Florida Hospital Carrollwood 4179

In December, my husband went to AdventHealth Carrollwood for an endoscopy procedure and was charged a total of $4,333 (20 percent was discounted from the $5,000 initial quote). However, when speaking to the insurance company prior to the procedure, the insurance representative provided contracted rates and codes, which totaled a charge of $2,439.11.

On the day of the procedure, my husband and I disputed the charges, but the hospital representative remained steadfast that the $4,333 total was accurate since it was apparently what they billed in the past. On the website, it is practically impossible to see what each procedure is charged since some procedures may have multiple billing codes as my husband's did.

An itemized receipt was provided (which had to be requested at the time of the charge), however, the charges do not match the contracted rates or billing codes as confirmed by insurance. The claim submitted to the insurance company also has double charges and no reference to billing codes. According to the claim submitted, Adventhealth Carrollwood believes that an hour long endoscopy should cost $19,711 before insurance discounts are removed. This is only for the hospital procedure, not including the cost of the doctors'. Even reaching out to Adventhealth Risk Management team, they responded that they cannot bill an insurance more than our contracted rate so if billing was incorrect, insurance would have rejected the claim, and then sent my husband back to the insurance explanation of benefits.

A complaint was even sent to the Florida State Commissioner and the insurance company's response was: they are not in control of the claim submissions and procedure codes utilized by the medical provider when submitting a claim. After notifying Adventhealth of the insurance company's response and FCI resolution, Adventhealth Carrollwood has not responded. They have the opportunity to make this right, and do not appear to have any interest.
Account_Number: XXXXXXX