Barton HealthCare System

All patient care is great at Barton Health. However, I question billing practices. I am a person with good insurance and received a bill (which I paid) with a date of service of March 2021 for a lab draw. Interesting how my insurance paid on May 30, 2021, and I did not receive a bill for my portion of the cost until June 21, 2022. It took over a year wait to receive a bill from this organization. I can understand this if the health care system were larger. Questionable billing practices on behalf of Barton, possibly? Staffing issues?

I am rejecting this response because:I contacted you on 10/14/- one of my many phone calls (most of which unsuccessful) - I spoke to '*** who on the phone admitted that no revised bills or notices of late payment were ever sent out My mailing address never changed between the one that I received from 5/16/and the one I received from the collections agency in October from CMRE It seems highly convenient that the one you claim was sent to me was the only one that was returned to sender despite my mailing address staying the same Nonetheless, nobody sends someone to collections without multiple notices There were no further notices beyond the one you allegedly claim was sent to me.It took weeks of phone calls until I was finally able to speak to *** at your billing office around 10/or 10/ At this time, at my request a three way conference call was made with the *** rep, Frank ID # *** At that time it was indeed confirmed the claim was processed under the wrong ID HOWEVER, at that time it was also confirmed that whether or not this provider was in contract, that I am 100% covered (minus my $deductible) as this was an emergency visit (I suffered a nerve palsy which qualifies for concern over loss of use of a limb) This was recorded on the line and witnessed by both myself as well as *** The referance number for this call is *** As such, I am not interested in any "additional discount' you can offer me as dealing with you has been nothing but an inefficient mess My calls have been many and the returns have been few My benefits clearly state I am covered with out of network providers on an emergency basis and I suggest you clear this with *** before bothering me with anything more than my copay balance And when you send me my copay balance, please note my cell is and my email address is *** in case you have another coincidental return to sender even though my address has never changed and the collections letter came to me no problem FYI I spoke to *** last week who stated the bill was reprocessed again on 11/6/ Dr***

To the Patient:The Emergency Physician’s bill from *** *** *** *** is an independent groupBy law we cannot employ physicians but by regulation have to contract for certain services such as emergency room physician to staff our ERTheir charges are based on Medicare CPT Coding
GuidelinesWe do have signage posted in our Emergency Department informing patients about their billing being -Any questions or concerns regarding their charges can be answered by their billing company at *** If your insurance covered your hospital bill but did not cover your ER physician bill, Tahoe Emergency Physician's Group can explain to you why your insurance did notPlease give them a call

This is a response in regards to *** ***'s complaint. The patient was seen at Barton Heavenly Ski clinic on 3/1/14. We billed his insurance *** on 4/16/14. Normally it takes 30-days
for an insurance to pay a claim and in this case we submitted a statement to Mr*** on 5/16/14. Mr*** called on 6/11/stating that *** sent payment on June 5th. This payment was forward to the hospital and then to our office and posted on 8/12/14. During that time, we sent another bill to Mr*** and we recieved return mail with no new forwarding address. The account was then flagged for collections.The patient then contacted us on 10/14/stating that he never received a revised bill and we notified him of the return mail and his new balance was $1,363.80. He stated that his address never changed. We explained that the *** EOB stated that his deductible was $and they paid $366.20. Since this provider does not have a contract with ***, we balance billed the entire balance for Mr*** to pay. Pt called again on 10/and 10/stating that *** told him that he is coverd 100% confirmed by rep*** ID# ***. After further research, per ***, this was processed incorrectly with the wrong Tax ID on 5/29/and he will send back for reprocessing as out of network as of 10/30/14.We are currently pending status on *** reprocessing the claim for additional payment since Heavenly Ski is not contracted. Also, if *** makes the additional payment, the patient is still responsible for the balance. We are able to work out an additional discount rate once this second EOB has been processed. We also placed this account on hold with collections.*** **

To Whom It May Concern,I do apologize, but I do not see this patient in our system. We are the ER billing service for Barton Hospital. There is no indication about this patient seeing one of our ER physicians. There needs to be somekind of copy of a statment in question that states
Tahoe Emergency Physicians Medical Group, which is the group we bill for.*** ***

Hello,Again, you are contacting the incorrect party. We do not bill for Tahoe Family Physicians office. We are a billing company that process the ER billing for Tahoe Emergency Physicians Medical Group. After reading the patient's letter, this is an isoloated visit at a location we do not bill for. You need to contact the Tahoe Family Physicians Office and have them review this complaint

I am rejecting this response because:Please pass this along to the Barton Billing Department.

Company states: We will need a date of visit and account number to verify the customer.

Review: March 1st I had a ski accident and visited on an emergency basis your Barton Ski clinic. The following business day I notified my insurance company, [redacted], that I had an emergency visit to which they verified my 100% coverage after a $100 copay. On 05/16/14 a statement was printed with a balance of $1730 stating that my claim was denied by [redacted]. I spoke to [redacted] at that time and they stated that they are in contract with [redacted] and the claim was improperly billed and that it should be resubmitted. On June 11th 2014 I spoke to [redacted] at the billing office [redacted] - she said the claim will be resubmitted and I will be notified of my copay balance. On October 9th I received a letter from a debt collection for $1363. Prior to this I never received any updated bill statements or any final notice. On Oct 13th I had a three way conference call with the collection company and my insurance company - the debt collection has not provided any information and my insurance company has reported that the claim was properly paid at the contracted rate and that there is no outstanding fee other than my responsible $100 copay. This was again confirmed with [redacted] on Oct 27th 2014. On Oct 14th I reported my issues to Barton - and I spoke with agent '[redacted]. She verified that a claim was paid and that no final notice or updated bill was ever sent. She was to follow up with me which she did via email simply stating that she is working on the issue. Through the week of Oct 20th I emailed Barton via the contact '[redacted] but never heard back despite three voicemails and three emails. I again called on Oct 27th and spoke to another representative who stated that '[redacted] was let go. She, as before, said she will speak to a supervisor and return my call the same day - this was never done. Barton Clinic is attempting to balance bill me in a fraudulent manner after receiving payment from [redacted] at their contracted rates. Barton is making zero attempts to help resolve this matter despite my outreach.Desired Settlement: As a physician I have a working matter of healthcare billing. Barton Clinic is attempting to balance bill me despite receiving payment from my insurance company at their negotiated contracted rates. This is fraudulent and on top of the fact has been sent to debt collections. Barton Clinic has not made any attempt at resolution of this matter and have not made themselves available for my numerous attempts for resolution. I have had to dispute my collections on Oct 13th.

Business

Response:

Company states: We will need a date of visit and account number to verify the customer.

Business

Response:

This is a response in regards to [redacted]'s complaint. The patient was seen at Barton Heavenly Ski clinic on 3/1/14. We billed his insurance [redacted] on 4/16/14. Normally it takes 30-45 days for an insurance to pay a claim and in this case we submitted a statement to Mr. [redacted] on 5/16/14. Mr. [redacted] called on 6/11/14 stating that [redacted] sent payment on June 5th. This payment was forward to the hospital and then to our office and posted on 8/12/14. During that time, we sent another bill to Mr. [redacted] and we recieved return mail with no new forwarding address. The account was then flagged for collections.The patient then contacted us on 10/14/14 stating that he never received a revised bill and we notified him of the return mail and his new balance was $1,363.80. He stated that his address never changed. We explained that the [redacted] EOB stated that his deductible was $100.00 and they paid $366.20. Since this provider does not have a contract with [redacted], we balance billed the entire balance for Mr. [redacted] to pay. Pt called again on 10/29 and 10/30 stating that [redacted] told him that he is coverd 100% confirmed by rep. [redacted] ID# [redacted]. After further research, per [redacted], this was processed incorrectly with the wrong Tax ID on 5/29/14 and he will send back for reprocessing as out of network as of 10/30/14.We are currently pending status on [redacted] reprocessing the claim for additional payment since Heavenly Ski is not contracted. Also, if [redacted] makes the additional payment, the patient is still responsible for the balance. We are able to work out an additional discount rate once this second EOB has been processed. We also placed this account on hold with collections.[redacted]

Consumer

Response:

I am rejecting this response because:I contacted you on 10/14/14 - one of my many phone calls (most of which unsuccessful) - I spoke to '[redacted] who on the phone admitted that no revised bills or notices of late payment were ever sent out. My mailing address never changed between the one that I received from 5/16/14 and the one I received from the collections agency in October 2014 from CMRE. It seems highly convenient that the one you claim was sent to me was the only one that was returned to sender despite my mailing address staying the same. Nonetheless, nobody sends someone to collections without multiple notices There were no further notices beyond the one you allegedly claim was sent to me.It took weeks of phone calls until I was finally able to speak to [redacted] at your billing office around 10/29 or 10/30. At this time, at my request a three way conference call was made with the [redacted] rep, Frank ID # [redacted]. At that time it was indeed confirmed the claim was processed under the wrong ID. HOWEVER, at that time it was also confirmed that whether or not this provider was in contract, that I am 100% covered (minus my $125 deductible) as this was an emergency visit (I suffered a nerve palsy which qualifies for concern over loss of use of a limb). This was recorded on the line and witnessed by both myself as well as [redacted]. The referance number for this call is [redacted]. As such, I am not interested in any "additional discount' you can offer me as dealing with you has been nothing but an inefficient mess. My calls have been many and the returns have been few. My benefits clearly state I am covered with out of network providers on an emergency basis and I suggest you clear this with [redacted] before bothering me with anything more than my copay balance. And when you send me my copay balance, please note my cell is 630 244 4181 and my email address is [redacted] in case you have another coincidental return to sender even though my address has never changed and the collections letter came to me no problem. FYI I spoke to [redacted] last week who stated the bill was reprocessed again on 11/6/14. Dr. [redacted]

Review: I have been visiting Barton Clinics and the Hospital, primarily for regular, annual check-ups and services for over 6 years now. I have an established Gynecologist and was working on establishing myself with a General Physician. I am well insured and have inclusive annual appointments in my plan that allow me to see these doctors for annual check-ups as is recommended to maintain preventative care. I visited Barton Family Medicine to begin establishing myself with the GP in December 2012 for a general check-up - included in my insurance plan. I did not receive a bill for this service until February or March of 2014. I was shocked because, A) It had been over a year since I had visited this doctor, B) I was being billed and this was a service included in my plan. Come to find out, when I called, I was being billed for a special visit as I had asked 2 questions regarding my sleep patterns and another question. Neither question involved any further examination, nor did I receive any prescriptions. However, I was billed, over a year later, for said "services".After speaking multiple times with my insurance and Barton FM and the Barton Billing Department regarding this matter over a period of several months, I was told I needed to submit a letter of appeal to their Quality Assurance department. I hand delivered this letter on January 8, 2015 and have yet to hear back - though I have called a couple times now to check on the status of this claim.Next, I received another bill from my annual Gynecology visit (I have been seeing him every year for at least 4 years) from May 2014 - but it was not sent to me until end of January 2015. This bill, again, a visit that should have been covered by my insurance plan, was billed as a specialty visit because I asked the doctor about a skin problem I had been experiencing. I asked upon his prompt if I had any other questions. I have never been billed for asking a preventative question before.Desired Settlement: I have currently been sent to collections surrounding the last noted visit. I have spoken with Barton numerous times about incorrect billing to my insurance and spoken with my insurance; Barton is refusing to bill correctly; and therefore in my opinion, are not providing preventative care. I believe they are trying to commit insurance fraud and trying to bill on top of annual services to receive money beyond what is deserved for services rendered.I want these charges removed and an apology.

Business

Response:

To Whom It May Concern,I do apologize, but I do not see this patient in our system. We are the ER billing service for Barton Hospital. There is no indication about this patient seeing one of our ER physicians. There needs to be somekind of copy of a statment in question that states Tahoe Emergency Physicians Medical Group, which is the group we bill for.[redacted]

Consumer

Response:

I am rejecting this response because:Please pass this along to the Barton Billing Department.

Business

Response:

Hello,Again, you are contacting the incorrect party. We do not bill for Tahoe Family Physicians office. We are a billing company that process the ER billing for Tahoe Emergency Physicians Medical Group. After reading the patient's letter, this is an isoloated visit at a location we do not bill for. You need to contact the Tahoe Family Physicians Office and have them review this complaint.