Columbia St. Mary's, Inc.

Review: On 9/19/2014 My Son had surgery at Columbia St.Marys Milwaukee. My insurance paid the claim November 2014. My Co-pay submitted to me by my insurance company was $3642.60. On 1/3/2015 I contacted St. marys I discovered they had the wrong billing address. On 1/9/2015 I recieved a bill threatening collections for the amount of $6347.60. On 1/26/2015 I re- sent the explanation of benefits from my insurance company to St. Marys so they could correct the bill. On 2/9/2015 I received my FINAL statement from St. marys for the incorrect amount I called and explained that they had the wrong amount and by making a payment I would be accepting this as my total bill. On 4/15/2015 I again contacted St. Marys billing and discovered my bill was corrected. At that time I requested a new correct statement be sent to me. I was informed that I was sent the 5 statements allowed and I could no longer recieve one, it was apparently my problem that because of their error the first 3 statements I never recieved and the final 2 they fraudulently tried to charge me almost double the amount. On 5/6/2015 my account was sent to collections. On 5/19/2015 I spoke with [redacted] a supervisor in the billing office I expalined that this account was unpaid due solely from St Mary's negligence and incompetence. I requested that my account be withdrawn from collections and to be sent a proper statement and I would pay the bill.I have continously requested to speak with a supervisor to work this out. They have refused to allow this for me.

Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Other (requires explanation)

I want my account to be withdrawn from collections and to be sent a correct statement. I want in writing a letter from St. Marys that this was not reported to any credit agency

Business

Response:

I called the person that filed the compliant, but unfortunately we were unable to connect. I am including a copy of the letter that I sent to them to explain the account has been corrected as well as withdrawn from the collection agency. If they have any further questions or concerns to contact me directly for further assistance.

Thank you

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.

Review: I keep receiving bills for services I've paid for in full. Payments: 06/03/2014 $20.00 06/30/2014 $20.00 07/31/2014 $20.00.Desired Settlement: Please stop sending me bills.

Consumer

Response:

I just received a letter from CSM Billing clarifying that they had made a mistake with my account and have corrected it. I don't know why they didn't respond to your inquiry, but in any case the problem is solved thanks to you.

Thanks again,

Review: I had received numerous bills from Columbia St. Mary's for surgical services I received late last year. 1/28/14 I spoke with someone ([redacted]) in their customer service dept. at phone numbe [redacted] and explained that I needed the bills combined and I would make regular payments as I was recovering from a 12/22/13 auto accident, who said that she would set me up for payment arrangements and that nothing further was needed (I made a $50 payment on 1/28/14-ck # [redacted]) . Since then, I have made regular payments with this understanding. Since arrangements were made, I had been receiving medical services due to the auto accident until spring, 2014, with my mother who was hospitalized for an isochematic attack & attending to her medical & business affairs, been caring for my stepdad who has severe Alzheimers, while attending every one of his & my mom's medical appoinments and attending to mom's follow-up care. In spite of all of this, I continued to make payments to Columbia St. Mary's.

On July 2, 2014, I received a collection notice from Americollect indicating the account was past due for $347.88. I contacted them and told them of arrangements made with St. Mary's. They told me to contact the hospital. (7/23/14, I faxed a dispute letter to Americollect and request for verification of the debt and am waiting for a reply from Americollect.)

I called (414) [redacted] numerous times and was put on hold several times, then left a message. 7/2/ 14, I finally spoke with [redacted] and explained the situation to her. She said that accounts had been "transferred to another department last week" and that [redacted] was not in their department and showed no record on my account of the payment arrangement conversation. I asked her to please check my account and when she checked and saw I had made numerous payments, and said that she would explain the situation to her supervisor and try to pull back the account from the collection agency and someone should be calling me about this. I mailed her a thank you card and sent a payment to Columbia St Mary's. for $40.55.

As of 7/21/14, I had not heard back from anyone, so I called customer service again, was placed on hold several times, then cut off. I called back again, placed on hold several times, then finally was able to leave a message with Ursula (after explaining the situation again and she could not help me) for [redacted] to call because [redacted] said she was not at her desk.

7/22/14 I spoke to [redacted], who said that she was waiting to hear back from her supervisor, but said she was told that [redacted] did write the information about payment arrangement and there was no record on my account "without notification the account cannot be pulled back". I told her I felt it was not right for me to be penalized because [redacted] did not follow through and asked to speak with her supervisor. [redacted] told me that she would leave a message for [redacted], her supervisor to call me. I also left a message on Leslie's voicemail to call 7/22 and 7/23. She left a message for me on 7/23 in the afternoon, but I couldn't return the call until the morning.

7/24/14 I spoke with Leslie, who refused to give her last name when I asked for her correct information, who told me since [redacted] no longer worked there and I should have made a payment over the phone with [redacted] (which I was never told before), there was nothing she could do. I asked for the name of someone to speak with at the hospital in person to discuss this matter and was told initially that this was not possible. When I asked how that is not possible, after putting me on hold, Julie said that she would leave a message for Julie in customer service support in charge of escalation support to contact me but said Julie may not meet with me in person. Nor would [redacted] provide [redacted] number so that I could contact her to resolve this matter.Desired Settlement: I want to have the account pulled back from the Americollect collection agency with the original payment terms restored with Columbia St. Mary's Hospital until I have the amount paid in full. It was not right that the account was turned over for collection after I made arrangements with [redacted] in customer service who failed to record this on my records. I have been told inconsistent reasons and actions that I was supposed to take but was not told of by [redacted], [redacted] and [redacted]. I have no reason to lie about this (as I told [redacted]) and am struggling to understand this mistreatment by a hospital that I have faithfully and happily dealt with for over 30 years.

Business

Response:

I have received complaint [redacted] and have contacted the client to discuss the issues. We had had a lenghy conversation to aid in understanding of the difference between hosptial and clinic services. We will be meeting on 7/31/14 so that together we can go over any questions to aid in resolution and better understanding. I ahve provided the client with my direct contact information and I am certain we will resolve and clarify any questions regarding the bills.

Thank you

Review: I have been trying to correct a billing issue with the West Allis location for over thirteen months. I have called over six different times. I was incorrectly billed. The insurance company gave me the correct codes for columbia st Mary's to correct and resubmit the bill. I paid the bill even though I did not owe the balance so that it would not get sent to collections. The date of service was in May 2014. After paying the bill I spoke with someone in customer service about five months ago that informed me the bill was corrected and I would receive a refund of my previous payment. Today I received the same bill saying I owe the exact same balance from thirteen months ago that I already paid even though I shouldn't have owed the balance in the fist place.Desired Settlement: I want the bill that I already paid corrected so that it does not show a balance owed of $19.57. I would also like a refund of the $19.57 that was incorrectly billed in the first place.

Business

Response:

I have addressed the concern with the client per phone call on 6/30/15, and generated the attched letter today once I ahd all the facts in place.

Thank you

Review: I have been visiting Madison Medical since 2012 for visits to my Endocrinologist. Last year at the end of my appointment I made an appointment for today Aug. 7, 2015 at 1:00 pm. This morning, given that I live about a 45 min. drive away and that no one called me to verify the appointment yesterday, I called at 9:30 and was informed I did not have an appointment because there was no doctor by that name there. I was put through to a voicemail where I left my info. At 12:10 I called back and was once again told I did not have an appointment and was once again put to the same voicemail. No one asked if I was in need of a prescription re-fill etc. At 1:40 pm I received a call from Madison Medical asking if I wanted to schedule and appointment. When I told the lady I had already made arraignments elsewhere she simply said, have a good day, and hung up.

I also put in a call to the office manager but there again got a voice mail.Desired Settlement: Get a call from the office manager and an apology. Also, that someone understand that I was at no time asked if I was short on medication or even if I was feeling well.

Business

Response:

Tell us why here...The complaint is being directed to the clinic so that the Manager can address the issue.Thank youJ[redacted]

Business

Response:

On the afternoon of 8/7/15 our office manager contacted the person who submitted complaint [redacted] and the two of them discussed the situation. I believe the matter was resolved as the patient had requested in her original message to you. Please contact me if you have any questions. Thank you. [redacted], Assistant Director-Operations & ComplianceMadison Medical Affiliates788 N. Jefferson St.Milwaukee, WI 53202Ph. (414) 274-6264[redacted]

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,

Review: On August 24th, 2012 I received mental health services from Columbia St. Mary's. At the time of service I provided my insurance information to Columbia St. Marys. Although my insurance is through [redacted], since it was mental health services Columbia St. Mary's was supposed to send the claim to Oasis Health Care Inc. Instead, Columbia St. Mary's sent to the bill to [redacted]. [redacted] denied the claim on October 12th 2012 and returned the bill to Columbia St Mary's stating that the bill must be sent to Oasis Health Care Inc. Columbia St. Mary's did not send the claim to Oasis Health Care Inc., and the claim went to collections.

I am doubly insured. At the time I thought [redacted] was my primary insurance. I have now learned that Human is my secondary insurance and that Group Health Cooperative is my primary insurance.

In July 2013 I began receiving calls from collections. This was the first time that I heard that there was a problem with the bill. I called Columbia St. Mary's about the bill and they stated that they had sent it to [redacted] and [redacted] required more information from me. I called [redacted] and [redacted] stated that they never asked for any kind of documentation from me. I called Columbia St. Mary's and requested a bill and that they send the claim to my primary insurance, Group Health Cooperative. Columbia St. Mary's refused to send me a bill and would not send Group Health Cooperative a bill. Since I am able to bill my primary insurance within one year of the services provided by Columbia St. Mary's timing was crucial.

I continued to call Columbia St. Mary's throughout the remainder of the 2013. Each time I called they stated that the last time they had spoken with me was in July 2013. All the information I provided, including an update of my primary insurance and new address which I gave them on three separate occasions, they stated was not in their records. I requested to speak with the director of the department and she stated that there was nothing she could do.

On January 23rd, 2014 I called Oasis Health Care Inc. and asked about the bill. Oasis Health Care Inc. stated that they never received the bill from Columbia St. Mary's for the services provided on August 24th, 2012. Oasis Health Care Inc. stated that they would request a bill from Columbia St. Mary's, however, Columbia St. Mary's refused to send Oasis Health Care Inc. the bill. At this time, Columbia St. Mary's is still attempting to collect the total amount of $4,214.00 of the services provided from me.Desired Settlement: I would like Columbia St. Mary's to acknowledge that I am not liable to pay for services. Since Columbia St. Mary's failed to send the bill to the correct billing agency, I should not be required to pay out of pocket for a mistake Columbia St. Mary's made. I would like Columbia St. Mary's to claim responsibility for the bill and to remove my name from collections.

Business

Response:

I have received your recent Revdex.com Complaint reference # [redacted] and I have reviewed your account and responded to the complaint.

Review: My family and I have been patient of Columbia St. Mary's (CSM) for several years. In the past few months I have noticed that I have been billed multiple times for items that have been previously paid. Originally, bills began being suspicious when In May 2013 I received an invoice that belonged to 2012. In the next few months other invoices were received from 2012 too. The sums are small so I decided to pay even though it was strange.

In November of 2013 I noticed that because some of the amounts I was paying were always very similar it could be possible that I had been paying values that were already paid. Thus, I decided to began reconciling the invoices to the insurance statements. In december two additional request for payment showed up as paid in my reconciliations: one totaling 19.46 and the other one totaling 94.93. These values had been billed posterior to the date of online payment so that it was not a case in which CSM had not received the payment yet and they billed before payment arrival.

After multiple instances in which I had tried to contact CSM' billing office [redacted] I finally had the opportunity to share my concerns with a representative. I explained what the problem was and I was told that the responsibility on verifying the accuracy of payments laid on the customer and that nothing could be done by CSM to ensure that customers were not paying more than once their accounts. The representative searched for one of the values (19.46) and she discovered that this amount had been misallocated. That basically I had written the wrong account number (using apparently the account number of a different family member) when entering the payment online.

I argued that if CSM was receiving payments that did not match previous invoices/accounts, it was the responsibility of CSM to return payments or grant credits to customers. However, that has never been the case in my particular circumstances. The only statements I receive are those showing values owned no credits (except for insurance payments). It has never been credited any of my payments to any of the accounts (one for each family member) for which I submit payments.

The representative told me that once the payment is receive online it is automatically allocated and that no human intervention exist. Apparently no one audits the billing accuracy.

The whole situation sounds to me as if CSM knows that there is a material weakness in their billing process. They have not implemented supplementary controls to mitigate the weakness. And that CSM is knowingly allowing for discrepancies to occur. It would be interesting to know how much CSM customers have been over billed in what seems to be a fraudulent scheme. If the online system does not have proper controls in place I cannot understand how is it possible that CSM has allowed this billing process to go live. Further, because this fundamental weakness in internal control, it is even possible that CSM is billing for services not even rendered. I guess, from now on I will have to keep a record of each doctor visit my family members attend.Desired Settlement: I think this system requires thorough investigation. Someone has to be held accountable and maybe authorities need to be involved. My next step would be to alert the external auditors in an effort to see if this problem is widespread.

Thank you.

Business

Response:

I have reached out to the customer and have left numerous messages since 1/10/14. At this time we have been playing phone tag. I have called and left a message again today 1/14/14 to request more information so that I can assist with the cusotmer with their concerns for ID [redacted].

Thank you

Business

Response:

From: [redacted]

Date: Sat, Jan 18, 2014 at 8:56 AM

Subject: RE: The Revdex.com of Wisconsin has received a customer comment regarding complaint #[redacted]

To: "[redacted]

On 1/17/14 I spoke with customer [redacted] to obtain the necessary information so that I can do the research and address the customers concern. I have requested a couple of days to do the research and will follow up with him once I have finished. The customer indicates he is fine with that.

Thank you

Columbia St Mary's

Patient Finance Support Supervisor

With a minor injury I took my daughter to a nearby urgent care center (Urgent Care center, Glendale). The care center released my daughter with a prescription of an antibiotic course. Next day, she was OK.

For this service, they charged for an emergency service. Can you believe? My insurance paid approx. $300 and my co-insurance is approx. $100. Total cost is approx. $400 .

I informed this to the respective authority. They simply ignored my appeal.