Aurora Health Care, Inc.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.My husband maintains that his discussions with the doctor about his weight were neither lengthy nor in-depth. It may have been the only additional topic to have come up in conversation since he generally does not have any other problems with his health. He scheduled this appointment as a yearly exam. That is what it should have been billed as. He was there no longer than 20 minutes. It is insane that a patient need worry about talking about any subject with their doctor for too long for fear that the visit could be coded as some specialized service. This practice is called upcoding and it is unethical.
Regards,
[redacted]

Revdex.com of WisconsinOctober 6 2015RE: Aurora Health Care complaint [redacted]Revdex.com,We see that [redacted] has rejected our response to his complaint but his rejection does not change our position.As we shared previously, on his visit with both the MD and podiatrist both doctors noted concerns with the condition of [redacted]'s feet; if the MD didn't have any concerns there wouldn't have been a referral to the podiatrist. If [redacted] disagrees that either or both doctors had concerns he is welcome to obtain a copy of his medical records and he will see the specific concerns each doctor documented on each visit.It is also worth noting that [redacted] has not denied receiving the service but rather the amount he expects to be billed for it. In his rejection he also made mention that actual service provided was very brief and didn't require a significant amount of time. Aurora does not bill services based solely on time but instead on the services themselves. Since there is no disagreement that the services were indeed provided we will look to [redacted] for payment when he is billed for them.Once again, we now respectfully ask the Revdex.com to accept this response and close this complaint. We are still willing to extend payment arrangements to [redacted] if needed when the balance is billed to him but outside of that there is nothing further we can offer on this matter.

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
Better Business...

Bureau:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. 
Regards,
Chris [redacted]

Revdex.com of WisconsinMay 19 2016RE: Aurora Health Care complaint [redacted] Revdex.com, James has been contacted regarding this complaint and a thorough explanation of the billing has been provided to him.There is mutual agreement that James's intent was to pay a specific charge when he submitted a...

$253.67 payment to Aurora but James was unaware that when he submitted payment, the charge had been placed with a third party collection agency. The payment was received and posted to the account but instead of being applied to the charge most recently billed, it was applied to older charges from 2011 and 2012 that were also in collections.A primary concern for James was that he was unaware the payment wasn't applied as intended and he was unaware that balances remained from several years ago. Our explanation is that charges are billed for four consecutive months before being placed with a third party agency. We encourage our patients to compare the bills to their Explanation of Benefits (EOB) provided from their insurance to ensure the amounts match. If a balance isn't paid in full, we include messages on the statements indicating the account is past due and collection placement is possible. In the event of charges being placed in collections, our process is for the agency to send notification to the patient and make efforts to collect the balance.Specifically for James, itemized bills have been sent to identify the specific visits his payment ultimately applied to. He was also made aware of the remaining balances owed on the account including other amounts still in collections. He was receptive to the information provided but remained frustrated in general. He acknowledged not sending payment in time to avoid collections but was dissatisfied that the billing wasn't explained in more detail on previous contacts and that he now has to try to reconcile the recent payment with billing records from several years ago. We do again acknowledge this fact since payment was applied to charges from 2011 and 2012.Please accept this response as resolution on this matter.

Revdex.com of Wisconsin
June 9 2015
RE: Aurora Health Care complaint [redacted]
 
Revdex.com,
 
[redacted]'s concern with the coding for her disputed visit was reviewed prior to this complaint being filed, but another review was recently conducted again. [redacted] insists she verified with the...

office staff the visit was for her annual preventative physical and a physical was completed but unfortunately, the documentation does not support this.
Per the documentation, a complete physical was not done and discussion during the visit centered on another pre-existing condition. [redacted] also had a physical exam completed five months prior in November 2014. Typically insurance companies will only allow a preventative visit to be billed once yearly but she says the Nov. 2014 visit was not with her primary care physician (PCP) so she believes both would've been covered as preventative.
Based on the information above, [redacted] was contacted and informed the coding can't be changed. Since filing this complaint [redacted] has had additional contact with Aurora and filed a separate complaint internally. That complaint is currently pending review but she will be contacted with the outcome when the review is completed. The balance remains on her account but we will not pursue collection activity during this time.

Revdex.com of WisconsinJune 28 2016RE: Aurora Health Care complaint [redacted] Revdex.com personnel, We have contacted John regarding this complaint but unfortunately, a signed consent release has not been received. We are unable to respond further without consent.

The concern was addressed by [redacted] at the time of Ms. [redacted]s call to the clinic.  When I called Ms. [redacted] I shared that information with her.

Revdex.com of WisconsinSeptember 4 2015RE: Aurora Health Care complaint [redacted]Revdex.com personnel,We have received [redacted]’s complaint and are aware he still disputes the $1728.96 amount charged for service but this matter has already been addressed.As stated in his complaint, [redacted] says he was under the...

impression that services provided by a physician’s assistant would not becharged the same rate as service provided by an MD. This concern was initially raised in January this year and since that time we have conducted several reviews of the charges in question, found no errors in our billing and communicated our results to [redacted] in writing on more than one occasion.There is no difference in the amount charged for service provided by a PA or MD and we were unable to verify how [redacted] would have been told otherwise. Eventually, [redacted]’s concern was brought to the attention of our clinical Risk Management; Risk completed another review of all information available and replied to [redacted] via letter that an adjustment for the disputedbalance was not warranted and would not be given. Aurora does not settle on balances owed and the review by Risk is also the highest level review available so this decision will stand.Lastly, [redacted] is likely unaware but the $1728.96 amount in question was also unfortunately placed with third party collection agency Americollect as of August 31. This was not an intentional act to punish [redacted] but rather a result of the billing system since the balance was unpaid and no financial arrangements were made either. The agency will be sending a letter informing him of placement with their agency so all payment and or arrangements would be handled by them at this time. It is very important to note however that [redacted]’s credit has not been affected; during the first thirty days of placement with an agency there is no negative credit impact if arrangements are made so we would encourage [redacted] to contact Americollect at his earliestconvenience.Having given our position on this matter, we respectfully consider it to be closed and ask for the Revdex.com to do the same.

An...

explanation has already been provided for the 3 services on 10/8/15.  Itemized statements have been sent to her directly.  Ms. [redacted] saw her doctor for two separate medical concerns on 10/8/15.  Two of the services were billed as office visits and one was laboratory services.  Generally speaking, the cost of office visits vary depending on key components including medical history, examination and medical decision making. The only balance she owed for all 3 services was $0.40.  All other charges were either paid or adjusted.  It is not illegal to bill for 3 separate services provided on the same date, in fact, medical providers are required to do so.    Ms. [redacted] was compelled to pay on previous judgments through garnishment.  The court agreed that Ms. [redacted] was liable for the debt.  The court did not comment on whether or not Aurora Health Care’s collection policies are reasonable.   By her own admission, Ms. [redacted] refused to increase payments or commit to a payment plan.

Please accept this message as confirmation that complaint was received in our office Wednesday. An acknowledgement letter and consent release was mailed to Gabriel.

Revdex.com of Wisconsin
December 18 2014
RE: Aurora Health care complaint [redacted]
 
Revdex.com,
 
We have spoken to [redacted] regarding her concerns and this matter has been successfully addressed.
As [redacted] stated Aurora has several billing systems currently in use and she has arrangements...

for herself and/or other family members to pay accounts in multiple systems. Since Aurora is in the final stages of moving all billing activity into one system, the two older billing systems are being phased out and will no longer be used.
Specifically for patients like [redacted] who are still paying balances in the older systems, those payments can no longer be made online via Aurora's website or phone system. Attempts were made to contact patients who would be impacted and as the accounts transition to our partner company, there will be additional attempts made to contact the patients and inform them of the changes taking place. While it is true that payment for accounts in the older systems can no longer be made through Aurora's website, it must be stated that all arrangements that were previously established will still be honored. We have just simply reached a point that Aurora has given the responsibility of managing the payment activity to another party.
Though she was still upset over how the changes were implemented [redacted] was receptive to the explanation given. Please accept this notice as resolution of her complaint.

Revdex.com of Wisconsin
November 12 2014
RE: Aurora Health Care complaint [redacted]
 
Revdex.com,
 
Our office received a call from [redacted] regarding his disputed doctor visit. He restated much of the same information provided by his wife and the initial complaint but he also said the discussion of weight didn't come up until the end of the visit with the doctor and was only briefly mentioned in passing.
[redacted] was informed of the efforts we took to secure payment from his insurance and was also informed they have continued to uphold their denial of the claim. The options of an appeal separate from Aurora's and/or a payment plan for the $300 balance still remain but [redacted] was also informed that the only way the coding for his visit can be changed would be for the doctor to amend the record of the visit. In that scenario, a new claim could then be submitted to his insurance but it is worth mentioning again that our professional coding staff has already reviewed the coding and determined it was accurate. It must also be mentioned that we respectfully disagree with his wife [redacted]'s assessment that this visit was up coded to be more profitable.
[redacted] was receptive to the information given to him and plans to contact the doctor, but at this time the $300 balance still remains. Unless the record is amended with a new claim being sent, his insurance reprocesses the claim or [redacted] makes payment there is no further option we have available. Please accept this message as our attempt to resolve this complaint.

Aurora Health Care has received complaint #[redacted]. An authorization/consent form has been sent to the patient.

Revdex.com of Wisconsin
December 24 2014
RE: Aurora Health Care complaint [redacted]
 
Revdex.com personnel,
 
Since receiving his complaint we've been unable to reach [redacted] by phone but we have the following update to provide.
As he stated, [redacted] lives in California and wants a claim...

sent to his insurance from his visit to our facility. Our records indicate we contacted his Medi-Cal insurance back in October and discovered it is Medicaid coverage for the sate of California. Unfortunately we are unable to bill Medicaid coverage for a state we do not provide service in and as a result, [redacted] would be responsible for the charges but we were able to extend a discount to him since his insurance couldn't be billed.
[redacted] says he has never received detailed billing information for his visit but we do have record that this information was provided to him twice in November via email and paper hardcopy. Lastly but perhaps most importantly, [redacted] has paid the majority of the balance. Only $130.90 remains from the initial $500 beginning balance and we have received payment as recently as the third of this month. If [redacted] satisfies the remaining $130.90 the account will be paid in full.
Please accept this information as our request to consider this complaint closed.

Revdex.com of WisconsinAugust 9 2016RE: Aurora Health Care complaint 11575238 Revdex.com personnel, We have been unable to reach [redacted] to discuss the concerns she mentioned in this complaint. The attached letter has been sent asking her to contact our office at her convenience so we can address...

this matter. Please accept this notice as our attempted resolution.

Revdex.com of Wisconsin
July 15 2015
RE: Aurora Health Care complaint [redacted]
 
Revdex.com personnel,
 
[redacted] has been contacted and though we provided an exp[redacted]tion for the billing of her visit she didn't agree with the information provided. Her primary complaint is the...

unscheduled visit resulted in a larger charge than she expected and she thought if she had a scheduled appointment it would have a lesser cost.
It was explained to [redacted] that she was only billed for an office visit as expected and that would've been the same even if her appointment was scheduled. All office visits fall into a range of level one through five; level one visits generally require minimal decision making from the provider and are very brief and general whereas level five visits generally require more complex decision making, are longer in length and more in-depth. [redacted] was billed at a level four and a review by our professional coding staff confirmed that was the correct level of service for her visit. The entire $305.91 billed balance was assessed to her deductible by her insurance though a small discount was also applied. With regards to the prescription she waited for, our records indicate it was called into Walgreen's shortly after 9AM on May 28 so it is unknown why it wouldn't have been available later that same day.
[redacted] was offered a payment plan where she can split the balance into monthly payments and pay over time but declined that offer. Despite sharing the results of our reviews she remained unsatisfied with the balance her insurance says she is responsible for. She is aware that if the balance remains unpaid she will risk placement with a third party collection agency but says she will allow that course of action.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution, assuming it proves to be true, is satisfactory to me. 
Regards,
 
[redacted]

This complaint was received in our office Monday September 26. An acknowledgement letter and release consent was mailed to the patient today. Please accept an apology for not acknowledging this complaint sooner.

This complaint has been received in our office. An acknowledgment letter and release consent has been mailed to Nathanial so please accept this acknowledgement of his complaint.

Revdex.com of Wisconsin
June 17 2015
RE: Aurora Health Care complaint [redacted]
 
Revdex.com,
 
[redacted] has been contacted regarding her complaint and though the conversation was productive she was unsatisfied with the information given to her.
As stated in her...

complaint, [redacted] had a balance with Aurora that she was making payment on each month and because of this [redacted] assumed the account would remain in good standing but she was placed with a third party collection agency. She was informed that once a balance has been billed it will continue to be billed for four to six consecutive months but at that time, any unpaid amount is subject to be sent to collections. The only way to prevent this is to establish a payment plan.
A payment plan is a formal agreement between Aurora and a patient where the entire balance is split into interest free monthly payment. The amount of the payment is based on the size of the balance and other factors but once the plan is set up, the account will not be sent to collections as long as the agreement is maintained. [redacted] acknowledged not contacting us despite messages on the bill indicating a past due status and warnings of collection placement if she failed to do so. She was also informed that there is no impact to her credit if the balance is paid or arrangements are made with the collection agency but regrettably, she refused to do so.
Since there was no Aurora error in the billing for [redacted]'s account there is no further action that we would take on this matter. Please accept this response as a respectful request to close this complaint.