Evangelical Community Hospital

August 16, 2016After review of the complaint and applicable account it has been determined that per the insurance that *** *** selected, which is *** *** *** of ***, indicates that we were to charge $2,instead of $1,for this procedure and we have to charge the
contracted amount - Evangelical Community Hospital treats all patients the same and bills according to the health insurance program that the patient selectedPlease see breakdown below that we received from *** ***s' selected insurancecompany: PROC# Charge $ Allowed $ *** Adjustment Pt Deductible Pt CO-Insurance *** $1, $2, -$ $ $285.18Total Outstanding Balance $ $285.18Total Patient Responsibility $573.24Please see attached Electronic Remittance Advise from *** *** *** of *** for your reference regarding the accuracy of our statement.Should you have any questions, please do not hesitate to contact Evangelical Community Hospital at (570) 768-3000.Sincerely,Sharon H. Director, Patient Financial Services

I was in to the ER last June due to very bad pain in my abdomen. When I arrived they took a urine sample and at the time I was not aware what a kidney stone looked like but I told them I think that is what it was and I passed it. I waited 4 hours in the waiting room. After being taken back to the actual ER the doctor did not come in for over 1.5hrs. When he came in I told him what happened and thought it was a kidney stone. He came back 30 minutes later and said there was blood in my urine. He said "we'll go with that" referring to me telling him it was a kidney stone. He said, "if you have any more issues just come back". I spent 6 hours in the ER for nothing only to be told I had blood in my urine and "we'll go with that" when I told him it was probably a kidney stone. I had letters threatening me with collections agencies for the $248 physician fee within 2 months. Now even after making payments I had a collection agency call for the $955 (and $500) for the ER room fee. My insurance doesn't pay a damn thing and they bill me for over $1,100 for doing what? Telling me I was probably right and "we'll go with that"? I am filing a complaint through the state at this time.

August 12, Evangelical Community Hospital is in receipt of the complaint referenced aboveThis patient did receive laboratory services at our facility on 11/08/as indicated in the letterThe patient was uninsured but did qualify for Select Plan for Women administered by the
Pennsylvania Department of Public Welfare (DPW)This program is not Medical Assistance and only covers limited laboratory services that are listed on their fee scheduleOnly one of the services rendered (*** ***) was covered by the Select Plan for Women and paid $The remaining balance of $for this charge was adjustedUnfortunately, the other four charges billed to Select Plan for Women (*** *** ***, and ***) were denied as the services were not payable under the program per their fee scheduleThe patient was uninsured therefore she was subsequently billed for these chargesThe updated amount due on this account is $as the additional adjustment of $was processedAn updated itemized bll is included with this response, The itemized bill also confirms that no HIV testing was charged to the patient.In addition to the itemized bill, a copy of the *** claim form and DPW explanation of benefits is included to confirm the services billed and denied by the Select Plan for Woman programThank you for allowing Evangelical Community Hospital the opportunity to respond and work toward an amiable resolution to this disputePlease contact me directly with any questions related to this case.Respectfully,Amy R
Director, Patient Accounts

I went to a specialist on Feb. 7th. I was told I would have a nurse call me two days later. No results so I called days later. The nurse told me the Dr. needed to call me with the results. No call and 2 days later I called again, and another nurse said that my results were caught in a glinch? And they would call back with the results. No call again so I called again and the nurse had to take a paper copy to the Dr. finally I had a result. Which they they referred me back to my Dr. they told me they should call the following week. No call again I called and they said she hasn't read the results yet. It's going on a full month and I still haven't gotten talked to a Dr. or been put on a medication yet. It's very sad we need to call the Dr. for results for our bloodwork and they just pass you like your not important.

Review: I had bloodwork done 11/8/2013 at Evangelical Community Hospital while being covered under the medical assistance program "Pennsylvania's Select Plan for Women". Which states they cover STD testing and HIV testing for free. Which is why the bloodwork was done. The hospital called my doctor and said they weren't able to do the HIV testing due to improper testing. The hospital sends me a bill 11/21/2013 that states I owe them :

$72.44 for laboratory

$422.62 for Laboratory-Immunology

Total $495.06

I believe the hospital might have charged me for an HIV test they never performed. I've never received an itemized bill for the blood work. Just the terminology stated above.

The main issue however is they have billed me when I was told medical assistance is to cover the blood work. The issue was thought to be resolved in December 2013 after I spoke with a woman who said I had received the bill due to a coding error.

However the hospital has sent me a bill now saying I owe them $491.06 on 7/17/2014. I called them and they said I was ineligible but didn't know what that meant.Desired Settlement: I would like to first make sure they aren't charging for an HIV test that they never performed.

Second I want them to do their jobs and find out who is responsible for the bill and give me a proper response besides I don't know. I had spoke with the Medical Assistance people back in November and they said I should be covered for the testing

Business

Response:

August 12, 2014Evangelical Community Hospital is in receipt of the complaint referenced above. This patient did receive laboratory services at our facility on 11/08/2013 as indicated in the letter. The patient was uninsured but did qualify for Select Plan for Women administered by the Pennsylvania Department of Public Welfare (DPW). This program is not Medical Assistance and only covers limited laboratory services that are listed on their fee schedule. Only one of the services rendered ([redacted]) was covered by the Select Plan for Women and paid $4.00. The remaining balance of $43.58 for this charge was adjusted. Unfortunately, the other four charges billed to Select Plan for Women ([redacted], and [redacted]) were denied as the services were not payable under the program per their fee schedule. The patient was uninsured therefore she was subsequently billed for these charges. The updated amount due on this account is $447.48 as the additional adjustment of $43.58 was processed. An updated itemized bll is included with this response, The itemized bill also confirms that no HIV testing was charged to the patient.In addition to the itemized bill, a copy of the [redacted] claim form and DPW explanation of benefits is included to confirm the services billed and denied by the Select Plan for Woman program. Thank you for allowing Evangelical Community Hospital the opportunity to respond and work toward an amiable resolution to this dispute. Please contact me directly with any questions related to this case.Respectfully,Amy RDirector, Patient Accounts