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North Cypress Medical Center

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North Cypress Medical Center Reviews (25)

Conference call was held this morning with Mrand Mrs***, as well as the hospital's directors of Patient Access, Guest Relations, and the Business Office manager.The emergency department patient intake process was explained (as it pertains to insurance information) The hospital will be appealing with Mrs***'s insurance company so that the claim can be reprocessed at the in-network patient benefit level We will follow up with the patient and her husband after the appeal process is complete The hospital is in network with [redacted] ( [redacted] ), however under [redacted] ( [redacted] the claim was processed with an out of network patient benefit level.We will also follow up with Mrs [redacted] regarding her itemized bill She said that she may have some disputes regarding services performed We will follow up with her after she has had an opportunity to more closely scrutinize the bill

Hospital staff contacted Mr [redacted] today to provide an update:The appeal to the patient's insurance provider is still pending We will try back again in two weeks for another update.The Medical Director of Emergency Services reviewed the dispute for the three tests performed at the time of service All three tests are standard of care orders, and would be expected to be done for patients presenting to the Emergency Department with abdominal pain The laboratory tests for amylase and lipase levels are for epigastric pain, and rule out conditions such as pancreatitis Urine pregnancy tests are standard for female patients of childbearing age - even despite a recent pregnancy.Mr [redacted] was sent reference material provided by the Medical Director detailing emergency medicine practices for patients with abdominal pain He was advised that we would follow up again after the next update from his insurance provider regarding his appeal

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint Sent: Monday, January 19, 12:PM To: drteam Subject: RE: [redacted] Great, thank you Here is my response: We have had two conference calls, one since the last update North Cypress posted an update on During the conference call last week, (jan 14) we notated separate charges that we were billed that we did not agree withNorth Cypress Medical Center is sending these charges to clinical review and they stated it would take about a week or so to process Two of these charges were tests for pancreatitis, which in our opinion are unnecessary since no symptoms or family history is present for pancreatitis The other was a pregnancy test and the hosiptal's response is this was only administered just in case an x-ray was needed I was breast feeding and told them I was not pregnant and was not told I was going to be given a pregnancy test I felt that if for some reason an xray was needed, then a pregnancy test could have been administered and didn't think it was ethical for them to test on a "just in case" it's needed basis We obviously did not receive x-rays, thus the pregancy test was not neededNorth Cypress Medical Center also stated that they have not yet heard back from the insurance company regarding underpaid benefits This process can take up to days At state with the insurance is the "in network" vs "out of network" portions they are paying My co-pay for out of network services is 35% and 15% for in network I asked twice upon cheif North Cypress Medical center was "in network" for my insurance and was told twice that yes they are in network After receiving my Explanation of Benefits from my insurance company, we found the hospital is out of network This was very upsetting and contradicted what the hospital told me when I asked upon checking Had I been told they were out of network, I could have gone to another hospital that was in network as it was not a life threatening emergency The hospital is supposed to contact me later this week for the results of the clinical review, and to let me know if there is an update on the insurance situationBased on our ongoing conversations and appeals in this matter, we have yet to sucessfully settle this disputeHopefully just more time is all we will need, but I would like this case to remain open and hope for the Revdex.com to continue to facilitate this unfortunate situationThank you very much for your assistance in this manner Regards,

For reference, PDF copies of both certified mail and U.Smail correspondence have been sent to Ms [redacted] via email Again, we regret that the mail was not received

RevDex.com: I have reviewed the response made by the... business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint. From: [redacted] [mailto: [redacted] ] Sent: Tuesday, September **, 2014 8:16 AM To: drteam Subject: Complain has not been resolved I still haven't got a call. Only one time north cypress medical center called me for my daughter information. never called and let me know what kind of action they doing. So no it hasn't been resolved at all. Sent from my iPad Regards,

The hospital's Business Office manager and Patient Access director have been made aware of this issue and have begun investigating.We will be happy to set up a call to Ms*** at her convenience to discuss her concern

The hospital business office is in the process of reviewing the complaint, and will follow up with the patient with resolution

Contact has been made with the complainant to gather information about the patient to conduct an investigation. Complainant has been informed that we will follow up with her after the conclusion of the investigation

Mr*** was contacted by hospital staff today - Director of Patient Access and Director of Guest Relations - to discuss the financial issue.It was clarified that the initial estimate for the procedure did not include any additional medication, equipment or implants that the physician may deem
necessary at the time of the operation. In Mrs*** case, an implant was necessary. Though the hospital would not be able to make any financial adjustments to the bill, there will be a stronger effort to make patients aware that an initial estimate could possibly change based on the circumstances of a procedure.A payment plan was initially offered to the patient and her husband upon their first inquiry to the Patient Financial Counselor, but the payment was made in full

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint
Complaint Detail / ProblemNature of Complaint:Billing or Collection Issues - The company has failed to provide itemized billingselectProblem:This hospital told me on last complaint, no problem on making payments and I have done so now I am getting paper bills days apart for same bill calls daily, but when I call to talk to someone never can I get anyone who can handle the problemI have let go of both of my doctors in this facility and will never step foot in it againPlan to let all in the area know of the problems I have had and what a rip off this place isHad same blood work done weeks in a row, at North Cypress shows different rates owed one at *** was $less.TranslateDesired Settlement / OutcomeDesired Settlement:selectDesired Outcome:out all bills due to time I have wasted trying to find some one to get this resolved
Regards,

The Business Office was able to contact Ms*** this morning. The discussion included insurance EOB (explanation of benefits) and how claims are processed from insurance providers. The correct balance was the $copay that was paid at the time of service. A zero pay balance letter has been sent to Ms*** confirming that she does not owe any remaining balance out of pocket. Ms*** is satisfied with the resolution

The Business Office at North Cypress Medical Center attempted to contact Ms. [redacted] today and explain her benefit coverage for her daughter's emergency visit.  A voicemail was left.  We would like to explain that her primary and secondary insurance have covered the hospital visit.  Secondary claim was filed on [redacted].
We will attempt to contact Ms. [redacted] again to explain in detail.

We were able to obtain the patient's information from Ms. [redacted] and investigate the concern.  It appears that there was a mistake on the hospital's part in obtaining the correct insurance information at the time of service and the inaccurate information caused the series of...

miscommunications described by Ms. [redacted].A conference call with hospital representatives and Ms. [redacted] was made today to explain the error and apologize for the inconvenience.  The hospital will not seek any additional payment on the account from Ms. [redacted], and we hope that we have completely resolved the concern to her satisfaction.Thank you for this opportunity to improve our services and to recover the relationship with our valued customers.

Conference call was held this morning with Mr. and Mrs. [redacted], as well as...

the hospital's directors of Patient Access, Guest Relations, and the Business Office manager.The emergency department patient intake process was explained (as it pertains to insurance information).  The hospital will be appealing with Mrs. [redacted]'s insurance company so that the claim can be reprocessed at the in-network patient benefit level.  We will follow up with the patient and her husband after the appeal process is complete.  The hospital is in network with [redacted]), however under [redacted] the claim was processed with an out of network patient benefit level.We will also follow up with Mrs. [redacted] regarding her itemized bill.  She said that she may have some disputes regarding services performed.  We will follow up with her after she has had an opportunity to more closely scrutinize the bill.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this proposed action would not resolve my complaint.  
I have received via email the correspondence dated September 22, 2014. It indicates that the balance on my account remains my responsibility. This does not resolve my complaint. 
Regards,
[redacted]

Thank you for making us aware of your concern in regard to your son's hospital visit in January 2016.Specialist physicians are consulted with patients based on assessments from the attending physician.  The clinical reasons for the consult would have been discussed with the patient and...

family at the time of service.  Please refer to your son's discharge paperwork for specific information, or contact the physician's office for further explanation.Based on claim denials from your insurance company, the North Cypress Medical Center Business Office began an appeals process.  The final insurance payment from [redacted] was received on 9/30/16. Your claim was processed in network and your insurance company paid in the form of two payments.  The first payment was paid at 90%/10% with a coinsurance of $119.10; and the second payment was also paid in network at 80%/20% with a coinsurance of $755.44.  The $1,986.64 patient responsibility is comprised of both coinsurance payments, a $200 copay, and $755.44 applied towards your annual deductible.Total charges for the hospital claim of $44,546.00 were processed as 'in network' according to your plan with your insurance provider.  If you are interested in resolving the account balance or setting up a workable payment plan, please contact the Business Office Customer Service line at 832-912-3722.Thank you again for contacting us.  We hope that this helps to resolve your concern.

Revdex.com:
I have reviewed the response made by the...

business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  
From: [redacted] [mailto:[redacted]]
Sent: Tuesday, September **, 2014 8:16 AM
To: drteam
Subject: Complain has not been resolved
 
I still haven't got a call. Only one time north cypress medical center called me for my daughter information. never called and let me know what kind of action they doing. So no it hasn't been resolved at all.
 
Sent from my iPad
Regards,

Ms. [redacted] initially contacted the hospital on 4/24/15 with her concern.  The hospital sent acknowledgment of receipt of her concern, investigated and sent follow up correspondence on 5/11/15.Ms. [redacted]'s case was reviewed by a clinician from the department of Quality/Risk.  Documentation...

from physicians and nursing staff determined that the quality of care that she received was appropriate from her entry in the Emergency Department on the evening of 12/31/14 until her discharge from the hospital the following day.  Tests ordered by physicians were performed and medications were offered to the patient.  Ms. [redacted] was referred to a specialist physician for follow up.Ms. [redacted] sent a request by mail on 5/20/15 for her medical records and an itemized billing statement.  A voicemail and letter were sent with instruction on the proper steps to follow to obtain her medical records.  The requested itemized billing statement was sent to her address.The physician who coordinated her plan of care was acting in the best interest of the patient's health, and was not financially motivated.  Clinical staff is unaware of the costs of a patient's treatment, as insurance coverage plans vary from patient to patient.  We regret that Ms. [redacted] was not satisfied with the care that she received at North Cypress Medical Center.  However, the amount due on her account for the disputed visit remains the patient's responsibility.  Our Business Office staff will gladly arrange a workable payment plan if it is her preference to do so.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  
Sent: Monday, January 19, 2015 12:26 PM To: drteam Subject: RE: [redacted]   Great, thank you.  Here is my response:  We have had two conference calls, one since the last update North Cypress posted an update on.  During the conference call last week, (jan 14) we notated 3 separate charges that we were billed that we did not agree with. North Cypress Medical Center is sending these 3 charges to clinical review and they stated it would take about a week or so to process.  Two of these charges were tests for pancreatitis, which in our opinion are unnecessary since no symptoms or family history is present for pancreatitis.  The other was a pregnancy test and the hosiptal's response is this was only administered just in case an x-ray was needed.  I was breast feeding and told them I was not pregnant and was not told I was going to be given a pregnancy test.  I felt that if for some reason an xray was needed, then a pregnancy test could have been administered and didn't think it was ethical for them to test on a "just in case" it's needed basis.  We obviously did not receive x-rays, thus the pregancy test was not needed. North Cypress Medical Center also stated that they have not yet heard back from the insurance company regarding underpaid benefits.  This process can take up to 30 days.  At state with the insurance is the "in network" vs "out of network" portions they are paying.  My co-pay for out of network services is 35% and 15% for in network.  I asked twice upon check-in if North Cypress Medical center was "in network" for my insurance and was told twice that yes they are in network.  After receiving my Explanation of Benefits from my insurance company, we found the hospital is out of network.  This was very upsetting and contradicted what the hospital told me when I asked upon checking.  Had I been told they were out of network, I could have gone to another hospital that was in network as it was not a life threatening emergency.   The hospital is supposed to contact me later this week for the results of the clinical review, and to let me know if there is an update on the insurance situation. Based on our ongoing conversations and appeals in this matter, we have yet to sucessfully settle this dispute. Hopefully just more time is all we will need, but I would like this case to remain open and hope for the Revdex.com to continue to facilitate this unfortunate situation. Thank you very much for your assistance in this manner.     
Regards,

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.

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