MedExpress Urgent Care

Review: I went to the Mars, PA facility and they performed a test. When the test was positive they sent me to the ER because they didn't have any other means to help. The ER conducted the same test an hour later and were paid by insurance because the ER coded it correctly (using an emergency code). Almost a year later, MedExpress still hasn't been paid by the insurance company and they are saying it is my responsibility now. I've talked to MedExpress billing over 7 times about the insurance coding issue - I even got the insurance company to call them directly TWICE to help them select the right codes to use. The problem is that MedExpress is coding the test as "routine" and have no "emergency codes" per their billing dept. Insurance won't cover because "routine" requires that I be over 50 yrs old for coverage (I'm 41 yrs). They are sending my bill for $37.50 to collections. I have the means to pay but refuse because they need to figure this out with insurance - it is an internal issue to solve.Desired Settlement: As an "urgent care" facility, they need to be able to use the same billing codes as an ER. This is false advertising if they can only perform and cover "routine" procedures. It is imperative they tell people their insurance is not valid for emergency tests at their facilities or turn away emergency cases. I would also like direct access to the coding dept instead of coordinating through billing dept. They won't even allow the insurance company to talk with the coding team directly.

Consumer

Response:

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: My husband and I went to the Med Express on Mosside Blvd. in Monroeville, PA on 1/24/15 for his sinus infection. We provided to the receptionist his insurance card at the time of service. She stated "that is a $45/copay." I then wrote a check for the amount. She processedd it electronically. She then requested my husband's driver's license and bank card and I asked why and she stated that was their policy in the event the insurance did not pay. I stated you said it was $45. She did not respond and said that is their policy. Now, 47 days later I am checking my bank account and notice a credit transaction for $150 from Med Express. They went into my bank account and took the money out without ANY NOTIFICATION!!!!!!!!!! No e-mail, bill, phone call. I tried to call the girl, Meg in Med Express Billing(888-249-6365) because the Monroeville office states that they connot help me she was rude to me as she states that this is my husband's account and cannot talk to me though she understands that the bank account is shared and someone has accessed my account as well as my husband's but she did not care she needed to talk to my husband. When my husband called she could not answer him the first time but had to call him back because she had to "look into it". When she called back she stated that the staff had entered the health card information incorrectly and that is why we were being charged. She states they would submit it and it may take up to 45 days to get our money back. Why, do I have to wait 45 days for my money back when I did not cause the problem it was there staff member that did. Also, I was not notified that an amount of $150 was going to be taken from my bank account.New information provided 03/17/15 This is the 2nd complaint I am filing on this business as the original date of service was 1/24/15 when my husband went to this location for a sinus infection. My husband has active health insurance through UPMC (a well known carrier). The receptionist told my husband his copay was $45 and we paid that directly via check that day. See previous complaint regarding the automatic deduction of a $150 from my bank account on 3/12/15 which was not authorized nor were we notified. Now on 3/16/15 my husband received in the mail a bill for an additional $91 for the same date of service. Really, a total of $286 for a visit this is not acceptable for a sinus infection of which the MD spent a total of 10 minutes in the room. There was no bloodwork, x-rays, stitches, ace wraps, no medicine given...etc. And we have HEALTH INSURANCE! What is going on? No one will give us a straight answer.Desired Settlement: I just want the Revdex.com to be aware of the situation as I did contact my bank as well to dispute the charge. In today's world this company should not be permitted to just go into a person's bank account and not provide some type of notification. As a consumer why should I have to pay now 45 days later for a mistake that their staff made by imputing the insurance incorrectly. But, if they are asking ahead of time for debit card numbers is this happening more then not. New information provided 03/17/15The bill taken care of as we have insurance.

Business

Response:

This is to acknowledge receipt of your March 1st, 2015, letter regarding theabove-referenced matter. During Mr. [redacted]’s 1/24/15 visit he signed our convenient paycontract. This agreement permitted us to charge his card up to $150 or any patientresponsibility as determined by his insurance carrier.Attached is the consent to treat signed by the patient which addresses that wemay secure information from the insurance company, but we’re not responsible for theaccuracy thereof.. The consent to treat also indicates that th.e patient is fully responsiblefor any and all charges. The second attachment is our convenient pay agreement, signedby th.c patien.t to authorize us to charge his card up to $150 and. the email address heprovided..MedExpress received notification from Mr. [redacted]’s insurance on 2/23/15reflecting a patient responsibility of $260.00 as a result of precertiuication /authorizationnotification absen On 3/1/15 we emailed Mr. [redacted] a notice flat we would be drafting$150 from his bank card. Therefore, on 3/11/15, the amount of $i50 was charged to Mr.[redacted]’s bank card. Mr. [redacted] did notreceive the email, notification.A refund of $150 was processed back to Mr. [redacted]’s credit card on 3/1 7/15. Wespoke with Mrs. [redacted] on 3/18/15 arid informed her of the resolution. We now considerthis issue resolved between the parties. Thank you.Very truly ours,[redacted],Quality assurance Representative

Review: I went to see a doctor at MedExpress on Friday October 17, 2014. I was refused care after showing my new PPO Blue Insurance card because I had a balance from a previous visit. Now, the previous time I was there, back in April, I was covered under my husband's insurance which was dropped about a week after I was there. I also paid a 20.00 co-pay. In June I received a bill in the mail for 240.00 which I should not have. My husband contacted my Insurance Company and they said it was by fault of MedExpress, while MedExpress was saying it was the insurance company. Because I did not want to have that on my credit report, I decided to just put it on a payment plan to be done with it, even though I should not have to owe anything.When I went to see them this second time they told me that they could not see me because I owed 40.00 from the past month. I a payment sent in at the beginning of this month from before my MedExpress visit and have an email to document me asking MedExpress if my check was received yet because it had not yet been cashed. They also said I owe another 40.00 for the following payment, which has no due date. So basically I owed them 80.00 plus 15.00 in co-pays at the time of my visit or they would not see me. My problem is, I had insurance both times. Not sure what happened the first time, but I did not enter empty handed this time either. I also went out of my way to put my past bill on a plan so that I could pay them back. I went to MedExpress due to coughing, chest pain as well as being out of breath doing light activity. I just wanted to make sure my cold was not turning into pneumonia and was hoping for a prescription of some sort. What if I had a medical emergency that I was unaware of? Nobody even bothered asking me why I was there. I think it's terrible to refuse somebody for a balance especially when it's already on a payment plan and I showed my insurance card!Desired Settlement: To resolve both of my issues with this company, I would like to be exempt from paying the rest of my first bill for all of the trouble I have had.

Business

Response:

In response to your October 20th, 2014 letter, this is to inform you that the above referenced

matter was resolved between the parties. MedExpress billed Ms. [redacted]’s

[redacted] insurance. The insurance denied the claim stating they had sent Ms. [redacted] a form

to fill out and send back but they never received the form.

The insurance was contacted and stated they do not actually show a form being

sent to Ms. [redacted]. The insurance representative has sent the claim back to be

reprocessed. Once we receive payment from the insurance, any overpayments will be

refunded to Ms. [redacted] via check. .

We have reviewed this information with Ms. [redacted] and she was satisfied with

the resolution. If you have any questions, please contact me. Thank you.

Review: I went to a Med Express center to be examined and consult with a doctor (seasonal sickness). I was not examined. A nurse took my vitals, the doctor came in and talked 'at' me about the book I was reading. He shined a light toward my ears, without really looking inside, and as an afterthought shined it in my mouth before leaving the room (my chief symptom was a very sore throat). I ended up with a prescription for antibiotics and an official diagnosis of 'viral infection' (not treatable with antibiotics). I complained to Med Express, told them I would pay for the strep test they performed, but not the examination fee as I don't feel I received an examination. The customer service rep said she would refer my complaint to their medical panel that reviews these matters and not to pay any bills I received while the issue was addressed - she said it could take months.I just received notice that they've referred the balance of my account to a collection agency.Desired Settlement: Refund of total bill (what I've paid to collections plus what was paid at the time of my appointment).

Business

Response:

Review: On Sunday November 22, 2015 I contacted Medexpress via telephone and told them of the problem I was experiencing and spoke to a nurse. I told her about the problem and she asked both the doctor on duty and the PA on duty if it was something they dealt with or should I go to the ER. She told me yes and advised me to come down to Medexpress When I got to the office, the woman took my vitals and they did a very quick basic eye exam. I again asked if this was something they could deal with and they told me it was. I was then taken to an exam room. The doctor came into the room, never examined me, and stated they need to send me to the ER. I was immediately referred to the ER as they told me this is something that they could not deal with and I should have been referred to the ER initally. The doctor acknowledged that what I was presenting with was the same thing they were told on the phone but they couldn't deal with it. I requested refund of my $40 copay because they did not do anything. They said I had to go through cooperate. I left the office and went to the ER as referred.

The next day I called cooperate and attempted to get my copay refunded as they did absolutely nothing at the office. They took a complaint and told me they would have the office manager call me. Several days went by and I heard nothing. I again followed up with the office manager. The office manager proceeded to tell me that the doctor had documented that she had examined my eye. I told her how this was not true and I described in detail how they brought in a "toolbox kit" and I can tell for certain they did not open it because I actually left curious about what was in there. The manager stated that it was documented that she performed a whole exam and once I was able to give her the information she knew this could not be true. She stated that it was up to the medical director to refund my copay but after what I told her she was certain that it would be refunded. She stated she would follow up with me and let me know the decision.

At least 2 weeks went by and I did not hear anything. Starting on December 19 I began calling daily to talk to the office manager. Each time I called she was unavailable or out of the office. I kept leaving my name and telephone number with no response. Each time I tried to the call the cooperate offices, I could not get through.Desired Settlement: I want my copay of $40 refunded.

Business

Response:

January 7,2016Attn: [redacted]Revdex.comWestern Pennsylvania[redacted]Re: [redacted]ID# [redacted]Dear [redacted]:This is to acknowledge receipt of your December 29, 2015 letter regarding the above-referenced matter. We spoke with Ms. [redacted] on 01/06/15, regarding her visit at MedExpress on 11/22/2015. It was explained to her that neither a nurse, nor a provider who has yet to examine the condition that she complained of, is in a position to ascertain whether or not a referral to the ER or Specialist is required. With that being said, the visit was reviewed by the area medical director and we have no charged the visit. The patient was refunded her $40.00 copay directly back to the card on file and she can expect to receive the credit in 3-5 business days. We now consider this issue resolved between the parties.Very truly yours,Nkliole C[redacted],Quality Assurance Specialist

Review: We received a letter on November 1, 2013 stating that our insurance did not cover our office visit. Because of this, they were going to charge us $100 the next day and since we used our debit card to pay the co-pay, they would be charging it on the card. We called the insurance company that day and found out that the paperwork was not submitted properly. When I called MedExpress back, they said they would resubmit the paperwork and once they got payment from the insurance, they would send us a check. The insurance company paid the bill and I was told it would be by December 14th that we would get our reembursment. When we hadn't gotten the check after Christmas, I called MedExpress again. This time, I was told that they would expedite the matter but it could be up to 4 more weeks to get the money. It has been exactly 4 weeks today, and still no check.Desired Settlement: We would just like our $100 back.

Business

Response:

Review: Took my daughter to MedExpress in [redacted], for fever and cough. After assesing vitals, it was determined that a breathing treatment would be needed due to low "pulse ox" from coughing. The doctor said we should get right to the emergency room at the local hospital and refused to treat my child any further. We were whisked out the door and off to the hospital with no breathing treatment administered. After receiving an exorbinant bill considering the brief time spent at the facility, I called to request a detailed bill. I was told by a pleasant customer service rep that there was really no way to get anything itemized to show what the actual charges were for, however was told that we were charged for "after hours visit" at 5:07 on Sunday even though they were open for business and a breathing treatment that was never administered. I was then told my case would be reviewed and given no claim or reference number to show that I was contesting the charges after requesting such. Hopefully it will be resolved before the collection letters come? I was told it should be?Desired Settlement: Removal of charges for services not rendered, and awareness of issue.