. I have contacted them 3 separate times to dispute the $1,800 they are trying to charge me for from the second visit, which wasn't even necessary if the radiologist had read the CT scan correctly on the first visit, and after my insurance had already paid over $7,000 towards that visit. This is my only phone line and I use it for business as well and I can NOT keep having them calling so much it's disrupting my business. I just spoke to someone today(2/14/14), as well as on 1/20/14 and 5/10/13, stating the same thing, that I wanted to dispute the charges. 2 hours after speaking with the billing department my phone rang twice from Alvardo Hospital stating the same thing as always, so I tried to call them and had to leave a message since no one is answering their phones yet I called during business hours & haven't heard back from them & now they are officially closed for the evening. It's becoming exhausting almost a year later! This hospital has and still is putting me through so much stress.

Now, if they had just told me about the kidney stones on the first visit, using the CT scan from that visit, I wouldn't have had to have been in such excruciating pain for 2 extra days, plus sitting for countless hours in pain at the hospital on the second visit, had to take extra days off of work after the first visit with no payed sick days, therefore I lost income and I am my sole supporter, not to mention all the disruptions and unorganized employees that won't stop calling me. The most baffling part is that after 3 tries to dispute the charges, I have yet to hear from anyone about any of the disputes.

Plain and simple, it's the radiologist's fault from the first visit that I even had to come in for a second visit, and if this can't be settled through Revdex.com, then I will be contacting my attorney to go after the hospital as well as the radiologist at fault. I just want the charges dropped, and the calls to stop. I don't think that's too much to ask for since I already payed for one account in full, my insurance payed thousands & I still had to suffer & I don't use that word lightly, kidney stones are brutal. Thank you for your help.

-[redacted]Desired Settlement: To have the $1,800 charges dropped and the phone calls to stop.

Business

Response:

I have spoken to Ms. [redacted] and have begun my investigation. Unfortunately Ms. [redacted] was transfered to the wrong departments and Thursday , March 20th was the first that it was brought to my attention. The business office has spoken to the collection agency to have the phone calls stopped at this point. I spoke to Ms. [redacted] and explained that it is actually the 2nd visit that she paid for not the first. I understand that she feels she is not responsible for the first bill due the supposed claim of miss-diagnosis. I am awaiting for a call back from the radilogist and a call back from Ms. [redacted].

I can request to have the first bill canceled, but then she would still owe the same amount due to the fact that the first bill all went towards her co-insurance and her deductible. So yes I can bak out the first bill and it would aply to the 2nd bill.

I will calling her again tomorrow to update her.

Thank you,

Consumer

Response:

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.

I appreciate [redacted] trying to help. I don't fully understand why if she cancels the first visit, which in my opinion doesn't need to be done, why I'll still owe the same amount. How does that help me at all? All I want is to pay for the services I received that were necessary! Since I spoke to many incompetent employees of Alvarado Hospital I thought I WAS paying for the first visit, because that's what I was told. I don't mind paying for the first visit, however, because of the radiologist not reading my CT Scan properly, I do NOT think it is right for me to pay for the second visit. Yes I understand I payed for that visit already but that's due to false information I received multiple times from Alvarado Hospital employees.

I want the second bill I payed for to be deducted from my first visit and then I will pay the difference. I believe it's around $275. Deduct that from the first bill making it closer to $1,200 and I'll pay that. I'm so furious that it's taken a year of back and forth with the wrong people and no one from Alvarado Hospital seem to care at all. I wouldn't recommend this hospital to my worst enemy! Also, the doctor on the second visit laughed when he said, "did they not tell you on the first visit that you had kidney stones. A different radiologist just looked at it and saw them right away.". My mother was there and heard everything and will testify against the doctor and radiologist if it gets to that point.

I will not accept any offer other than what I've stated. If you can not do that, my attorney will write a letter and start the process. Do not contact me by phone anymore, I will only discuss this through the Revdex.com, per my attorney's request.

Review: May 8, 2013, I underwent Hernia surgery at Alvarado Hospital. The time that was scheduled for admittance of surgery, was approximately one week prior. At that time, I paid the co-payment $175.00 July of 2013, I received a bill from Alvarado Hospital saying that I owed $350.00 Called the billing office regarding this, and the woman who had answered the phone, then said that NO MONIES were owed by me. That it was Alvarado Hospital Billing Dept. mistake. Then in January, 2014 received another billing statement for $350.00 Called the billing office regarding this charge, and spoke to "[redacted]" on January 21, 2014. [redacted] told us that she would be sending an 'itemized' statement, showing what this charge of $350.00 was for. We agreed to it, and on February 6, 2014 we received a statement which WAS NOT ITEMIZED! Just showed several 'charges' on these pages, and not itemizing what these were for. Itemized statements LEGALLY MUST HAVE CODES with the items for which each charge is being billed. NO SUCH ITEMIZING AT ALL. I wrote a letter, along with copies of the pages from their 'so-called' itemizing statement... showing that there were NO codes and/or description for each charge. I wrote that they had NOT fulfilled their 'obligation/agreement' as was ASSURED BY THIS EMPLOYEE, [redacted] on January 21, 2014!

Received another billing statement (again) with the amount of $350.00 owed. OBVIOUSLY, these people in the Billing Dept of Alvarado Hospital, TOTALLY IGNORED my written letter to them regarding the Codes, needed to prove what the charges were for $350.00 Called (again) the Billing Dept of Alvarado Hospital regarding this billing statement. Spoke to a woman named, "[redacted]" on February 18, 2014. This employee, along with the other employees we had spoken to over the phone regarding these charges, COULDN'T EXPLAIN why there was that charge. On February 18, 2014 [redacted] ASSURED/PROMISED us that she would get the corrected 'itemized' statement from the Medical Center in Alvarado Hospital, and send us the copy.... ALL CODES/ITEMS OF CHARGES, per the cost of each one. NEVER RECEIVED ANY SUCH ITEMIZED STATEMENT, PER [redacted]'S ASSURANCE.

We have been getting harassing phone calls, as they are all HANG UP calls with all sorts of different numbers (Unavailable ..messages on the answering machine). And, have gotten from W. [redacted] with NO messages and/or return phone numbers. Heard once, on the machine.. Alvarado, and then it disconnected. Tried to call this place back, and the phone number comes back... "the number you have reached is NO LONGER in service", etc.

The medical staff of Alvarado Hospital are just TERRIFIC/PROFESSIONAL/CARING people! Such a pleasant experience when I have had to have surgeries.

But, the Billing/Administrative staff, are totally UNPROFESSIONAL/NOT EDUCATED WITH THE SKILLS FOR WHICH THE JOB REQUIRES! LACK OF CLERICAL/BUSINESS ETHICS, AND ALSO PERFORM HARASSING TACTICS TO ALL PATIENTS, INCLUDING THE ELDERLY... BY MAKING THESE PEOPLE LIVE IN FEAR BECAUSE OF ALVARADO HOSPITAL BILLING DEPT. LACK OF BUSINESS PRACTICES!

This is NOT the first time that I have had to file a complaint regarding Alvarado Hospital Billing Dept., for each time that have done the same thing. Charging for things, and not giving any consideration toward the patient.. as to being considerate, intelligent enough to explain things that NEED to be explained by this location.Desired Settlement: Alvarado Hospital has messed up my credit rating! I want my credit rating to be put back in 'good' where I was all along before.

I DO NOT WANT TO BE HARASSED by Alvarado Hospital, and any Collections. I have asked REPEATEDLY what the charges of $350.00 were for, and NO ONE CAN GIVE ME A SIMPLE ANSWER. ONLY TO SEND $350 OWED. It is up to Alvarado Hospital to PROVE, beyond a doubt, why is this charge - for what? I paid the co-payment, and that was ALL I was responsible to pay!

This charge should be totally withdrawn from Alvarado Hospital Billing's records!!!!!!!!! Again, July of 2013 we were told by the employee of Alvarado Hospital Billing... that there were NO MONIES OWED by me, and that it was the error of Alvarado Hospital!!!!!!!!!!!!!!

Business

Response:

I have just received this complaint and I will discuss with the business office. I will have an answer for you tomorrow. I am so sorry for the frustration that this has caused.

Consumer

Response:

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.

Revdex.com of San Diego

4747 Viewridge Ave. #200

San Diego, CA 92123

RE: Complaint ID #[redacted] ALVARADO HOSPITAL

Please find attached, a copy of the statement from Alvarado Hospital.

There are NO explanations given regarding the $350 balance owed! We have continually contacted the staff of the Billing Department of Alvarado Hospital, since January of this year.

July of last year (2013) a statement was sent to us regarding a payment owed of $350.00 We spoke to a worker regarding this amount owed, and she had said that "NO MONIES WERE OWED BY US!!!!!!!!!!"

Then six (6) months later, we get another billing statement from Alvarado Hospital. We had contacted them NUMEROUS times, and each time spoke to people (I had written their names, dates, etc. in my original complaint to you on March 12, 2014). No one basically knew what the charge of $350.00 was for!!!!!!!!!!

We paid the co-payment charge before the surgery on May 8, 2013. So, that was all was 'required' of us. I fulfilled my OBLIGATION and paid the co-payment amount.

We have been getting harassing phone calls from some places that we have NO IDEA as to who they are. Get these phone calls, and they have ALL BEEN HANG UP CALLS. Once I heard, "Alvarado" and had no idea what it was regarding. Always HANG UP CALLS, AND NO PHONE NUMBERS!

So, again receiving this statement page ... there are NO reasons given for this charge of $350.00!!!!!!!!!!! !! !

Can't believe how so UNPROFESSIONAL these people at the Alvarado Hospital Billing Department are!!!!!!!!!!! The fact that NO ONE can give us a 'straight' answer what the $350.00 charge is for!!!!!!!!!!!!! To us, we feel that they are just 'pulling numbers' out of the air, and then deciding that is a good amount to charge us!!!

The Medical staff/hospital workers at Alvarado Hospital are FANTASTIC!!!!!!!!!!!!!!!!!! Nothing but the BEST CARE given by everyone!!!!!!!!!! But, the Administrator's Billing area, has allot to accomplish to ever get thought of as the people within the Medical field that work within the actual hospital!

This is NOT the first time that the Alvarado Hospital Billing Dept has proven how poorly operated it is, as I have had to file complaints against them, before.

With the way that they have sent this statement to us, showing the $350.00 WHAT IS IT FOR???????????????????

Because of the lack of professionalism by these individuals within the Billing Department, we feel that we are being harassed and that they are charging for something - they can't even give us a detailed

description what the charges are for????

Cordially,

Business

Response:

Ms. [redacted]

Regarding complaint #9964742, our business office has attempted to resolve this complaint many times. The issue is that the patient feels that since she was quoted $175.00 for her part of the copay for an OUT-patient procedure that is all she should have to pay. The problem is that she had to stay three days which changed her outpatient procedure to an IN patient procedure. Her insurance copay for in-patient is $175 per day. So she stayed 3 days X 175+ 525.00 she has paid 175 balance due is $350.00.

I have requested that they send her another detail report with my number in case she has questions. Thank you

Risk Management/

Patient Experience

6655 Alvarado Rd

San Diego, Ca 92120