K***:After investigating this patient complaint it was found that there had been an error in posting of this paymentThe error has been corrected, the patient contacted and acknowledgement and apologies made for our error.Thank youK*** H*** *** Mary Black Health System
Thank you for the opportunity to investigate and review this patient complaint. After investigation we have realized that the patient did in fact change her address information as stated in her complaintThis was an error on our part as we did not change the address of the guarantor
listed for her so she never received a bill, which is now in collectionsT*** M*** was made aware of this and this has been correctedThis account went to PASI but has been pulled back on 8/24/PASI does not report to the credit agencies so this will not reflect on her credit at allAlso, it looks as if all the info has been updated so she will be receiving a bill soonI have contacted the patient and made apologies and the Director over Physician Practices will also contact her regarding resolution of this complaintAdditionally, I gave the patient my contact information should she have any further concerns in the future Thank you for allowing our facility to address and correct this patient's concerns.SincerelyK*** H***Mary Black Risk Management
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is not satisfactory, but, will comply.
Regards,
M*** G***
I am rejecting the business response because my son was seen by the same doctor within a few days of each otherWhen it is a follvisit then office visit charge should not be more than what it was to begin with at the first visitMy son's symptoms did not worsen, they just were not getting any better therefore he was treated for the same thing he was at the initial office visitFor instance if you called because your air conditioner was broken and they came out and fixed it with a part and you called back a week later and still having the same problem and they wanted to charge you for the part again, that is not how you do business I'm not wanting the second office visit charge to be free, but I feel that it should be less than and no more than the first office visit charge
Dear Sir or Madam:We have reviewed the billing address for the client below which is *** ***All correspondence or bills have been sent to his address, as he is listed as the responsible partyAdditionally, there has been no correspondence with our billing deptfrom the
complainant. Unless she can provide documentation that the bills are being forwarded to her due to a change in his address, it is unclear why she would be receiving these bills. Please let me know if there is anything else that we can do. If Mr***'s address has been changed please have her submit this information, so that we can complete our inquiry into this complaint.*** *** *** Ave***, 29323 Thank you *** ***/ MB Risk Manager
Dear Sir/Madam:The notes indicate that nothing was mentioned to the patient on what was owed prior to the services being performed. We have no benefit information documented. This patient has paid no out of pocket expense to date. There is no documentation of who
she spoke with and nothing mentions anywhere. This patient has called and spoke to our Business Office, they reviewed for correct coding, the coding manager reviewed it, and stated the “MD order on file is accurate to the charges on the account”. Her insurance state that is her deductible, is her co-insurance and her copay is 500.00. It appears that was paid to the patient/insured/responsible party, not to Mary Black (per notes in our system) Thank youK*** H***: Risk Manager
We have all our documentation where this patient was contacted on numerous occasions with no responseOur official letter was sent to the individual as aboveI hope this adds some closure to this caseI appreciate your help and support.On account # *** its stated multiple times in notes that
we were unable to give her an estimate, and only asked her for a “down payment” in the amount of to lock in a 25% discount If she pays on the day of the procedure, or within days of discharge, she would be eligible for the 25% prompt pay discount when/if additional bills were receivedThis was discussed prior to her surgery.On the day of her surgery she was asked for her payment, and she stated “I can’t pay today, I’m going to pay *** on Monday”. She never called *** to make her down payment. Patient called *** in July after she received her bill, and *** again reminded her that she could not give her an estimate of the charges, and that’s the reason she gave her the option to pay as a down payment, and reminded her that she never called and paid that amount. Patient then told *** that she would have to make monthly payments, and we provided her the number to the Business Office so a monthly payment could be made.Patient called back to Business Office on 8/and asked for her account to be audited, that request was sent to *** ***. On 8/26, we extended the 25% discount offer, and patient said she would call back after the audit.** called patient on 8/with audit findings, per *** charges are correct. Patient stated she felt that she was told incorrect amount, she stated that we quoted her 15,000, the Business Office informed that patient that nowhere in the notes does it say a quoted amount. We offered that it could have been the doctors portion that she’s confusing it with, and reminded her again that we have documentation in multiple places that we were unable to give her an estimate of her charges.On 10/5/*** *** approved a settlement for a 35% discount, leaving patient responsibility at 2655.57. Notes indicate that *** *** was going to contact patient per email.No payment has been made on the account to-date. *** ***
Dear Sir or Madam I apologize for not responding sooner regarding this complaint. I did investigate this complaintIt is my understanding that the
patient came into the Emergency Department at Mary Black on July *, 2015 as a result of a motor vehicle accidentAt that time the patient provided the hospital a copy of the police reportShe was unable to provide the liability carrier at that timeIn September of she did present the hospital with a copy of her Medicaid card, however it had been over two years since her accidentAt that point we were past a timely filing period and we would not have been reimbursed for services provided Thank youK*** H*** RN, MSNMary Black Hospital, Spartanburg
We are in the process of investigating this patient complaintWill give a full response when investigation is completedThank you K*** H***Risk Manager Mary Black Health System
Response to letter of complaint:The physician had documented justification as to why he ordered the tests. He did bill a higher code on the 2nd visit but he had the documentation to support it according to coding guidelines. It sounds as if his symptoms were less initially, which is why
all tests were negative during the first visit. During the second visit, the symptoms had worsened and he felt that level was justified. Thank you***
On account # [redacted], On 9/15/15, [redacted] screened the patient to see if they would qualify for any programs ([redacted], etc..), it’s notated that patient makes 3700 a month, and has no qualifying dependents, per [redacted] patient does not qualify for [redacted].On 9/18 the patients wife called and stated they...
do not have insurance and asked for financial assistance, we placed application in the mail.On 9/29 the patients wife came to hospital to drop off the financial application and documents, [redacted] explained to the patients spouse that it does not appear they qualify for financial assistance based on the income amount per month. [redacted] asked for payment, and patient stated they could only pay 10.00 per month, [redacted] asked about insurance through the ACA (Affordable Care Act), patients wife stated they applied but was told it would be 400.00 a month with a 10k deductible, [redacted] reminded patient of open enrollment anyway.On 10/26 patient called to see if he could get set up on a monthly payment for 10.00 a month. Patient was informed that on a balance of 9,366.23, 10.00 is not a sufficient enough payment, and the balance is to large to accept a 10.00 a month payment and this amount would not keep it from going to a collection agency.Patients original balance was 14,455.74, with a self-pay discount, patient’s balance is 9,366.23, patient has paid 30.00 to-date.
[redacted] The complainant did speak with our business office and unfortunately a thorough review of the account was not performed initially. The complainant did contact the hospital designated line for issues and concerns in June. A thorough review of the account was then...
conducted. An error was discovered. The patient has been refunded $750, all of the monies that were overpaid by our business office. The complainant is satisfied with the outcome. [redacted] 864-[redacted]
Dear Ms. N[redacted]:Our facility has extensively reviewed the charges for this account, locally and corporately. The Patient Access Director, Revenue Integrity Manager, Manager Coding Support Services l Health Informatics and Information Management have reviewed your account and have informed me that the coding was correct. There was not a code for chiropractic care related to this account. The charges were correct for procedures as ordered by your physician. I am sorry to say that we cannot honor your request for bill adjustment based on the information provided above. Sincerely:K[redacted] H[redacted]MB Risk Manager
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Regards,
[redacted]He does not live at my address, they put my name on it
This is all I have for details. Mary Black would have to provide the details with codes, etc. They never sent that to me, was only told over the phone how it had been coded.
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. I have already spoken with someone at Mary Black that said they did see where the out of pocket estimate was given to me over the phone(all of their conversations are recorded). The lady at the desk also confirmed the amount on the day I was waiting to have the test done. Every time you call you get a different person with a different response. They are also the ones that told me about the code being wrong on the bill. They said it was coded as a muscular skeletal code, which did not apply to the test that I had performed. The $500 copay is due to it being coded that way. My copay had already been met for the year. The test was for stomach pain & bloating, & had nothing to do with a chiropractic code. The person at Mary Black already said it was coded wrong & was supposed to have it reviewed & refiled with insurance.
Regards,
C[redacted] N[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Regards,
[redacted]
K***:After investigating this patient complaint it was found that there had been an error in posting of this paymentThe error has been corrected, the patient contacted and acknowledgement and apologies made for our error.Thank youK*** H*** *** Mary Black Health System
Thank you for the opportunity to investigate and review this patient complaint. After investigation we have realized that the patient did in fact change her address information as stated in her complaintThis was an error on our part as we did not change the address of the guarantor
listed for her so she never received a bill, which is now in collectionsT*** M*** was made aware of this and this has been correctedThis account went to PASI but has been pulled back on 8/24/PASI does not report to the credit agencies so this will not reflect on her credit at allAlso, it looks as if all the info has been updated so she will be receiving a bill soonI have contacted the patient and made apologies and the Director over Physician Practices will also contact her regarding resolution of this complaintAdditionally, I gave the patient my contact information should she have any further concerns in the future Thank you for allowing our facility to address and correct this patient's concerns.SincerelyK*** H***Mary Black Risk Management
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is not satisfactory, but, will comply.
Regards,
M*** G***
I am rejecting the business response because my son was seen by the same doctor within a few days of each otherWhen it is a follvisit then office visit charge should not be more than what it was to begin with at the first visitMy son's symptoms did not worsen, they just were not getting any better therefore he was treated for the same thing he was at the initial office visitFor instance if you called because your air conditioner was broken and they came out and fixed it with a part and you called back a week later and still having the same problem and they wanted to charge you for the part again, that is not how you do business I'm not wanting the second office visit charge to be free, but I feel that it should be less than and no more than the first office visit charge
Dear Sir or Madam:We have reviewed the billing address for the client below which is *** ***All correspondence or bills have been sent to his address, as he is listed as the responsible partyAdditionally, there has been no correspondence with our billing deptfrom the
complainant. Unless she can provide documentation that the bills are being forwarded to her due to a change in his address, it is unclear why she would be receiving these bills. Please let me know if there is anything else that we can do. If Mr***'s address has been changed please have her submit this information, so that we can complete our inquiry into this complaint.*** *** *** Ave***, 29323 Thank you *** ***/ MB Risk Manager
They have records of who I spoke to, I do not I get someone different every time I call them
Dear Sir/Madam:The notes indicate that nothing was mentioned to the patient on what was owed prior to the services being performed. We have no benefit information documented. This patient has paid no out of pocket expense to date. There is no documentation of who
she spoke with and nothing mentions anywhere. This patient has called and spoke to our Business Office, they reviewed for correct coding, the coding manager reviewed it, and stated the “MD order on file is accurate to the charges on the account”. Her insurance state that is her deductible, is her co-insurance and her copay is 500.00. It appears that was paid to the patient/insured/responsible party, not to Mary Black (per notes in our system) Thank youK*** H***: Risk Manager
We have all our documentation where this patient was contacted on numerous occasions with no responseOur official letter was sent to the individual as aboveI hope this adds some closure to this caseI appreciate your help and support.On account # *** its stated multiple times in notes that
we were unable to give her an estimate, and only asked her for a “down payment” in the amount of to lock in a 25% discount If she pays on the day of the procedure, or within days of discharge, she would be eligible for the 25% prompt pay discount when/if additional bills were receivedThis was discussed prior to her surgery.On the day of her surgery she was asked for her payment, and she stated “I can’t pay today, I’m going to pay *** on Monday”. She never called *** to make her down payment. Patient called *** in July after she received her bill, and *** again reminded her that she could not give her an estimate of the charges, and that’s the reason she gave her the option to pay as a down payment, and reminded her that she never called and paid that amount. Patient then told *** that she would have to make monthly payments, and we provided her the number to the Business Office so a monthly payment could be made.Patient called back to Business Office on 8/and asked for her account to be audited, that request was sent to *** ***. On 8/26, we extended the 25% discount offer, and patient said she would call back after the audit.** called patient on 8/with audit findings, per *** charges are correct. Patient stated she felt that she was told incorrect amount, she stated that we quoted her 15,000, the Business Office informed that patient that nowhere in the notes does it say a quoted amount. We offered that it could have been the doctors portion that she’s confusing it with, and reminded her again that we have documentation in multiple places that we were unable to give her an estimate of her charges.On 10/5/*** *** approved a settlement for a 35% discount, leaving patient responsibility at 2655.57. Notes indicate that *** *** was going to contact patient per email.No payment has been made on the account to-date. *** ***
Dear Sir or Madam I apologize for not responding sooner regarding this complaint. I did investigate this complaintIt is my understanding that the
patient came into the Emergency Department at Mary Black on July *, 2015 as a result of a motor vehicle accidentAt that time the patient provided the hospital a copy of the police reportShe was unable to provide the liability carrier at that timeIn September of she did present the hospital with a copy of her Medicaid card, however it had been over two years since her accidentAt that point we were past a timely filing period and we would not have been reimbursed for services provided Thank youK*** H*** RN, MSNMary Black Hospital, Spartanburg
We are in the process of investigating this patient complaintWill give a full response when investigation is completedThank you K*** H***Risk Manager Mary Black Health System
Response to letter of complaint:The physician had documented justification as to why he ordered the tests. He did bill a higher code on the 2nd visit but he had the documentation to support it according to coding guidelines. It sounds as if his symptoms were less initially, which is why
all tests were negative during the first visit. During the second visit, the symptoms had worsened and he felt that level was justified. Thank you***
We are currently investigating this case and will send a follow up as soon as possible.Thank youK*** H*** Risk Manager, MBHS Spartanburg
On account # [redacted], On 9/15/15, [redacted] screened the patient to see if they would qualify for any programs ([redacted], etc..), it’s notated that patient makes 3700 a month, and has no qualifying dependents, per [redacted] patient does not qualify for [redacted].On 9/18 the patients wife called and stated they...
do not have insurance and asked for financial assistance, we placed application in the mail.On 9/29 the patients wife came to hospital to drop off the financial application and documents, [redacted] explained to the patients spouse that it does not appear they qualify for financial assistance based on the income amount per month. [redacted] asked for payment, and patient stated they could only pay 10.00 per month, [redacted] asked about insurance through the ACA (Affordable Care Act), patients wife stated they applied but was told it would be 400.00 a month with a 10k deductible, [redacted] reminded patient of open enrollment anyway.On 10/26 patient called to see if he could get set up on a monthly payment for 10.00 a month. Patient was informed that on a balance of 9,366.23, 10.00 is not a sufficient enough payment, and the balance is to large to accept a 10.00 a month payment and this amount would not keep it from going to a collection agency.Patients original balance was 14,455.74, with a self-pay discount, patient’s balance is 9,366.23, patient has paid 30.00 to-date.
[redacted] The complainant did speak with our business office and unfortunately a thorough review of the account was not performed initially. The complainant did contact the hospital designated line for issues and concerns in June. A thorough review of the account was then...
conducted. An error was discovered. The patient has been refunded $750, all of the monies that were overpaid by our business office. The complainant is satisfied with the outcome. [redacted] 864-[redacted]
Dear Ms. N[redacted]:Our facility has extensively reviewed the charges for this account, locally and corporately. The Patient Access Director, Revenue Integrity Manager, Manager Coding Support Services l Health Informatics and Information Management have reviewed your account and have informed me that the coding was correct. There was not a code for chiropractic care related to this account. The charges were correct for procedures as ordered by your physician. I am sorry to say that we cannot honor your request for bill adjustment based on the information provided above. Sincerely:K[redacted] H[redacted]MB Risk Manager
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Regards,
[redacted]He does not live at my address, they put my name on it
This is a copy of the bill
This is all I have for details. Mary Black would have to provide the details with codes, etc. They never sent that to me, was only told over the phone how it had been coded.
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. I have already spoken with someone at Mary Black that said they did see where the out of pocket estimate was given to me over the phone(all of their conversations are recorded). The lady at the desk also confirmed the amount on the day I was waiting to have the test done. Every time you call you get a different person with a different response. They are also the ones that told me about the code being wrong on the bill. They said it was coded as a muscular skeletal code, which did not apply to the test that I had performed. The $500 copay is due to it being coded that way. My copay had already been met for the year. The test was for stomach pain & bloating, & had nothing to do with a chiropractic code. The person at Mary Black already said it was coded wrong & was supposed to have it reviewed & refiled with insurance.
Regards,
C[redacted] N[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Regards,
[redacted]