I reviewed the response made by the business in reference to complaint ID [redacted] , and find the resolution is satisfactory to me The gentleman who phoned me was especially kind and understanding It seems apparent they had a bad employee Regards, [redacted]
I am writing to you re complaint # [redacted] I do not seem to be able to update this complaint on your website since it tells me that "there is nothing for you to do on this complaint right now."Apparently Baumann Plumbing has not contacted you They have, however, contacted me A MrS [redacted] called me last Friday and explained that he is the owner of Baumann Plumbing and wanted to "make things right." He said he would send me a check for $and today this check arrived.Since MrS [redacted] has been willing to reimburse me (twice over!) for the expense I incurred as a result of Baumann Plumbing not fulfilling their contract with me, I would therefore like to withdraw my complaint I am more than satisfied with MrS [redacted] 's compensation for the expense I incurred in this situation.Please withdraw my complaint and record this complaint as one that was satisfactorily resolved.Thank you for your assistance in this matter Revdex.com is a godsend in these situations, since most merchants and service providers fear more than anything an outstanding and unresolved bad report in your files!With gratitude, [redacted] ***
To Whom It May Concern: I am writing in regard to the complaint filed with the Revdex.comIn order to address your complaint specifically, we would need your daughter's information to pull up her accountAt Carle when a patient is over the age of they are their own guarantor and thus would be responsible for the billingIf you are on her PHI you may contact our offices with questions and this gives us permission to speak with you, but you will not be the person that we contact in order to collect on balances I would be happy to look into this issue further with the appropriate information.Carle's outpatient clinics are departments of the hospital and as such are billed as provider based servicesThis results in a bill from Carle Physician Group as well as a bill from Carle Foundation HospitalProvider Based Billing is a nationally recognized billing model for hospitals and clinics that complies with Medicare regulationsIt is not a new model of billingThe vast majority of insurance companies are familiar with provider based bills and pay claims accordinglyI apologize if we have failed to meet your expectations, and I thank you for your feedbackWe continually look for ways to improve the experience for our patientsIf you have any further questions please contact Patient Accounts at (217) 326-Respectfully, Michelle Smith
RevDex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] 4, and find that this resolution is satisfactory to me.
Initial Business Response / [redacted] (1000, 5, 2015/09/11) */ To Whom It [redacted] Concern, I am writing to you in response to your inquiry regarding a Carle Physician Group date of service October 14, I understand that the patient would like the charge removed from her credit report as this was an issue involving her insurance company and Carle In reviewing this account, it appears that Blue Cross Blue Shield had originally denied the claimThe patient received multiple statements before being sent to H&R Collection AgencyBlue Cross Blue Shield reprocessed the claim on May 3, and paid $Carle then adjusted the remaining balance of $1,on January 9, As of today, September 11, we have notified the collection agency to have this removed from her credit reportThis can take up to days I apologize for any inconveniences that this has caused the patient and thank her for taking the time to bring her concern to our attention If she has any further questions please have her contact Patient Accounts at (XXX) XXX-XXXX Respectfully, [redacted] Initial Consumer Rebuttal / [redacted] (3000, 7, 2015/09/14) */ (The consumer indicated he/she DID NOT accept the response from the business.) Thank you for your response, but I need them to contact all three credit reporting agencies with this informationFrom the letter, they imply that they made contact with only one Final Consumer Response / [redacted] (2000, 10, 2015/10/01) */
To Whom It May Concern: I am writing in regard to the complaint filed with the Revdex.comCarle's outpatient clinics are departments of the hospital and as such are billed as provider based servicesThis results in a bill from Carle Physician Group as well as a bill from Carle Foundation HospitalProvider Based Billing is a nationally recognized billing model for hospitals and clinics that complies with Medicare regulationsIt is not a new model of billingThe vast majority of insurance companies are familiar with provider based bills and pay claims accordinglyYou may want to contact your insurance company to advise them that the Carle Foundation Hospital charges are facility fees related to Provider Based Billing for the associated services billed from Carle Physician GroupThis is not double billingThe hearing and vision exam that is referred to in the complaint is part of the well-child examI apologize if we have failed to meet your expectations, and I thank you for your feedbackWe continually look for ways to improve the experience for our patientsIf you have any further questions please contact Patient Accounts at [redacted] Respectfully, [redacted] ***
Initial Business Response /* (1000, 5, 2015/10/07) */
To Whom It May Concern,
I am writing in response to your inquiry regarding a request for a replacement of a CPAP machine that was broken in late November or early December of I understand that Carle agreed to replace the machine and
that this was not done prior to the patient passing away in April of
I reached out to the Manager of Respiratory CareShe advised that she had set up a date to deliver the CPAP machine to the patient and that she received a call advising her that the patient had been admitted into the hospital and the appointment was cancelledShe also said that in the following months the patient was in and out of the hospital until he passed awayShe explained that she reached out to the Manager of Risk Management and that it was determined that the device could not be replaced as Carle only reimburses/replaces for devices that are necessary for everyday useAs this is no longer the case, the machine can no longer be replaced
A letter was sent to the spouse on October 2, by the Manager of Risk Management to advise of the decisionI apologize if we have failed to meet your expectations and thank you for taking the time to bring your concern to our attention
Respectfully,
*** ***
Initial Consumer Rebuttal /* (3000, 7, 2015/10/09) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The Carle employee damaged my father's equipment in late November/early DecemberReplacement should have occurred at that time; however, we were advised that Carle wanted to see if Medicare would cover the cost of a new machineOut of fairness, we agreed to wait until Carle received this information, even though my father believed we should insist on a new machine prior to him leaving the hospital in December
Subsequently, we contacted Carle, and an appointment was set up in mid/late January for a representative to come to the nursing home to speak to my father and meAt the time, we did not foresee this as being a stall tacticUnfortunately, on the day we were to have the meeting, we had to admit my father to the hospital
Please note that the conference call was set up in mid/late January - approximately months after my father's machine had been brokenI tried several times to contact Carle to set up an appointment, but the person to whom I needed to speak was frequently out of the office, and setting up an appointment was extremely difficult
After we had to cancel the appointment in January, we needed to wait until my father was coherent enough to be able to meet with the Carle representative, and since I was his POA, I needed to be thereMy mother is not capable of conducting business of this natureI tried to contact Carle during February, March, and April, even though I was trying to take care of both of my parents and get my father qualified for Medicaid
Ultimately, my father passed away before we could rearrange anythingAfter his death, I tried to contact Carle from May until the current time, and I received excuse after excuseEarlier during this time period, I was led to believe there would be some sort of compensation (in the form of a machine), but that Carle's Risk Management team would have final sayDuring the June/July timeframe, my contact told me that Carle had a new machine in its inventory that was similar to my father's machine, and the plan was to give us this machine
The moment the Carle representative learned of my father's death, she stopped returning my calls, and now, I finally received an EMail stating that Carle only reimburses if the patient must have the equipmentObviously, since my father is deceased, he doesn't need the equipment, so they won't reimburse usWhat Carle's Manager of Risk Management seems to have overlooked is that when they damaged my father's CPAP machine, it was absolutely necessary for him to breathe, as he had congestive heart failure and COPD and was on oxygenCarle's own records from when he was hospitalized will verify this is someone were to review his records
My Carle contact purposely didn't return my phone calls; I know this because I asked my brother to call her, and since he had an Illinois phone number, my contact answered the phoneHer response to him was that she hadn't called me back because she didn't have an answer for me yetAll of phone call avoidance took place for approximately months, with my brother's phone call occurring in late August
Please note that to ultimately receive a response, I had to go around my contact at Carle and find out the name of the Director of Carle RespiratoryHe gave me the name of the Director of Carle Medical suppliesI then tried to contact the Director of Medical Supplies and got his secretaryHis secretary EMailed him, and at my request, she copied meFrom this information, I was able to EMail him directly and copy the original contact at Carle on the EMailAll of this occurred in late September,
Now, after approximately ten months of getting the runaround and Carle's avoidance tactics, Carle sent me an EMail (not a letter) stating that since my father is deceased, he doesn't need a new CPAP machine, and they won't provide reimbursementAlso, Carle's response, above, is incorrect in that they sent nothing to my mother; they sent an EMail to me, his daughter
The fact remains that their employee dropped and irreparably damaged my father's personal equipmentCarle clearly has culpability in this matter, and they're trying to use my father's death for their own financial gain
This is a particularly deplorable business practice, and I will ensure that all of my relatives, friends, and acquaintances know about it
Initial Business Response /* (1000, 5, 2016/07/22) */
To Whom It May Concern,
I am writing to you in response to your complaint to the Revdex.com regarding the billing for your son's visit in and how the charges were processed by your insurance company
Carle's outpatient
clinics (Primary Care, Convenient Care, Specialty departments) are departments of the hospital and as such are billed as provider based servicesThis results in a bill from Carle Physician Group as well as a bill from Carle Foundation HospitalProvider Based Billing is a nationally recognized billing model for integrated healthcare delivery systems such as oursI understand your concern related to the billing model utilized by Carle; however, it is an allowable Medicare status for hospitals and clinics and complies with specific Medicare regulations
A consent form was signed on your son's date of service acknowledging that separate bills may be received for services provided by Carle Physician Group and Carle Foundation Hospital (Illinois Fair Patient Billing Act ILCS 88/50)A copy of this consent form was made available for review at the chestation
Blue Cross Blue Shield has a limited contract with CarlePrimary Care Providers including Convenient Care and Pediatrics in Champaign, Urbana, and Mahomet are out of network with Blue Cross Blue ShieldI apologize if you were misinformed by staffIt is our policy to not inform patients regarding insurance coverage and refer patients to their insurance companies with any questions about coverage including contracting information
As a one-time gesture of goodwill we have given you a 30% discount on the Carle Physician Group charge of $leaving a balance of $
Thank you for taking the time to bring your concerns to our attention
Respectfully,
*** ***
Initial Consumer Rebuttal /* (3000, 7, 2016/07/27) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Hello, if the understanding is that I was misinformed by staff at Carle of its billing practices, then there is no other option but to waive the entire $billing amount, and not just 30% thereofAs Ms*** stated in her response, "It is our policy to not inform patients regarding insurance coverage and refer patients to their insurance companies with any questions about coverage including contracting information." However, I was given incorrect information by Carle staff, as conceded to by Ms*** in her responseHowever, an apology for this is not enoughThe proper remedy, out of goodwill to a patient like my son, is to waive the $billing amount in full due to this mis-information provided by Carle staff and this is what I am respectfully requestingI should not be punished for inadequate training given to receptionists at CarleThank you
I am rejecting this response because: the bill from Carle hospital does not match the Explanation of Benefits from PacificSource. I have spoken with multiple people at PacificSource who assure me that the items in question are provider responsibility. PacificSource is a northwest insurance company. While in Illinois, I called PacificSource and they said to go to Carle because they will be in-network because they are a part of First Health. So Carle should be able to work with PacificSource. On the EOB's, PacificSource claims that Carle uses an invalid billing code. Instead of Carle communicating with PacificSource, an in-network insurance company, they passed the bills onto me. Even though the EOB's state provider responsibility.
To Whom It May Concern: I am writing in regard to the complaint filed with the Revdex.com. In order to address your complaint specifically, we would need your daughter's information to pull up her account. At Carle when a patient is over the age of 18 they are their own guarantor and...
thus would be responsible for the billing. If you are on her PHI you may contact our offices with questions and this gives us permission to speak with you, but you will not be the person that we contact in order to collect on balances. I would be happy to look into this issue further with the appropriate information.Carle's outpatient clinics are departments of the hospital and as such are billed as provider based services. This results in a bill from Carle Physician Group as well as a bill from Carle Foundation Hospital. Provider Based Billing is a nationally recognized billing model for hospitals and clinics that complies with Medicare regulations. It is not a new model of billing. The vast majority of insurance companies are familiar with provider based bills and pay claims accordingly. I apologize if we have failed to meet your expectations, and I thank you for your feedback. We continually look for ways to improve the experience for our patients. If you have any further questions please contact Patient Accounts at (217) 326-8300. Respectfully, Michelle Smith
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted]4, and find that this resolution is satisfactory to me.
I am writing to you re complaint #[redacted]. I do not seem to be able to update this complaint on your website since it tells me that "there is nothing for you to do on this complaint right now."Apparently Baumann Plumbing has not contacted you. They have, however, contacted me. A...
Mr. S[redacted] called me last Friday and explained that he is the owner of Baumann Plumbing and wanted to "make things right." He said he would send me a check for $220 and today this check arrived.Since Mr. S[redacted] has been willing to reimburse me (twice over!) for the expense I incurred as a result of Baumann Plumbing not fulfilling their contract with me, I would therefore like to withdraw my complaint. I am more than satisfied with Mr. S[redacted]'s compensation for the expense I incurred in this situation.Please withdraw my complaint and record this complaint as one that was satisfactorily resolved.Thank you for your assistance in this matter. Revdex.com is a godsend in these situations, since most merchants and service providers fear more than anything an outstanding and unresolved bad report in your files!With gratitude,[redacted]
Initial Business Response /* (1000, 5, 2015/09/11) */
To Whom It [redacted] Concern,
I am writing to you in response to your inquiry regarding a Carle Physician Group date of service October 14, 2011. I understand that the patient would like the charge removed from her credit report as this was an...
issue involving her insurance company and Carle.
In reviewing this account, it appears that Blue Cross Blue Shield had originally denied the claim. The patient received multiple statements before being sent to H&R Collection Agency. Blue Cross Blue Shield reprocessed the claim on May 3, 2012 and paid $254.66. Carle then adjusted the remaining balance of $1,305.34 on January 9, 2013.
As of today, September 11, we have notified the collection agency to have this removed from her credit report. This can take up to 60 days.
I apologize for any inconveniences that this has caused the patient and thank her for taking the time to bring her concern to our attention.
If she has any further questions please have her contact Patient Accounts at (XXX) XXX-XXXX.
Respectfully,
[redacted]
Initial Consumer Rebuttal /* (3000, 7, 2015/09/14) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Thank you for your response, but I need them to contact all three credit reporting agencies with this information. From the letter, they imply that they made contact with only one.
Final Consumer Response /* (2000, 10, 2015/10/01) */
Initial Business Response /* (1000, 5, 2016/03/15) */
To Whom It May Concern,
I am writing to you in response to your complaint to the Revdex.com regarding charges you are being billed for services your son has received from Carle. I understand from the complaint that you feel your...
son's mother should be responsible for the medical bills. The law in the State of Illinois states that both parents are equally responsible for the medical bills of a minor.
I have reviewed your account, and found that you've had contact with our Customer Service Representatives. You were advised that Carle policy states that we must have the legal documents (divorce decree) specifying the legal custody of your son before we can remove him from your guarantor account and place him on his mother's guarantor account. As of today, there is no record of us ever receiving the requested documentation. Therefore, until we get the legal documentation supporting this information, your son will remain on your guarantor account as.
Once we receive the required documentation, and verify that the mother is custodial, we can move your son from your account to hers. Please understand that even if we move him off of your account, in the state of Illinois you are still equally responsible for the charges unless your divorce decree specifically states that the mother is responsible for all payment of medical bills.
I apologize if we have failed to meet your expectations, and I thank you for your feedback. We continually look for ways to improve the experience for our patients.
If you have any further questions please contact Patient Accounts at (XXX) XXX-XXXX.
Respectfully,
[redacted]
Initial Consumer Rebuttal /* (3000, 7, 2016/03/23) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I appreciate the information in the response. While the business claims to not have received any legal documents showing the mother as having legal custody, I sent said documents to the business with a cover letter dated 11/13. After that time, I stopped receiving bills, but did not get a confirmation letter stating the charges have been moved to my son's mother (as requested in the cover letter 11/13). In February, I got one new bill from Carle along with a new bill from a collection agency. It is suspect as to why it seemed like the issue was settled and then all of a sudden I started a new round of bills. And there is a mysterious disappearance of the legal documents that it seems will never be explained. So, I'll send the legal documents again, though would prefer the business provide me a specific name/address with hope that the documents will get to the correct person this time around. I'd prefer not to spend funds on registered mail.
This delay is still hurting my credit rating, so I want this issue to remain open until that part is resolved. IF Carle addresses the charges with the collection agency and the credit bureaus so that I am not harmed with credit, I'm willing to help the business receive at least half of the payment (from me). As I've told the Patient Accounts people a number of times, I'm obligated to 1/2 of any medically necessary charges that are incurred via in-network medical providers. All but one of the charges from Carle are 'in-network' for my PPO, but I'm willing to overlook that. What is supposed to happen is that the child's mother pay all medical bills and then seek 1/2 reimbursement from me for all allowable charges (medically necessary, in-network providers, etc.). The problem is that the child's mother is impossible to deail with in a rational manner. She incurs medical bills all over the state and often registers with my name using an incorrect billing address such that by the time I find out about it, the charges are delinquent. This is what is wrong with Carle's policy. People like me are being charged for services a third party agreed to pay (at patient check-in). The mother is the one who you should be going after, regardless of what Carle beleives the law is (which I have contradicting opinions on). Besides, in its response, Carle says that both parents are equally responsible for the charges. To that extent, the business should just charge each parent accordingly without all of the legal document stuff.
I'd rather not ever deal with my child's mother ever again, so like I said, I'd be willing to pay 1/2 of the charges directly to Carle. As long as the other half lands on my son's mother's account and I have a receipt for my portion, I'm good. But, this willingness on my part depends on how willing Carle is at restoring my credit. Even in the interim while we get this straightened out. I have never in my life not paid a bill that I don't owe. I have, on occasion, not paid a bill that I feel I do not owe. I don't owe any of these charges directly to Carle, BUT am willing to bypass ** child's mother so Carle gets the 1/2 I would eventually need to pay my son's mother.
I reviewed the response made by the business in reference to complaint ID [redacted], and find the resolution is satisfactory to me. The gentleman who phoned me was especially kind and understanding. It seems apparent they had a bad employee.
Regards, [redacted]
To Whom It May Concern,I am writing to you in response to your concern regarding service provided to you by our patient accounts representative on 7/20/17. The notes on the account determined that the supervisor of the call center spoke with you on 7/21/17 regarding these concerns.If you have...
further concerns, please contact Patient Accounts by calling (888) 71-CARLE.
To Whom It May Concern: I am writing in regard to the complaint filed with the Revdex.com. Carle's outpatient clinics are departments of the hospital and as such are billed as provider based services. This results in a bill from Carle Physician Group as well as a bill from Carle...
Foundation Hospital. Provider Based Billing is a nationally recognized billing model for hospitals and clinics that complies with Medicare regulations. It is not a new model of billing. The vast majority of insurance companies are familiar with provider based bills and pay claims accordingly. You may want to contact your insurance company to advise them that the Carle Foundation Hospital charges are facility fees related to Provider Based Billing for the associated services billed from Carle Physician Group. This is not double billing. The hearing and vision exam that is referred to in the complaint is part of the well-child exam. I apologize if we have failed to meet your expectations, and I thank you for your feedback. We continually look for ways to improve the experience for our patients. If you have any further questions please contact Patient Accounts at [redacted]. Respectfully, [redacted]
To Whom It May Concern:I am writing in regard to a complaint filed with the Revdex.com. In order to address these concerns, we would need your daughter's information in order to identify her account and provide the appropriate information. We are unable to respond to this complaint with...
the information you have provided.Sincerely,[redacted]on behalf of [redacted]Carle Foundation HospitalPatient Accounts
I reviewed the response made by the business in reference to complaint ID [redacted] , and find the resolution is satisfactory to me The gentleman who phoned me was especially kind and understanding It seems apparent they had a bad employee Regards, [redacted]
I am writing to you re complaint # [redacted] I do not seem to be able to update this complaint on your website since it tells me that "there is nothing for you to do on this complaint right now."Apparently Baumann Plumbing has not contacted you They have, however, contacted me A MrS [redacted] called me last Friday and explained that he is the owner of Baumann Plumbing and wanted to "make things right." He said he would send me a check for $and today this check arrived.Since MrS [redacted] has been willing to reimburse me (twice over!) for the expense I incurred as a result of Baumann Plumbing not fulfilling their contract with me, I would therefore like to withdraw my complaint I am more than satisfied with MrS [redacted] 's compensation for the expense I incurred in this situation.Please withdraw my complaint and record this complaint as one that was satisfactorily resolved.Thank you for your assistance in this matter Revdex.com is a godsend in these situations, since most merchants and service providers fear more than anything an outstanding and unresolved bad report in your files!With gratitude, [redacted] ***
To Whom It May Concern: I am writing in regard to the complaint filed with the Revdex.comIn order to address your complaint specifically, we would need your daughter's information to pull up her accountAt Carle when a patient is over the age of they are their own guarantor and thus would be responsible for the billingIf you are on her PHI you may contact our offices with questions and this gives us permission to speak with you, but you will not be the person that we contact in order to collect on balances I would be happy to look into this issue further with the appropriate information.Carle's outpatient clinics are departments of the hospital and as such are billed as provider based servicesThis results in a bill from Carle Physician Group as well as a bill from Carle Foundation HospitalProvider Based Billing is a nationally recognized billing model for hospitals and clinics that complies with Medicare regulationsIt is not a new model of billingThe vast majority of insurance companies are familiar with provider based bills and pay claims accordinglyI apologize if we have failed to meet your expectations, and I thank you for your feedbackWe continually look for ways to improve the experience for our patientsIf you have any further questions please contact Patient Accounts at (217) 326-Respectfully, Michelle Smith
RevDex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] 4, and find that this resolution is satisfactory to me.
Initial Business Response / [redacted] (1000, 5, 2015/09/11) */ To Whom It [redacted] Concern, I am writing to you in response to your inquiry regarding a Carle Physician Group date of service October 14, I understand that the patient would like the charge removed from her credit report as this was an issue involving her insurance company and Carle In reviewing this account, it appears that Blue Cross Blue Shield had originally denied the claimThe patient received multiple statements before being sent to H&R Collection AgencyBlue Cross Blue Shield reprocessed the claim on May 3, and paid $Carle then adjusted the remaining balance of $1,on January 9, As of today, September 11, we have notified the collection agency to have this removed from her credit reportThis can take up to days I apologize for any inconveniences that this has caused the patient and thank her for taking the time to bring her concern to our attention If she has any further questions please have her contact Patient Accounts at (XXX) XXX-XXXX Respectfully, [redacted] Initial Consumer Rebuttal / [redacted] (3000, 7, 2015/09/14) */ (The consumer indicated he/she DID NOT accept the response from the business.) Thank you for your response, but I need them to contact all three credit reporting agencies with this informationFrom the letter, they imply that they made contact with only one Final Consumer Response / [redacted] (2000, 10, 2015/10/01) */
To Whom It May Concern: I am writing in regard to the complaint filed with the Revdex.comCarle's outpatient clinics are departments of the hospital and as such are billed as provider based servicesThis results in a bill from Carle Physician Group as well as a bill from Carle Foundation HospitalProvider Based Billing is a nationally recognized billing model for hospitals and clinics that complies with Medicare regulationsIt is not a new model of billingThe vast majority of insurance companies are familiar with provider based bills and pay claims accordinglyYou may want to contact your insurance company to advise them that the Carle Foundation Hospital charges are facility fees related to Provider Based Billing for the associated services billed from Carle Physician GroupThis is not double billingThe hearing and vision exam that is referred to in the complaint is part of the well-child examI apologize if we have failed to meet your expectations, and I thank you for your feedbackWe continually look for ways to improve the experience for our patientsIf you have any further questions please contact Patient Accounts at [redacted] Respectfully, [redacted] ***
Initial Business Response /* (1000, 5, 2015/10/07) */
To Whom It May Concern,
I am writing in response to your inquiry regarding a request for a replacement of a CPAP machine that was broken in late November or early December of I understand that Carle agreed to replace the machine and
that this was not done prior to the patient passing away in April of
I reached out to the Manager of Respiratory CareShe advised that she had set up a date to deliver the CPAP machine to the patient and that she received a call advising her that the patient had been admitted into the hospital and the appointment was cancelledShe also said that in the following months the patient was in and out of the hospital until he passed awayShe explained that she reached out to the Manager of Risk Management and that it was determined that the device could not be replaced as Carle only reimburses/replaces for devices that are necessary for everyday useAs this is no longer the case, the machine can no longer be replaced
A letter was sent to the spouse on October 2, by the Manager of Risk Management to advise of the decisionI apologize if we have failed to meet your expectations and thank you for taking the time to bring your concern to our attention
Respectfully,
*** ***
Initial Consumer Rebuttal /* (3000, 7, 2015/10/09) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The Carle employee damaged my father's equipment in late November/early DecemberReplacement should have occurred at that time; however, we were advised that Carle wanted to see if Medicare would cover the cost of a new machineOut of fairness, we agreed to wait until Carle received this information, even though my father believed we should insist on a new machine prior to him leaving the hospital in December
Subsequently, we contacted Carle, and an appointment was set up in mid/late January for a representative to come to the nursing home to speak to my father and meAt the time, we did not foresee this as being a stall tacticUnfortunately, on the day we were to have the meeting, we had to admit my father to the hospital
Please note that the conference call was set up in mid/late January - approximately months after my father's machine had been brokenI tried several times to contact Carle to set up an appointment, but the person to whom I needed to speak was frequently out of the office, and setting up an appointment was extremely difficult
After we had to cancel the appointment in January, we needed to wait until my father was coherent enough to be able to meet with the Carle representative, and since I was his POA, I needed to be thereMy mother is not capable of conducting business of this natureI tried to contact Carle during February, March, and April, even though I was trying to take care of both of my parents and get my father qualified for Medicaid
Ultimately, my father passed away before we could rearrange anythingAfter his death, I tried to contact Carle from May until the current time, and I received excuse after excuseEarlier during this time period, I was led to believe there would be some sort of compensation (in the form of a machine), but that Carle's Risk Management team would have final sayDuring the June/July timeframe, my contact told me that Carle had a new machine in its inventory that was similar to my father's machine, and the plan was to give us this machine
The moment the Carle representative learned of my father's death, she stopped returning my calls, and now, I finally received an EMail stating that Carle only reimburses if the patient must have the equipmentObviously, since my father is deceased, he doesn't need the equipment, so they won't reimburse usWhat Carle's Manager of Risk Management seems to have overlooked is that when they damaged my father's CPAP machine, it was absolutely necessary for him to breathe, as he had congestive heart failure and COPD and was on oxygenCarle's own records from when he was hospitalized will verify this is someone were to review his records
My Carle contact purposely didn't return my phone calls; I know this because I asked my brother to call her, and since he had an Illinois phone number, my contact answered the phoneHer response to him was that she hadn't called me back because she didn't have an answer for me yetAll of phone call avoidance took place for approximately months, with my brother's phone call occurring in late August
Please note that to ultimately receive a response, I had to go around my contact at Carle and find out the name of the Director of Carle RespiratoryHe gave me the name of the Director of Carle Medical suppliesI then tried to contact the Director of Medical Supplies and got his secretaryHis secretary EMailed him, and at my request, she copied meFrom this information, I was able to EMail him directly and copy the original contact at Carle on the EMailAll of this occurred in late September,
Now, after approximately ten months of getting the runaround and Carle's avoidance tactics, Carle sent me an EMail (not a letter) stating that since my father is deceased, he doesn't need a new CPAP machine, and they won't provide reimbursementAlso, Carle's response, above, is incorrect in that they sent nothing to my mother; they sent an EMail to me, his daughter
The fact remains that their employee dropped and irreparably damaged my father's personal equipmentCarle clearly has culpability in this matter, and they're trying to use my father's death for their own financial gain
This is a particularly deplorable business practice, and I will ensure that all of my relatives, friends, and acquaintances know about it
Initial Business Response /* (1000, 5, 2016/07/22) */
To Whom It May Concern,
I am writing to you in response to your complaint to the Revdex.com regarding the billing for your son's visit in and how the charges were processed by your insurance company
Carle's outpatient
clinics (Primary Care, Convenient Care, Specialty departments) are departments of the hospital and as such are billed as provider based servicesThis results in a bill from Carle Physician Group as well as a bill from Carle Foundation HospitalProvider Based Billing is a nationally recognized billing model for integrated healthcare delivery systems such as oursI understand your concern related to the billing model utilized by Carle; however, it is an allowable Medicare status for hospitals and clinics and complies with specific Medicare regulations
A consent form was signed on your son's date of service acknowledging that separate bills may be received for services provided by Carle Physician Group and Carle Foundation Hospital (Illinois Fair Patient Billing Act ILCS 88/50)A copy of this consent form was made available for review at the chestation
Blue Cross Blue Shield has a limited contract with CarlePrimary Care Providers including Convenient Care and Pediatrics in Champaign, Urbana, and Mahomet are out of network with Blue Cross Blue ShieldI apologize if you were misinformed by staffIt is our policy to not inform patients regarding insurance coverage and refer patients to their insurance companies with any questions about coverage including contracting information
As a one-time gesture of goodwill we have given you a 30% discount on the Carle Physician Group charge of $leaving a balance of $
Thank you for taking the time to bring your concerns to our attention
Respectfully,
*** ***
Initial Consumer Rebuttal /* (3000, 7, 2016/07/27) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Hello, if the understanding is that I was misinformed by staff at Carle of its billing practices, then there is no other option but to waive the entire $billing amount, and not just 30% thereofAs Ms*** stated in her response, "It is our policy to not inform patients regarding insurance coverage and refer patients to their insurance companies with any questions about coverage including contracting information." However, I was given incorrect information by Carle staff, as conceded to by Ms*** in her responseHowever, an apology for this is not enoughThe proper remedy, out of goodwill to a patient like my son, is to waive the $billing amount in full due to this mis-information provided by Carle staff and this is what I am respectfully requestingI should not be punished for inadequate training given to receptionists at CarleThank you
I am rejecting this response because: the bill from Carle hospital does not match the Explanation of Benefits from PacificSource. I have spoken with multiple people at PacificSource who assure me that the items in question are provider responsibility. PacificSource is a northwest insurance company. While in Illinois, I called PacificSource and they said to go to Carle because they will be in-network because they are a part of First Health. So Carle should be able to work with PacificSource. On the EOB's, PacificSource claims that Carle uses an invalid billing code. Instead of Carle communicating with PacificSource, an in-network insurance company, they passed the bills onto me. Even though the EOB's state provider responsibility.
To Whom It May Concern: I am writing in regard to the complaint filed with the Revdex.com. In order to address your complaint specifically, we would need your daughter's information to pull up her account. At Carle when a patient is over the age of 18 they are their own guarantor and...
thus would be responsible for the billing. If you are on her PHI you may contact our offices with questions and this gives us permission to speak with you, but you will not be the person that we contact in order to collect on balances. I would be happy to look into this issue further with the appropriate information.Carle's outpatient clinics are departments of the hospital and as such are billed as provider based services. This results in a bill from Carle Physician Group as well as a bill from Carle Foundation Hospital. Provider Based Billing is a nationally recognized billing model for hospitals and clinics that complies with Medicare regulations. It is not a new model of billing. The vast majority of insurance companies are familiar with provider based bills and pay claims accordingly. I apologize if we have failed to meet your expectations, and I thank you for your feedback. We continually look for ways to improve the experience for our patients. If you have any further questions please contact Patient Accounts at (217) 326-8300. Respectfully, Michelle Smith
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted]4, and find that this resolution is satisfactory to me.
I am writing to you re complaint #[redacted]. I do not seem to be able to update this complaint on your website since it tells me that "there is nothing for you to do on this complaint right now."Apparently Baumann Plumbing has not contacted you. They have, however, contacted me. A...
Mr. S[redacted] called me last Friday and explained that he is the owner of Baumann Plumbing and wanted to "make things right." He said he would send me a check for $220 and today this check arrived.Since Mr. S[redacted] has been willing to reimburse me (twice over!) for the expense I incurred as a result of Baumann Plumbing not fulfilling their contract with me, I would therefore like to withdraw my complaint. I am more than satisfied with Mr. S[redacted]'s compensation for the expense I incurred in this situation.Please withdraw my complaint and record this complaint as one that was satisfactorily resolved.Thank you for your assistance in this matter. Revdex.com is a godsend in these situations, since most merchants and service providers fear more than anything an outstanding and unresolved bad report in your files!With gratitude,[redacted]
Initial Business Response /* (1000, 5, 2015/09/11) */
To Whom It [redacted] Concern,
I am writing to you in response to your inquiry regarding a Carle Physician Group date of service October 14, 2011. I understand that the patient would like the charge removed from her credit report as this was an...
issue involving her insurance company and Carle.
In reviewing this account, it appears that Blue Cross Blue Shield had originally denied the claim. The patient received multiple statements before being sent to H&R Collection Agency. Blue Cross Blue Shield reprocessed the claim on May 3, 2012 and paid $254.66. Carle then adjusted the remaining balance of $1,305.34 on January 9, 2013.
As of today, September 11, we have notified the collection agency to have this removed from her credit report. This can take up to 60 days.
I apologize for any inconveniences that this has caused the patient and thank her for taking the time to bring her concern to our attention.
If she has any further questions please have her contact Patient Accounts at (XXX) XXX-XXXX.
Respectfully,
[redacted]
Initial Consumer Rebuttal /* (3000, 7, 2015/09/14) */
(The consumer indicated he/she DID NOT accept the response from the business.)
Thank you for your response, but I need them to contact all three credit reporting agencies with this information. From the letter, they imply that they made contact with only one.
Final Consumer Response /* (2000, 10, 2015/10/01) */
Initial Business Response /* (1000, 5, 2016/03/15) */
To Whom It May Concern,
I am writing to you in response to your complaint to the Revdex.com regarding charges you are being billed for services your son has received from Carle. I understand from the complaint that you feel your...
son's mother should be responsible for the medical bills. The law in the State of Illinois states that both parents are equally responsible for the medical bills of a minor.
I have reviewed your account, and found that you've had contact with our Customer Service Representatives. You were advised that Carle policy states that we must have the legal documents (divorce decree) specifying the legal custody of your son before we can remove him from your guarantor account and place him on his mother's guarantor account. As of today, there is no record of us ever receiving the requested documentation. Therefore, until we get the legal documentation supporting this information, your son will remain on your guarantor account as.
Once we receive the required documentation, and verify that the mother is custodial, we can move your son from your account to hers. Please understand that even if we move him off of your account, in the state of Illinois you are still equally responsible for the charges unless your divorce decree specifically states that the mother is responsible for all payment of medical bills.
I apologize if we have failed to meet your expectations, and I thank you for your feedback. We continually look for ways to improve the experience for our patients.
If you have any further questions please contact Patient Accounts at (XXX) XXX-XXXX.
Respectfully,
[redacted]
Initial Consumer Rebuttal /* (3000, 7, 2016/03/23) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I appreciate the information in the response. While the business claims to not have received any legal documents showing the mother as having legal custody, I sent said documents to the business with a cover letter dated 11/13. After that time, I stopped receiving bills, but did not get a confirmation letter stating the charges have been moved to my son's mother (as requested in the cover letter 11/13). In February, I got one new bill from Carle along with a new bill from a collection agency. It is suspect as to why it seemed like the issue was settled and then all of a sudden I started a new round of bills. And there is a mysterious disappearance of the legal documents that it seems will never be explained. So, I'll send the legal documents again, though would prefer the business provide me a specific name/address with hope that the documents will get to the correct person this time around. I'd prefer not to spend funds on registered mail.
This delay is still hurting my credit rating, so I want this issue to remain open until that part is resolved. IF Carle addresses the charges with the collection agency and the credit bureaus so that I am not harmed with credit, I'm willing to help the business receive at least half of the payment (from me). As I've told the Patient Accounts people a number of times, I'm obligated to 1/2 of any medically necessary charges that are incurred via in-network medical providers. All but one of the charges from Carle are 'in-network' for my PPO, but I'm willing to overlook that. What is supposed to happen is that the child's mother pay all medical bills and then seek 1/2 reimbursement from me for all allowable charges (medically necessary, in-network providers, etc.). The problem is that the child's mother is impossible to deail with in a rational manner. She incurs medical bills all over the state and often registers with my name using an incorrect billing address such that by the time I find out about it, the charges are delinquent. This is what is wrong with Carle's policy. People like me are being charged for services a third party agreed to pay (at patient check-in). The mother is the one who you should be going after, regardless of what Carle beleives the law is (which I have contradicting opinions on). Besides, in its response, Carle says that both parents are equally responsible for the charges. To that extent, the business should just charge each parent accordingly without all of the legal document stuff.
I'd rather not ever deal with my child's mother ever again, so like I said, I'd be willing to pay 1/2 of the charges directly to Carle. As long as the other half lands on my son's mother's account and I have a receipt for my portion, I'm good. But, this willingness on my part depends on how willing Carle is at restoring my credit. Even in the interim while we get this straightened out. I have never in my life not paid a bill that I don't owe. I have, on occasion, not paid a bill that I feel I do not owe. I don't owe any of these charges directly to Carle, BUT am willing to bypass ** child's mother so Carle gets the 1/2 I would eventually need to pay my son's mother.
I reviewed the response made by the business in reference to complaint ID [redacted], and find the resolution is satisfactory to me. The gentleman who phoned me was especially kind and understanding. It seems apparent they had a bad employee.
Regards, [redacted]
To Whom It May Concern,I am writing to you in response to your concern regarding service provided to you by our patient accounts representative on 7/20/17. The notes on the account determined that the supervisor of the call center spoke with you on 7/21/17 regarding these concerns.If you have...
further concerns, please contact Patient Accounts by calling (888) 71-CARLE.
To Whom It May Concern: I am writing in regard to the complaint filed with the Revdex.com. Carle's outpatient clinics are departments of the hospital and as such are billed as provider based services. This results in a bill from Carle Physician Group as well as a bill from Carle...
Foundation Hospital. Provider Based Billing is a nationally recognized billing model for hospitals and clinics that complies with Medicare regulations. It is not a new model of billing. The vast majority of insurance companies are familiar with provider based bills and pay claims accordingly. You may want to contact your insurance company to advise them that the Carle Foundation Hospital charges are facility fees related to Provider Based Billing for the associated services billed from Carle Physician Group. This is not double billing. The hearing and vision exam that is referred to in the complaint is part of the well-child exam. I apologize if we have failed to meet your expectations, and I thank you for your feedback. We continually look for ways to improve the experience for our patients. If you have any further questions please contact Patient Accounts at [redacted]. Respectfully, [redacted]
To Whom It May Concern:I am writing in regard to a complaint filed with the Revdex.com. In order to address these concerns, we would need your daughter's information in order to identify her account and provide the appropriate information. We are unable to respond to this complaint with...
the information you have provided.Sincerely,[redacted]on behalf of [redacted]Carle Foundation HospitalPatient Accounts