Children's National Medical Center

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

Review: I was a Children's National Medical Center facility in Fairfax, VA for an outpatient visit. They tried to make me sign a paper acknowledging that there will be facility charges not covered by insurance. Before signing I requested for an estimate and they told me that it was about $30. I spent about 30 minutes overall at the facility for an outpatient visit and received a bill later for $111. I called and asked and they did confirm that it was for the 15 minutes I waited in their waiting room. On the call they indicated that at a minimum anyone will be charge a "facility fee" of $140 (not quite sure why they charged me just $111). This information is not available anywhere before or during the visit. The paper they make you sign agreeing to pay for the facility charge DOES NOT have the minimal amount of $140, and when I asked they said about $30.

Any patient going for an outpatient visit, not an acute visit if told that the waiting room time is going to cost at a minimum $140 regardless of health service provided will not do business with them. Of course I am going to go ahead and cancel any and all subsequent visits with this organization. They need to be transparent with this pricing. They should include in the form they make patients sign agreeing to pay the facility charge the $140 minimum so that patient know what they are signing. I was mislead when I asked the question before signing, and I am sure many other customers have also. I have never been to an outpatient setting with such a fee, but also with the process of making you legally liable without disclosing the fee.Desired Settlement: Change the policy, be transparent upfront about the pricing so that customers know that on top of the health services they will be financing something else unrelated to the service. I refund of the amount above the $30 quoted to me would be nice.

Review: There are several errors in our billing in the year 2013 from National Children's Medical Center. I have pointed out the errors for many times. I sent letters and payment records to the billing department, to the doctor office, and to the hospital. I have the payment records in the bank statement. I have sent the statement to the hospital a few months ago. But there is still no responses. Unfortunately, no one corrected the bills. There are no one responding to the errors. Furthermore, the hospital asked the TransworldSystems the collection company to collect money from me. There is no one explain why there is no responses to the correction. Why the hospital keeps sending out the wrong bills without any reasons?

Please help us solve this problem. Thank you very much!Desired Settlement: Children's National Medical Center should corrects all the wrong bills.

They should withdraw all the ridiculous money collection from TransworldSystem company.

In addition, they should give me an apologize letter with the hospital president's signature.

Business

Response:

To Whom It May Concern:We have looked into the billing concerns listed in **. [redacted]'s complaint and made corrections to his account in September 2013.After making corrections to **. [redacted]'s account there remains a $150 balances on account [redacted].Our records show that we have received $660,00 in payments from **. [redacted]. I have attached an Account Payment Activity Summary Report for account [redacted] that list $585.00 in payments and an Itemized Statement for account [redacted] that list $75.00 payment for review.If **. [redacted] has made payments that total more than $660.00, please ask him to send that information to us for review.Additionally, the billing office along with the Ombudsman at Children's National has made several attempts to meet with **. [redacted] in regards to the concerns he has about his bills. Unfortunately, due to a personal emergency, **. [redacted] was not able to attend.The Children's National team remains available to **. [redacted] to sit down and meet with him to review the attached documents and answer any questions.If there are any further questions, please do not hesitate to contact [redacted], ###-###-#### or [redacted] ###-###-####Regards,

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

This response is not correct. What I complain is to correct this response. I have received the copy of the payment mentioned in this response. But the record was not correct. In their copy, it showed that they didn't receive the payment on 04/11/13, 04/12/13, 04/16/13, 04/23/13, and 05/03,13.

Review: An initial office consultation of our daughter with a doctor practicing at Children's National Medical Associates was billed as an outpatient hospital

Our daughter initially visited Dr. [redacted] of Children's National Medical Associates in [redacted], Maryland on December 31, 2012. The purpose of the initial visit was a consultation which included no intrusive procedures. As a follow-up visit was recommended, our daughter visited the same facility and doctor on March 8, 2013. Upon receiving a bill from Children's National Medical Associates after the second visit, we were quite surprised as our copayments should have been all that was required from us. The initial consultation, which they claimed was an outpatient hospital visit resulted in an unexpected bill of $244.32 as no written nor verbal disclosure was provided to my wife regarding the billing as an outpatient hospital. Interestingly, the follow-up visit with the same doctor at same location was handled as an office visit. Upon several inquiries to Children's National Medical Associates, we were told both visits were submitted to the health insurance provider and billed correctly based based upon specific location of services rendered. Upon asking for a reasonable explanation as to how both visits could be billed differently for the exact same office location for an initial consultation and follow up visit respectively, one was not provided. In addition to be spending several telephone calls with no resolution, I would add **. [redacted] of the billing department was very unprofessional on more than one occasion.

After contacting our health insurance company, a supervisor agreed it made no sense as the visits should have been billed identically. However, without modification of the claim by the doctor's office, they could not process the claim. Upon dialog with very belligerent and unhelpful persons at Children's National Medical Associates, no progress has been made regarding their improper billing practices.Desired Settlement: Expect bill be corrected to reflect office visit rather than outpatient hospital visit. In addition, request nature of complaint with Revdex.com be added to website for others to view.

Review: During Oct 2013, my 4 year old son required emergency care and surgery due to a broken arm. We were referred by our urgent care provider to take our child the Children's Hospital and we were told to immediately depart from urgent care and report to the hospital since our son would most likely need to undergo surgery that evening. Everything went well with the procedure and our son has since recovered fully. However, I am still trying to resolve the billing errors that Children's NMC is making with submitting the claim to my insurance company, [redacted] Family Care Plan. As an active duty member, my insurance covers 100% of my child's emergency care. I have already spoke with my insurance company to confirm and determine if I will be responsible for any of the payment that I am being billed for by Children's and I have been told that I will not be. My insurance company has provided me with numerous benefit statements, since Dec 2013, stating that Children's is failing to "submit a valid [redacted] code" . Children's NMC has mailed me numerous statements for the services which were billed, equating to more than $20,000, requesting the payment. I have been in contact with Children's on numerous occasions but have only been able to speak with a Customer Service representative and I have been told that I can not speak with the billing department. I have been in contact with my insurance company and have been told that they have informed Children's billing department that a correct code is required to process the claim. At this point, my fear is that I am going to be sent to collections for failure to pay the medical bills that have accrued due to my child's emergency even though I have no obligation per my Insurance benefits. As a military member, my credit rating affects my security clearances and can have a negative impact on my position. It has been 8 months since the services have been billed and after numerous attempts to resolve the situation I am still no further along than when I received the first bill. Children's policy does not allow me to assist in resolving this issue since I can't make contact directly with the billing department and customer service has not assisted in resolving this issue. My insurance can not process the claim and clear my financial obligation without the correct information and Children's is not willing to correct the issue. I am stuck in a never ending cycle which will have a negative impact on my job due to the failure of others to do theirs. I am at a loss of what other options I have to resolve this billing issue.Desired Settlement: The desired outcome would be for Children's National Medical Center to submit a valid code to my insurance company so that the claim can be finalized and any financial obligation involving my credit can be cleared. I would be willing to have a conference call involving myself, my insurance provider, and Children's National Medical Center so that we can resolve this issue for good.

Review: On April 10, 2013, my adult daughter was admitted to [redacted] Hospital in [redacted], VA. She gave birth to her daughter. At the time my daughter was 25 years of age and covered under my [redacted] health plan. She also provided insurance information to the hospital from the baby's father, for any expenses related to the child that may not be covered under the normal delivery. According to [redacted], all normal and routine labor and delivery charges should be submitted under the mother's name for coverage. [redacted] uses Children's National Medical Center and it's associates for neonatology services during labor and delivery.

After the delivery I received several Explanation of Benefits from [redacted] for "BabyGirl". The amount was for $239 and the claim was repeatedly denied as "Babygirl" was not a covered member of this policy. I assumed the bill would have been submitted to her father's health plan, but apparently they never submitted the bills to the right insurance company.

Both my daughter and I called, emailed and mailed Children's National Medical Associates several times to try to straighten this out. Most of the customer service representatives were very unhelpful, saying there was nothing they could do about this. I later learned from [redacted] that CNMC just needed to resubmit the bill under my daughter's name rather than "Babygirl" and it would be covered.

I called and spoke to [redacted] on 2/28/2014 and she completely understood the situation. She advised me they have been seeing a lot of this since the new healthcare laws. She said she took my account out of collections and said I may get another bill, but not to pay it. She would fix it. Meanwhile, I received several more phone calls from [redacted]. I sent them all the info I had, the EOB, a copy of the birth certificate, documentation of my conversation with [redacted]. I asked that they stop bothering me because this was not my bill to pay. The child in question is not my child and I am not legally liable to pay the bill. The correspondence from [redacted] stopped, but the bills from CNMC did not. I continue to be billed from them monthly. A follow up phone call with [redacted] on 4/4/2014 got me nowhere. She said nothing is happening with this, but you don't have to pay it. Well, if I don't have to pay it, why am I getting billed?

Since we do not know what exactly they are billing for, we are going under the assumption that this is for normal labor and delivery exam for the baby's birth.

My daughter has advised me she is now also getting billed for this, the same amount as I am. She has submitted everything to the baby's father's insurance, but they denied claims saying it should be covered under [redacted]. Meanwhile, she too has been sent to collections. Kind of unfair since she just got her first bill from CNMC.Desired Settlement: My desired outcome would be that Children's National Medical Center submit the bill in question $239 back to [redacted] under the mother's name as part of the normal labor and delivery. If this was outside of normal labor and delivery, then they need to obtain the correct insurance information from the baby's father and mother and submit the billing information to that insurance company.

I need to be left out of this. I am not the baby's legal guardian. I was only the carrier of the insurance for my daughter at the time of her delivery.

Business

Response:

June 12, 2014Dear [redacted]:Thank you for sharing your concern regarding the bill you received for $239.00.We apologize for your frustration and experience with the billing department. In response to your concerns we have adjusted the balance due to 0.00 because we failed to handle the account correctly.When your daughter arrived at Childrens National she should have been instructed to contact medical records to have the patients name updated so the correct insurance could have been billed. The reason you were billed was because Childrens National used the billing information provided by the birth/transfer hospital.We are including a 0.00 balance statement for your review.Please do not hesitate to contact us if you have any further questions or concerns.Regards,

Consumer

Response:

[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.]

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,