Marshfield Clinic

Corrupt. Lack of ethics. Physical abuse. Apathetic staff. Lacking of any compassion or empathy. Unnecessary tests and procedures done to gain financial moneys. HIPAA laws grossly ignored and abused. Altering of medical records. Threats and coercion. . Trampling of patients civil rights. Degradation and humiliation if patients...

In November, 2019 I had an apt with a Dr Joshi, a rheumatologist at the clinic. I had no symptoms at that time and wanted to reschedule the apt but the receptionist told me that the next available would be in June, 2020 so I had better just keep the one that I had. Fine, I kept it, and then explained to the nurse why I was there and why I keeping the unneeded apt. Frustrated, she explained how in demand those appointments were and without symptoms I was keeping someone else from seeing the doctor. Something I completely understood. When the doctor came in, she reiterated what the nurse had said- then called another receptionist to see if the original receptionist had told me the truth. She had not. Number one reason for my low rating.
Then in February I received my bill. Fine-after insurance, the bill was 23.66- no big deal. I am more than willing to pay that even after my frustrating appointment. Now, take a minute and look at the statement below. Do the math- how does that work? If the Office Visit was 72.90 and you received payments of 1.89 and 92.73, how do I owe you anything? Reason #2 of my low review.
After receiving the statement, I called your customer service number to get a better understanding of the statement. I talked to an agent- she didn't understand it either. She came to the same conclusion that I did but said I needed to speak to someone else and would I hold. Sure. SEVENTEEN minutes went by- no one answered. I then pushed 5 and left a message asking someone to call me back. That was over a week ago- still nothing. The next day I went through the same process. Spoke to someone at customer service, they didn't understand the statement, she put me though to someone else, I was on hold for TWENTY-FOUR minutes, I pushed 5, left another message for a call back, then nothing. The next day I went through the same process for a third time and was on hold for TWENTY-SEVEN minutes, pushed 5 again, and got nothing AGAIN.
My statement is dated 1-09-2020, I received it on 1-16-2020, and the 23.66 is due on 1-27-2020. I wonder if someone will take any action if I don't pay? Will I FINALLY get a response from Customer Service?
P.S. to be fair, I'm getting the Clinic a one star for the Doctor that I saw and her nurse who were very nice. I have no idea if they were good at their jobs since I had no complaints.

As stated in previous replies, Marshfield Clinic is not able to disclose further information without appropriate authorizationMs [redacted] may call me at ###-###-#### to discuss her concern [redacted] Manager, Patient Financial Services

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below I have contacted Marshfield Clinic Multiple times requesting an itemized statement and an explanation of the inaccuracies of their Emergency Room Billing I have yet to receive an actual itemized bill from their billing office I have only ever received a basic summary billing statement I have also not received any explanation as to why Lakeview Medical Center Emergency Room department is billing me for an Emergency room Level FOUR visit And Marshfield Clinic is double dipping and also billing me for an Emergency Room Level FIVE visit They can't even accurately double bill based on medical records, as you can see the difference in the level of emergency room care my son received I have not ever received an explanation of any of this, nor have I ever received an itemized billing statement from Marshfield Clinic Regards, [redacted]

Revdex.com: I reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaintFor your reference, details of the offer I reviewed appear belowWe do disagree on coding and costAnd if it is true Marshfield Clinic bases their billing on the Evaluation and Management Coding and Documentation Guide (E/M) then the coding is most assuredly offThe repeated claim the coding isn't based on time is incorrectThe E/M's own website specifically shows that Time is a KEY factor in determining costAccording to their site the most appropriate code for my visit is a 99212, the coding for an Outpatient Established Outpatient Evaluation Level The E/M's own site states that this coding is for a visit that is "minutes or less" with "minimal complexity"The AMA's PDF on understanding the E/M coding system ( [redacted] ) describes the code as follows "For code 99212, the office or other outpatient visit is for the evaluation and management of anestablished patient, and requires at least two of these three key components be present in themedical record:o A problem focused historyo A problem focused examination;o Straightforward medical decision making" Whereas, a level coding (99213) for an existing patient is described as "For code 99213, the expanded assessment for office or other outpatient visit requires at least twoout of these three key components to be present in the medical record:o An expanded problem focused historyo An expanded problem focused examination o Medical decision making of low complexityA tip for code is to think of expanded visits as a sum of the continued symptoms oranother extended form of the problemUsually, the presenting problem or problems are of low tomoderate severityTypically minutes are spent face-to-face with patient and/or family." If it were not for the fact that I had to actually see my doctor, my visit would easily have fit the description of coding, which is described as a minute visit with minimal issues.I do not have an "expanded problem", I did not have an examination of any sortNor did the decision to switch back to Adderall constitute a complex decision (it was not based upon medical issue but cost of Strattera which I could not afford under my current insurance) And this all presumes that you used the correct type of code (coding for an Established Patient)Marshfield Clinic is notorious for coding established patients as new patients which allows you to charge them an extra “new patient” chargeSince you refused to give me an EOB, that is a LINE-ITEM Break Down of my Bill, which you are required to give by law upon request, I can only conclude the goal of Marshfield Clinic is to defraud meAs of now, if Marshfield Clinic does not change the coding to a level (99212) code and reduce my bill accordingly (a level (99212) averages only 90$ prior to applied insurance in the state of Wisconsin), I will be reporting Marshfield Clinic to the State of Wisconsin District Attorney's office, the American Medical Association, and I will pursue other legal options to resolve the issueBe aware, continued refusal to change the coding to an appropriate level and code will constitute predatory billingMarshfield Clinic has a history of predatory billing which fits this very situation, which only makes this inappropriate coding more suspicious Regards, [redacted]

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below MsKathy [redacted] has stated that she will not respond further this unresolved issueWhat remains is my request for information about why I have been billed for a $office visit With Ms [redacted] refusing to clarify/explain information further, I am asking that she refer the matter to the clinic's board of directors and the clinic's director Regards, Alan [redacted]

Tell us why here...As I previously stated, I will not be responding further to this concern Kathy ***

Marshfield Clinic follows the Evaluation and Management Coding and Documentation Guide that is based on material from the American Medical Association and CMSThe specific components are outlined under the AMA web site A level of service is determined by the components for History of Present Illness (HPI), Review of Systems and Past Medical, Family and Social History Mr [redacted] and I agree that we disagree on the level of service Marshfield Clinic follows all guidelines established for coding and billing Cost is not based on time but on components which I have listed above, the number of components was listed in a previous message Thank youKathy [redacted]

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below [To assist us in bringing this matter to a close, we would like to know your view on the matter.] Regards, Carol [redacted]

I had the opportunity to review the concern expressed by Trever [redacted] Without authorization, I am not able to disclose information regarding this account An authorization has been mailed to the guarantor When the authorization is received back, I will be able to respond Mr [redacted] should receive the authorization in the next 7- days.Thank youKathy ***

Marshfield Clinic received a HIPAA authorization which allows me to respond to this concern for date of service 7/47/ Mr [redacted] initially contacted Marshfield Clinic on 9/8/ The charges in question were an office visit in the amount of $and the simple repair in the amount of $ The contract discount applied was $and $was applied to your deductible by Medica, your insurance company The charges were sent to our coding/reimbursement department who concluded that the documentation supports the billing of the services The coding correct letter was mailed to Mr [redacted] on 9/19/ After receiving a letter from the patient, Marshfield Clinic responded via the US Mail on 10/11/17, the letter is as follows:Thank you for contacting Marshfield Clinic regarding your account.I had the opportunity to review your concern and the charges in question from 07/17/Based on my review it has been determined that the coding of these services is appropriate and will remain as billedI have also attached an itemized statement, which you requested.If you are unable to pay your balance in full, please contact Marshfield Clinic, Patient Financial Services Department at ###-###-#### and select the appropriate phone option to establish a monthly payment plan within the next business days or by 10/25/2017, as we consider this matter to be concluded.We appreciate the opportunity to serve you and are committed to service excellence in meeting your health care needs.Mr [redacted] contacted Marshfield Clinic via a letter on 11/2/with the same concernMarshfield Clinic responded with the following letter:I had the opportunity to review your concern regarding your charges on July 17, for your Initial Office visit level and the Simple Repair CM or less.At your request, our coding- reimbursement staff reviewed the medical documentation and confirmed that the billing of the charges and the fees are appropriate.Marshfield Clinic fees are based on a wide range of factors: time, staff requirements, equipment, supplies and risk involvedJust like other businesses, we have different p***s than other health care providersOur fees are published and are available to you in our business office.At this time, we have no additional itemized information we are able to provide and the balance due on your account of $will remain as patient responsibilityWe will also no longer hold your account and without payment in full or contacting us to establish a payment arrangement, this balance will risk being placed with a collection agency.This will be the final review of your concerns, as we consider this matter to be concludedMr [redacted] is asking for a copy of the fees, I apologize that MC is not able to supply Mr [redacted] with a copy of the fees but he can contact our fee estimators at ###-###-####, extension to obtain a fee quote.The fees for these services are the standard fees for all patients The cpt (procedure) codes are created by the AMA and are used by all medical facilities Mr [redacted] may visit the AMA on line for further information Time is not a factor for most procedural codes Components of the service provided play an important role when establishing the correct CPT code which in turns creates the correct fee.Sincerely,Kathy [redacted]

RevDex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below. I will pay the $467.20 for the stitches, but not the office visit, by the December 13 due date. I will attempt to get the reasons for the office visit charge from other contacts (director, board of directors?) at Marshfield clinic, unless I hear back with a response from Marshfield within the ten day time limit. Regards, Alan [redacted]

November 22, 2017Marshfield Clinic:Again, your reply did not address my specific questions This is happening repeatedlyYour most recent reply said I should call [redacted] for a fee quote I called that number five times from both my cell and home phones and got messages that the number was "not available from calling area." I also got recordings about "team mobile, medical alert system, and a Florida cruise." So again, Marshfield, please just inform me of the itemization on my specific bill I want to know what I was charged for, which I would think would be easily assessable to you since you sent me the bill.It would greatly expedite this matter if you would get me this information I would like to know the code numbers, what they mean, and the itemized amounts This would give information on how the $was reachedAlso, Marshfield, to avoid continuously repeating myself, please just re-read my previous correspondences so that all of my questions will be addressedThis includes the "desired outcome" in the Revdex.com documentIn addition to the reply I just sent, please be aware that I did do what you told me to do, "visit the AMA on line for further information." I also called their toll free number and listened to many menus and recordings The information was not helpful to me and did not address my questions Thank you

As I previously stated, I will not be responding further to this concernKathy [redacted]

Due to privacy regulations, I am not able to provide additional information. An authorization has been sent to Mr. ***. As soon as I receive the authorization back, I will be able to respond.Kathy [redacted] Marshfield Clinic

A letter was sent to Revdex.com and a copy to Mr [redacted] earlier this weekKathy ***

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below In response to Mr [redacted] 's letter of January 9, I am replying in a separate letter I am emailing that letter to Revdex.com this morning Thank you Alan [redacted]

I had the opportunity
to review the concern expressed in the submission by Ms***She may call
me at ###-###-#### to discuss a resolution or she may wait for a letter to be
mailed to her
Privacy
regulations prevent Marshfield Clinic from disclosing further information
***
***
Manager -
Patient Financial Services

I had the opportunity to review the concern expressed by Ms*** regarding her billing concerns. The concern was previously brought to our attention and has been discussed with Ms***Privacy laws prevent Marshfield Clinic from disclosing further information regarding this
account. I will have an authorization sent to her and I can respond after the authorization is received back.Sincerely,Kathy *** * *** *** ***

Please provide the account number or the patient's medical history number regarding your concern or call me at ###-###-#### for assistance.Thank youKathy ***###-###-#### T