Phoenix Children's Hospital

Review: On 1/26/15 I took my daughter to PCH urgent care in Glendale, AZ. She had broke her foot. They recommended that I follow up with their orthopedic surgeon and that it would be considered an office visit but it would be at the urgent care. After the follow up I received bills for Imaging Services of $500 as well as an $1755.00 Ancillary service fee. The Ortho also charged me a $500 fee to read the images. I know that I would have to pay for the x-ray but the ancillary fee nor the surgeon huge fee was disclosed to me. I was told it would be billed as an office visit. My insurance company has told me the bill was coded as and EMERGENCY and not an office visit and also the location of the service was in [redacted] when in fact it was at the Glendale Location. This seems like shady practice to me if the billing can't even get the codes right to state an office visit and it was not an emergency room visit. I have talked with several billing customer service people and no one can give me a straight answer. I really like the surgeon but it is too bad I won't be returning to this "urgent care" location because of the poor billing practices.Desired Settlement: I want the billing to reflect an office visit and not an emergency visit as well as the right location. I am willing to pay the fees but an ancillary fee of $1755.00 for an office visit was never disclosed to me for using this location. I was told by the billing people I should have just gone to the actual office. so disappointed.

Business

Response:

Ms. XXXXX's account has been reviewed. Calls are being placed to discuss the account and the details of the billing with her directly. PCH will discuss with the parent and resolve as soon as possible.

Consumer

Response:

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. I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

Review: My daughter, [redacted], had services done at Phoenix Children's on October 12, 2012. I am told through my insurance, [redacted], and their Explanation Of Benefits that three of the bills sent from [redacted], MD (Pathologist) is "NOT PAYABLE". I was not sure what this meant, as per my EOB [redacted] shows that I do not owe anything for these specific charges. When I first contacted Phoenix Children's Medial Group about this error, they said they hadn't seen the EOB and would correct it once they could see them. I faxed [redacted] the EOB on 12/13/2012. The matter is still not resolved.

Since then I continue to get bills seeking payment for the three charges [redacted] has fully "discounted" on my EOBs. I have spoken with supervisor, [redacted], who also told me she would review and resolve once I sent the EOB AGAIN because she couldn't find it. I sent the EOB to her on 4/11/2012 It is still not resolved.

I then received another bill for other services for approximately $2000.00. I paid it in full. The following month I received another bill for those same services but it had been reduced. When I called to get that corrected, I was told that they had taken the money I had sent for that new bill and applied it to the three charges that had not yet been corrected! Since they agreed that they had no right to adjust my payments and shift them to other bills, they corrected this issue. Thus leaving the three charges still appearing to be "outstanding". I've continued to call and to this day have not had resolution.

I am now getting collection agency calls to collect these three incorrect bills. I am told from the collections agency that if it doesn't get resolved by September 1, 2013 it will start affecting my credit score.

I tried to expedite the resolution with my last contact, [redacted], beginning August 2nd, 2013. So far she has only replied with "I have sent the information to a supervisor for review". This morning, I asked for that person's name and contact information so I could resolve this issue and I have not yet heard back from her.

When I spoke with a woman named [redacted] both last week and today, she agreed that all accounts show $0 balance except for these three charges of issue.Desired Settlement: I need this to be resolved by August 26th, 2013 so I know that my credit rating will not be affected. I need the correct adjustments to be made through Phoenix Children's Medical so that their statements reflect what the insurance has already provided. Both Phoenix Children's Medical and [redacted] should be in agreement that these three specific charges are "not payable to this provider based upon the provider's contract." My balance, as of today, to Phoenix Children once this issue is corrected should be $0.

Business

Response:

Ms. [redacted],

On behalf of Phoenix Children's Hospital, I aplogize that you had to continually try to correct an issue that should have been dealt with immediately. I received an email from one of my staff from your husband on 8/9/2013 requesting I respond within 2 hours and we met that request. Please note the copy of the body of the email sent to [redacted] that outlines the resolution of your concern and the corrective actions taken. If you have any additional concerns, please contact me at [redacted]. - [redacted], Manager Customer Service

"Mr. [redacted],

We sincerely apologize for the inconvenience that our delay in customer service has placed on your family. Upon review of your accounts we did find errors on the following invoices [redacted] and [redacted] and have corrected them. These corrections result in a $75.40 credit, which will be processed for refund. In addition, we did identify that the accounts were sent to the collections agency in error. We have notified the collection company to remove these accounts from your credit report if they have been reported to the agencies. We have also instructed them to send you a letter confirming this activity.

Phoenix Children's Hospital wants to ensure that we are providing the best care, both clinical and administrative, to our families. This means that we will take your concerns and forward our findings to the appropriate areas for education and training purposes.

I have spoken with our legal department and they provided the following contact information:

Phoenix Children’s Hospital

Attn: Risk Management

Please feel free to contact me if you need additional information at [redacted] or via email at [redacted].

Sincerely,

Manager Physician Revenue Cycle/Customer Service

[redacted] ph

[redacted] fax"

Consumer

Response:

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. I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

Review: MY ACCOUNT WAS SENT TO [redacted] FINANCIAL SERVICES FOR A VACCINE THAT WAS GIVEN IN HIS PCP'S OFFICE. MY INSURANCE DENIED THE CLAIM FOR NO AUTHORIZATION BECAUSE THE VACCINE WAS BILLED UNDER THE HOSPITAL. I HAVE CONTACTED PHOENIX CHILDRENS HOSPTIAL, [redacted] AND [redacted] MULTIPLE TIMES WITH NO RESOLUTION. SOMEONE AT PHOENIX CHILDRENS HOSPITAL NEEDS TO REQUEST AUTHORIZATION FOR THIS VACCINE. I HAVE BEEN DEALING WITH THIS FOR ALMOST A YEAR NOW. MY SONS ACCT # IS [redacted] DOS 5/4/12 & 1/10/13.Desired Settlement: PLEASE REQUEST AUTHORIZATION FOR VACCINES GIVEN ON 1/10/13 AND 5/4/12. MY INSURANCE SAID I AM NOT RESPONSIBLE FOR THESE CHARGES, THE PCP SHOULD HAVE REQUESTED AUTHORIZATION IF YOU ARE BILLING UNDER THE HOSPITAL

Business

Response:

Thank you for notifying us of this challenge regarding insurance denial for the care you received at our clinic. Accounts [redacted] and [redacted] for the dates of service 1/10/2013 and 5/4/2012 respectively are currently reprocessing with your insurance. We have spoken with your insurance, and according to the representative, reference call number [redacted], these services do not require authorization. They have committed to reprocessing the claims and have asked that you allow 15 to 30 business days for resolution. We apologize for the inconvenience this has caused you and your family. Account [redacted] has been removed from [redacted] Financial Services inventory and removed from any reporting on your credit.

Review: We visited the Phoenix Children's Hospital Urgent Care Facility at there [redacted] on February 13, 2013. I paid my insurance copay of $75 at the facility. My daughter was seen and treated. We were there maybe an hour. Doctor and staff were great. I would say about 3 weeks later I received another bill, showing we owed an additional $70. I called my insurance and asked why it was not covered and was told that PCH sent the bill in to them as a "Specialty Office Visit". Which is what added the additional copay of $70. My insurance company stated that I would need to get PCH to resubmit the bill as an coded "Urgent Care" visit. I called PCH and made them aware of the issue and was told that they would review my account for the incorrect coding issue and it may take up to 21 days. 30 days passed during this time and I received the same bill, for the same amount. I called PCH again. I was told that they review it again. Again I received the same bill in the mail, and this time that my account was delinquent and if no response is received I would be sent for assignment to a collection agency. At this time I reluctantly decided to give in and go ahead give payment to PCH to avoid any issues with or damage to my credit. I asked the customer service rep to send me a statement or receipt showing my payment and zero balance, she said she would. No statement ever arrived. A few months go past and I brought up the situation to my employers health benefits department. They told me that they would inquire my concerns to there insurance representative and get back to me. A few days later on 10/11/13 I received this email:

Jason,

I have received an update from [redacted]. They were able to speak with [redacted] at the provider's office. [redacted] advised that the charges are correct except that the physician claim was billed with the wrong place of service as office and not Urgent Care. This is what caused the two co-pays to apply. [redacted] is going to fax in a corrected statement to [redacted] with the Urgent Care place of service which will reverse the $70 copay that was applied when it was billed as an office visit. [redacted] also advised that once they get the additional payment from [redacted] they will refund the you the additional $70.00. Please let me know if you have any questions.

Great news, I thought. Now during this same time I also received another bill from PCH saying I owe an additional $5!! I couldn't believe it. I called PCH regarding the new bill and was told by "Helen" that there was a credit for $5 that would be applied and the balance due was $0. I asked her to please send be a new statement showing this and she said she would. Again, I never received a statement. I assumed things were good and started to wait for my refund. I checked with [redacted] and the corrected bill showing "Urgent Care" was received and payed to PCH on 10/09/2013. I followed up with PCH on 11/13/13 (4 weeks after PCH was paid) and was told it takes 4-6 weeks to process and to follow up if not received by 12/2/13. On 11/29/13 I received another bill for the same $5, along with the delinquency notice. I tried calling there office, but they were closed due to the holiday. I called that following Monday 12/2/13. The customer service rep this time was Julia. I immediately told [redacted] I needed to speak with a supervisor. [redacted] put me on hold numerous times, telling me she is trying to get a supervisor on the phone. This went on for around 40 mins. I finally asked for the supervisors name and phone number. I was told it was [redacted] S at [redacted]. I asked to me transferred to her voice mail so I could leave her a message and I was told that they did not have that capability. Finally [redacted] gets on the phone. I explained my situation again, and told her that I needed it fixed immediately. [redacted] told me that she does see the credit and that she does not know why "the ball was dropped" but that she would personally escalate it to the proper people, ([redacted]. was the name given) and that she would call me back that day. I never received a call back. I called back that following morning 12/03/13 and asked for [redacted] at [redacted] the rep this time told me that she was not in. [redacted] took my name and information and said she was going to personally deliver it to [redacted]. At 9:58 on 12/03/2013 [redacted] called me back. She said that she apologizes for not calling me back on 12/02/13. [redacted] also stated that she expedited the issue and to allow her 24 to 48 hours to get a response back on the outcome, she said "even though, I already know the outcome, that there is a $75 refund, which $5 would be deducted for the amount owed, for a total of a $70 refund". I told her ok. [redacted] called back @ 10:13 that day (12/03/13). She asked for my card number that it was billed to so they could apply the refund. I gave her my card information. I also asked her to send me a corrected statement showing the $0 balance and refund. She said she would do that. So, on 12/11/13 I still had not received a refund. I called PCH again. Monica answered, I told her I need to speak with [redacted]. She put me on hold and returned and said "[redacted] is not in yet. Would you like to be transferred to her voice mail?" (they must have just got this capability). I left a message for [redacted] at 8:37am. No return call from [redacted]. At 2:18pm that same day (12/11/13) I called PCH again and asked to speak to [redacted]. This time [redacted] answered the phone again, and again it was being put on hold numerous times. [redacted] came back and told me that [redacted] is in a meeting. I asked who [redacted]'s supervisor was and to speak with her. I was told that [redacted] was her name, put on hold again, and again. Finally [redacted] returned and said [redacted] was in a meeting as well. She said that she would take my information and personally deliver it. I gave her my information again.

Another day has passed. It is now 12/12/13 at 8:26 pm and I have still yet to receive a phone call back from anyone at Phoenix Children's Hospital. I have yet to receive a corrected statement ever. And, I have yet to receive the $70 owed to me. The customer service provided by the Financial Services/Billing Department is completely unacceptable . Such a headache. I'm asking for this to be remedied please.

Thank you.Desired Settlement: I want to receive a full refund of the charges I incurred during this visit to PCH. I want Phoenix Children's Hospital to fix there billing practices and customer service department.

Business

Response:

Phoenix Children's Hospital was in process of reviewing Mr. [redacted] account in response to an email received on our website when this Revdex.com complaint was placed. We resolved Mr. [redacted] issue and addressed his concerns during this time.

Review: I paid my co payment to the PCH urgent care for my son and now I keep receiving a bill saying I owe and there going to send it onto my credit and I don't think it's fair. I have called a couple months ago and spoke to a women she said I had a credit of $10.00 but didn't owe and at the time it was $40.00 I received a bill again for now $30.00 and so I called and they wanted to argue so I lost my temper I think this is fraud what there doing. I don't want my credit to have something on there if I already paid in full.Desired Settlement: Taken off of my credit and have it paid in full

Business

Response:

[redacted],

Thank you for your feedback. Your account has been reviewed along with the recorded calls associated with your concerns and the following was found:

1. Representative on the call was appropriate. The representative was unable to share any information on the account once she located it within the system as you would not allow her to speak. Also, your use of vulgar and abusive language met our protocols for termination of the call by a representative. Representative followed these protocols and terminated the call.

2. We did find that you attempted to address the issue of the credit and the funds transfer previously. This should have been addressed on your initial call. As a courtesy, we will adjust the $40.00 balance that was originally due on account [redacted] and move the $10.00 credit to another one of your accounts, [redacted], that was sent to collections on 5/30/2013. The balance due after the $10.00 credit transfer will be $115.

3. We also reviewed account [redacted] to ensure it was sent to collections appropriately, and the account met regulations for bad debt referral. Five Statements were sent and four phone calls were made between 12/28/2012 and 5/16/2013 to the address and phone numbers verified by you on the call. If you have questions on this account, please contact CMRE, the agency responsible for this account at ###-###-####.

We appreciated feedback on our customer service and will use the instance of delayed response to your request as education material for our staff.

Sincerely,

Jamie Davis

Manager, Customer Service

Phoenix Children's Hospital

Review: I took my two of my children to this facility in Oct 2012 and one of the same children again in Dec. 2012. I paid the required co-payment prior to the children being seen by medical staff on all three visits. I received repeated billings from this facility stating I had not paid the co payment and I submitted receipts to the billing department which took them a long time to register, so the phone calls to collect funds that I had paid continued for another week or so. There were additional fees charged by this facility for a doctor specialty fee in addition to the urgent care fee. The problem I am now having is that I was billed in January for my daughter's Dec. visit and I paid that along with other charges that were also on the bill for my son to the amount of $150.00 on my [redacted]. The charge went through on my statement, yet in June, I was sent another bill claiming I did not pay my daughter's doctor copay of $50, when I had. PCH has now turned it over to a collection agency. This billing practice is unacceptable and apparently not an isolated incident to myself, now 4 examples of improper crediting patient accounts, and from looking at the internet reviews, there are several other people complaining about the similar frustrations.Desired Settlement: I want a letter of apology from them and proof that they are not reporting me to a credit agency for non-payment when I did in fact pay my bill.

Business

Response:

Ms. [redacted],

We apologize that you have been placed in the middle of this situation. We have contacted your insurance and escalated the concern with them on two separate occasions because we strongly believe that this was billed correctly as an urgent care visit. Unfortunately, they will not overturn their decision. Phoenix Children's Hospital wants to ensure that we are providing the best care, both clinical and administrative, to our families. So that we can alleviate the inconvenience this has caused you, we have credited your balance and you will not be billed for any balances on account [redacted].

If you have any questions, feel free to contact me directly at [redacted].

Sincerely,

Manager Customer Service

Phoenix Children’s Hospital

Business

Response:

Ms. [redacted],

I apologize, the response to your concern was attached to your concern in error and I have been attempting to contact the Revdex.com to correct it, although they did not respond.

Thank you for bringing the billing errors to our attention. We sincerely apologize for the inconvenience this has caused your family. We have corrected your accounts and you will be receiving a letter from the collection agency indicating the account was sent in error and that it is no longer in collections.

We will use this concern as an opportunity to improve our customer service and processes. If you need further assistance or would like addition information, please feel free to contact me directly at [redacted].

Sincerely,

Manager Customer Service

Phoenix Children’s Hospital

Consumer

Response:

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. I will wait until for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

Review: In July 2015, I was referred to Dr. Ronald H[redacted] by my son's physician, for removal of a small mole on his nose. My insurance plan allows an in-network specialist visit for $25, and when I called to make the appointment, PCH did not inform me of any additional charges, nor did the doctor's office inform me of additional charges the day of the appointment, or at the time the doctor asked if we'd like to go ahead with removal of the mole after she examined it. I went ahead with the mole removal as that was the whole intent of the office visit with this doctor who so happens to practice in an exam room located in a section of the hospital reserved for practicing physicians (this was not an urgent care or ER visit). To my surprise, several months later I received a bill for $757 from PCH for "ancillary services"($462 after an insurance adjustment). In addition to a $95 fee for the physician. I was never informed of this fee prior to the removal of the mole, nor could I have ever imagined this fee, as I have never been charged a "facility fee" for visiting a doctor's office. When I called PCH they clearly deal with this issue all the time, since they right away offered me a 50% discount, but only if I paid within a few days. I feel this is nothing more than scam, fraud, a "shakedown". Of course I'd rather only pay $278 instead of $557, so I felt pressured into making this payment right away. After this payment, I still received a bill from them a month later for the full amount. After trying to deal with my insurance on this, I then looked online and saw numerous articles about this very same situation happening for patients at doctors offices that have now been bought by hospital groups. This is obviously fraud as state's attorney generals are proposing legislation for this very same reason all across the country. You cannot perform a service and inform patients of an exorbitant amount AFTER the fact.Desired Settlement: I would like a refund of my $253 paid (I paid $278, when I should have paid a $25 copay for a specialist), as this is unfair business practice, and there are other complaints against PCH for this very reason, as well as complaints across the country for this. This is a scam - PCH did not incur $772 in charges for my son to sit in the same exam room for removal of the mole that he just sat in that exam room for a consultation from the doctor.

Review: I took my daughter to the Phoenix Children's Hospital (PCH) ER in October of 2013. After receiving care at the ER, I still had all of my contact information paperwork in hand as well as my insurance information which staff members failed to take from me. I had to track some staff member down and ask them to take my paperwork and a copy of my insurance card. Approximately four months later, the first notification of any bill for this visit came to my via a collections agency. PCH never sent me a bill and instead sent it to collections. I called PCH to fix the matter; I was told they had an incorrect address. The PCH billing staff apologized and took my correct address and said they would have the bill recalled from collections and submitted to me. I was lied to, as a month later I received a second notice from the collections agency regarding an outstanding bill. I once again contacted PCH and spoke to a manager (Blanca), she told me she would have the bill recalled and resubmitted to me. I asked for her to send me some form of proof that this was done such as email notification or other form of documentation that I could view. She said she was unable to do that. I waited for a bill, and still never received one from PCH. At this point PCH tried submitting the claim to my insurance, but it was denied due to waiting to long to file the claim.

Again this bill was sent to collections, although PCH has never given me a bill (electronic or paper) as I have requested numerous times. This company has demonstrated their unprofessional conduct in numerous instances with poor staff education on how to collect information during a visit, billing personnel lying to customers about services they will complete, as well as shady billing practices (i.e. never sending a bill to customer/patient and instead sending to collections). All of the misconduct from this company has caused me great stress and anxiety. They have lost a customer/patient as well as a referring provider.Desired Settlement: Phoenix Children's Hospital is responsible for the entire bill that was incurred during the emergency room visit including provider professional fees as well as procedure codes. They have never provided me with a bill, only sent the bill to collections (twice), and failed to submit the bill to my insurance company in a timely manner (my insurance company denied the claim because of this).

Business

Response:

Discussed the billing concern with Ms. Freeman and have reached a resolution.

Review: My wife took my son to PCH emergency and after tried to pay the 250.00 co-pay.....the refused to take payment at that time. They never sent a bill for us to pay, just recieved a bill from [redacted]...they are a collection agency. I feel that this is completely a fault of PCH for not sending a bill after refusing to take a payment at the time. How can a business be allowed to ruin or attempt to ruin someones credit with out first doing there job!!!!! Why was a bill not sent, payment is not a problem and now my credit is being dinged because of it !Desired Settlement: It needs to be taken out of the collection agency's hands and reported to all three credit beareaus ! A bill needs to be sent to me so I can Pay it and have a record of the bill..... should be easy to take care of....but lets see.

Business

Response:

The date of service and patient name were not provided in Mr. [redacted]s complaint. To ensure HIPPA compliance we arerequired to confirm patient name, date of birth and address to allow release of information. Also, we will need the date of service or account number to reserach this activity appropriately and provide Mr. [redacted] with a timely response.

Thank you,

Review: On November 18, 2012, I took my daughter in to Phoenix Children's Hospital Urgent Care. My daughter was seen and I paid the $40 insurance co-pay for an urgent care visit with my bankcard and was given a receipt. On Jan 21, 2013, Phoenix Children's Hospital (PCH) sent me a bill for $40. I contacted PCH and told them the $40 was paid at the time of service. I was told they would send a request to billing to review the account. On 2-19-2013 PCH sent another bill for $40. I again contacted PCH to tell them my co-pay was paid at the time of service. [redacted] requested I fax a copy of my receipt to her. I faxed a copy of the receipt on 2-26-2013 and again a bill for $40 was sent to us on 3-19-2013. I contacted PCH by phone again and was told that they received my fax and that it was still being processed and I would not owe anything. On 5-06-2013, I received a bill from PCH for $30. I again contacted PCH and was told that this was a doctor fee and must be paid. I spoke to the Supervisor [redacted] who additionally told me it was a doctor fee. I then noticed on my bill that in the itemized area it only showed $10 of my co-pay applied. I then contacted my Insurance, [redacted], who contacted [redacted] at PCH. [redacted] contacted me back to say there was an error on the account. I contacted [redacted] at PCH again to verify what my insurance told me. She said that they only applied $10 of my $40 co-pay and that the remainder amount would be adjusted. I thanked her for taking the time to review my case, when even her supervisor would not. She again verified I did not owe any money. On 6-24-2013 PCH sent another bill for $30. I am very frustrated that PCH keeps harassing me for a bill I do not owe.Desired Settlement: I would really love it if they would stop billing me for their error and apologize.

Business

Response:

This complaint is a result of failure to follow process and an error in billing. This has been corrected in our system. I spoke with Ms. [redacted] today and shared my apology, indicated the account has been corrected and will send a statement of zero balance tomorrow once the correction has posted in our system. I have also emailed Ms. [redacted] to provide written confirmation that the account balance is zero.

We sincerely apologize for any inconvenience this may have caused.

Thank you,

Review: In February of 2013, I took my daughter to the Phoenix Children’s East valley URGENT CARE. We were charged a co-pay of $60, which we paid at the time. This was the correct rate for an in-network urgent care according to our insurance. A month later, we received a bill from PCH for $202.66. I called PCH, and they said it was billed correctly to [redacted]. I called [redacted] multiple times between March and May of 2013. I verified with them that we should only have a copay and no co-insurance as it was NOT an Emergency Room visit. I was informed by [redacted] that it was billed as ER and that PCH would need to resubmit it correctly. I informed PCH of this, and they said they would submit a corrected bill to [redacted]. I never heard anything else about this.

Then, 20 months later, in November of 2014, we received another bill from PCH for the same charges of $202.66. When I called to ask about this bill, and why it was never resubmitted, I was told that they never resubmitted to [redacted] because it was billed correctly to [redacted] the first time around, so there wasn’t anything they could do. I asked why no one ever notified me of this, and Monica, from PCH stated that I shouldn’t worry about it, and that it would be taken care of or that they would see what else [redacted] needed. I then called [redacted], and they again verified that it was billed as ER. I then received an itemized statement from PCH on 12/30 and called to ask about it and why they sent this to me, as the codes and information meant nothing to me as a customer. This time, I spoke to Donna, and she said it was billed correctly, that they are a “hospital-based facility”. The very next day, we received a collection call from Joanna at PCH. We talked in circles again about the same thing that had been discussed numerous times. She stated that their tax ID # for the facility charges was tied to Phoenix Children’s Hospital, and that the urgent care did not have its own tax ID at the time. At this time I contacted [redacted] with the PCH rep on the phone at the same time. Again, PCH says it was billed correctly, [redacted] says it was not. [redacted] told me that they would look into again and get back to me. They did call me back and I was told I needed to file an appeal. I did this, but it was denied on 1/26/15 because it was more than a year old. Because the date of service was February of 2013, there was nothing I could do with my insurance. This is the fault of PCH as they went over a year and a half from the date of service to send me a 2nd statement. I did try taking care of the issue at the time of service, then again in November of 2014, and was told by PCH that I “shouldn’t worry about it”, as I noted at the beginning of this paragraph.

Once I had received the statement from [redacted] stating it was too old, I called PCH on 1/28/15 and spoke with Julia. I informed her of the whole situation once again, she looked at the notes and said it would be sent for review, and that I would get a call back within 2 weeks. Between this date and now I have made 9 calls to [redacted], each time hearing the same thing, that it would be reviewed and I would receive a call back. I spoke with Julia, Monica, Joanna, Claudia, Olinda twice, Grecia, M[redacted](supervisor) and Kenyata (manager).

I spoke to Manny(supervisor) on 10/15, and we talked about the same things we had talked about numerous times before. He said that the determination was above him, and that I could file a formal appeal through PCH. He stated that his manager Kenyata (sp?) would get back to me the same day or the next.

I did not get a call from the supervisor or manager, so I called again on 10/20/15. I spoke with Cambria, who transferred me to Kenyata. She said she had received an email from Manny, but that she was out of the office Friday. She began reviewing notes from the account. I explained the whole situation again, and asked why they didn’t just communicate with [redacted] when this all started in 2013. She said that her system showed the first statement was sent in October of 2014. I said, no, you sent a statement in March of 2013, and that is where this all started! She said that they do in fact, communicate with insurance companies. But for some reason, they refused to do this with our account. I asked why no one told me I needed to file a formal dispute long ago, instead of telling me over and over that it would be reviewed. She said, “Ma’am, I do see that you have disputed this.” I said, yes, of course I’ve disputed it, but no one will ever get back to me. She told me that they’ve contacted me, sent statements and corresponded with me multiple times. I asked when, and she could not tell me. She then said she would try to get the UB 4 and send it to me. She stated that she would see if she could get the account retracted from collections and put us on a payment plan. She said it would be 25 minutes and that she would email the form and touch base with me (this was at 2:48 pm). I received an email attachment with the UB 4 and looked over it before I left my house. She called back at 3:57 pm and left a voicemail asking me to call her back. I called back the next day (10/21) at 1:53 pm. I spoke with Erica, who looked at her notes and said that Kenyata had called to verify that I received the document that she had emailed to me. I said, yes, I did, but I’d like to speak to her. She then put me on hold, came back and said that Kenyata is on another call, but that she has me on her call-back list, and that she’d call be back within an hour. When I got home that evening, I had a voicemail on my house phone from 4:40 pm. This was after I had asked them to call my cell phone. I spoke with [redacted], and they looked at the claim and told me that place of service code was ER, the provider was PCH and that the revenue service codes combined with the place of service meant that they were billing as emergency room. I called PCH again the next morning (10/22) at 8:05 am and spoke with Helen. She said that the notes that Kenyata put in said that the bill was correct and they would not retract it from collections. I said that I would like to speak to Kenyata, as I had not spoken with her since she sent the form, and that Kenyata’s voicemail from the day before asked for me to call her back. She then told me that Kenyata was not in the office yet. She said she would leave a note for her to call me back, specifically on my cell phone. It is now the evening of 10/23, and I never received a call from her.

Not only was this billed incorrectly (as emergency room) to my insurance, I also see that multiple customers have had the exact same issue with the billing done by PCH. In addition, the bill does not even show the $60 that I paid at the time of service. The customer service that I have received from PCH has been nothing but horrible and I have spent hours upon hours waiting on hold and speaking to representatives with no resolution whatsoever. I feel that PCH was not even willing to provide documentation or really communicate and escalate the issue until it had already been sent to a collection agency. I appreciate your effort to get the matter resolved.Desired Settlement: I would like PCH to retract this from the collection agency and adjust our bill to $0 owed.

Business

Response:

[redacted]The parent is being contacted directly to discuss her concerns and come to a resolution.

Consumer

Response:

Phoenix Children's Hospital stated in their response that they would contact me directly to resolve the issue. It has now been a week, and still, no one has contacted me. I'd also like to add that there was an error in my original complaint that said I had called Cigna 9 times, when I meant to say that I had called Phoenix Children's 9 times between January 28th and October 20th.

Business

Response:

Messages have been left with this parent - with no response. This issue was resolved on 11/3/15 and the balance is zero.

Review: My daughter has been going to the PCH for more than a year, usually we have been receiving great service, but 4or5 months ago we start receiving a bill from something that we don't understand and we have been trying to get an explanation but nobody can solve it. I have my daughter in my job health insurance, I always take my daughter to the PHC appointments, and I pay the copayment and I just use my credit card to pay any expense regarding her visits. For that reason we don't understand why the bill [redacted]-** has been issue under my wife's name [redacted] when she never use any health insurance or credit card for my daughter's hospital visits. We get last night a bill with a final notice that the bill is going to delinquent if we don't pay the $45 dollar, but during the last appointment I already ask the hospital receptionist about any pending charges and she told my that in the account there is no balance. So we would like to get help from the Revdex.com to solve this problem, because there is no reason to charge my wife when I have been paying all the charges regarding my daughter health condition.

There is a WID [redacted] reference number in the bill that could help to find the case.

Thank you

[redacted]Desired Settlement: I would like the hospital to cancel that charge because there is no reason to charge my wife when the insurance and payments have been made from my accounts.

Business

Response:

Account [redacted]-** was reviewed and Mr. [redacted] is correct regarding the balance. The payment was not linked to the account which made it appear that the account was not paid. The payment is being moved, however, this account was not scheduled for collections. The account that was slated for collections is hospital facility account [redacted]. The insurance company approved and applied $32.00 to the patient's deductible for date of service 5/2/13. This account has been placed on a 30-day hold pending payment from Mr. [redacted]. I can be reached at [redacted] should Mr. [redacted] have additional questions.

Consumer

Response:

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. For your reference, details of the offer I reviewed appear below.What I don't get is why the bill is under my wife name, there is no reason for that, and why there is a charge almost one year after the service. Regards,[redacted]

Business

Response:

I spoke to Mr. [redacted] personally and I was under the impression that this issue was resolved.

Review: I had a finger fracture - I wasn't bleeding or unstable or anything. I was simply in a bit of pain. This happened right outside the Phoenix children's hospital. When I walked into their emergency room - they didn't turn me away saying its a children's only emergency room and that they will not be able to treat me. They happily welcomed me and triaged me (ie took my blood pressure and vitals). A doctor saw me an hour later and said he couldn't treat me as I was an adult. Didn't they know this when I walked in first? I was basically kept in pain for an hour for the doctor to not ever look at me - why? So they could collect the triage charge of $450? When asked they say they HAVE to triage me to make sure I am not dying? Really - because my broken finger is going to kill me? They are taking advantage of consumer ignorance and blindside them with a huge bill knowing they can't provide any emergency services. Their billing department gives me a different answer every time I talk to them - during our visit the billing agent said I won't be charged anything. When I called on August 2nd their phone their agent says they won't charge me as the services dont make sense (but there was no record of this call). The supervisor I spoke to on sep 4th says he doesn't understand why I was accepted as a patient either. Whilst the manager says the charges are 'justified'. Just would like someone to explain how it's justified to accept a patient you know you can't treat and the said patient visually looks perfectly healthy other than an injured finger?Desired Settlement: Partial or full refund of the triage charge

Review: In 2015, my son was seen at [redacted] several times, he saw Judith O[redacted] These appointments were to treat a wart on his face and hand. My bills from PCH after these appointments were typically around $70.

List of previous appointment DATES & CHARGES –

*ALL APPOINTMENTS WERE TO TREAT THE SAME TWO WARTS:

June 24, 2015 – received bill for $63.86 – PAID

September 16, 2015 – received bill for $71.55 – PAID

October 23, 2015 – received a bill for $71.55 – PAID. I also received the invoice for $716.00 this month, for ancillary Services.

November 10, 2015 – received a bill for $71.55 –pending payment.

In October we made another appointment to have the wart looked at again (as it hadn’t disappeared). In November, I received a bill for $716.00. Since November, I have been following up with PCMG regarding this high invoice. I finally received a call back on Jan. 5th from Teresa in Customer Service. She explained that the $716.00 comes from a facility charge, “ancillary services” (how statement reads).

I am outraged by this charge and find it unacceptable. We’ve been seen at Dermatology several times (see above appointments and charges) and never had our visit coded as a “facility charge” until October. If something changed and my visit in October was somehow different, I SHOULD HAVE BEEN ADVISED THAT THIS PARTICULAR APPOINTMENT WITH JUDITH OHAVER WAS DIFFERENT AND WOULD INCUR A FACILITY CHARGE. If I had been advised of such, I would have never let her treat my son’s wart. Since we had been seen in previous months and never received such an invoice, I was not expecting this type of charge.

This dispute has been going on since November. I get passed around, there is no follow up and no one is able to help with my questions/concerns.

After speaking with Teresa (customer service) on Jan. 5th I wrote a letter to the grievance department. I dropped it off IN PERSON. As of Jan. 19th no communication or response regarding my grievance/appeal. I had to call and follow upDesired Settlement: Called Jan. 19th to follow up, was told that my grievance was denied and was expected to pay the $716 bill. I called (Jan. 19th) the dermatology office/department and spoke with Christina (she's the admin assistant). I wanted an explanation as to why this office visit was charged at a higher rate. She had me leave a message for Kate the office manager. I called and left a message for Kate, waited over 24 hours and never received a call back. Called on Jan. 21st to follow up. Spoke with Christina again and demanded a call back ASAP. Kate called told me the charge stands. I asked about the other visits and fees being different, she said it's likely the first visit was coded wrong. That's unacceptable. That's the doctor's fault if they coded a visit incorrectly. I was not under the assumption that my visits would cost $700+, otherwise I would not have visited their facility. This is unethical, their customer service is just awful. I want my bill adjusted, I will only pay the office fee.

Business

Response:

Further conversations have taken place with the consumer. An agreement has been reached to resolve the complaint.

Consumer

Response:

We have not reached an agreement. I still feel the charge is assured and not fair. Per the comments mentioned in my complaint. I'm seeking further action, which is why I submitted this complaint.

Review: PCH's billing department has been calling us regarding payment before our bill is even due. They refuse to collect a copay at the time of service and instead send us a bill. Their last call was the day before Thanksgiving, 11/25/15, and we had already mailed a payment that wasn't even due until 11/30/15. Our account is current and has always been current. I contacted customer service and spoke with [redacted], who likely, but hopefully will not, answer this complaint. I found her to be defensive, unapologetic, and even somewhat argumentative. My only request was to not be contacted by PCH billing unless our bill becomes past due. She said that was "not possible" and that they were only calling as a "courtesy" (to them?). I am filing this complaint to avoid what feels like harassment from the PCH billing department.Desired Settlement: I would like to not be contacted by PCH's billing department unless our account is overdue.

Business

Response:

This inquiry has been completed. The billing process has been explained. The billing process is not customizable by patient and is established to assist parents with keeping track of their many bills. This is a process that is helpful to many parents that are overwhelmed with their paperwork.

Consumer

Response:

I find it difficult to believe that an exception cannot be noted on our child's chart. I continue to request that PCH not contact me for an account that is not, nor has ever been, delinquent. I continue to assert that this constitutes harassment by PCH's billing department.

Review: We went to Phoenix Children's Urgent Care on 08/14/15 for my son's broken arm. We were correctly charged our $60 copay which included the exam, x-rays and a splint. We were told we needed to make a follow-up appointment with an orthopedic doctor to have a cast put on the following week. At that time, I scheduled the follow-up visit and verified with the staff that this would be a specialist, in-network appointment. On 08/19/15 I brought my son in and had a 30 minute appointment where a technician placed a cast on his arm after a 5 minute consult with the doctor. As per my insurance, and my verification with the office staff during the urgent care appointment, I expected to receive a bill for my $60 copay amount. Instead, Phoenix Children's billed $3932.00 for this 30 minute appointment. These charges include $2350.00 for "Ancillary Services", $1260 for "Surgical Care", and $322.00 for "Medical Care". We did not go to a hospital, there were no x-rays done, nor did my son have any surgical procedures done. We were provided with no estimation of charges nor were we informed that this appointment would fall under "hospital emergency charges". In fact, we were told this would be a regular, in-network, office visit.

We have been going to PCH for 14 years and have always been pleased with the care received. We have had many appointments at multiple locations, including specialists as well as urgent care physicians, and we have never seen such an excessive amount billed.Desired Settlement: I am expecting to have the bill adjusted to correctly reflect my $60 copay for an office appointment with a specialist. This is what I verified was going to happen with the staff at PCH while scheduling the appointment. I am more than willing to pay the $60 in full upon receiving the corrected bill.

Business

Response:

Multiple discussions have taken place regarding the billing. The billing is accurate - a resolution has been offered by PCH, MRS. XXX has declined.

Consumer

Response:

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. For your reference, details of the offer I reviewed appear below.

It is correct that we have

had multiple discussions with PCH in an attempt to resolve this issue and make

them aware of the incorrect billing that has taken place. In fact, beginning on 9/25/16, within the

first week of receiving the bill, we contacted PCH five times regarding this

billing error, each time escalating to another level of management. While I did not get the name of the first

person we spoke with, I did note that future conversations were with Claudia,

Kenyatta, Dianna Sierra, and finally, Wanda Bartels. We

were billed an exorbitant, incorrect amount for a standard, scheduled

appointment. There was no “operating

room” and he received no “surgical services”.

The incorrect bill was not reflective of the amount quoted to us at the

time of scheduling the appointment, nor was it reflective of the minimal services

my son received in the twenty minutes he spent in the room. During the very first interaction, PCH

offered a 50% discount off the bill. We

explained that we were not looking for a discount; we simply were requesting a

bill that correctly reflected the services quoted and received. Additionally, we requested the detailed records

from the appointment, both billing and medical, from PCH. We were

told it would take approx. 30 days to receive the medical records and that the

billing record would be a single line item – “Ancillary

Services”. PCH continued to offer 50% off the bill and said the

offer would expire within 7 days. We asked PCH to put their offer in

writing as we have had miscommunication with them regarding billing since

scheduling the appointment. This is very standard practice in any

financial negotiation. PCH (specifically,

Dianna S[redacted] and Wanda Bartels[redacted]We have and continue to ask

only that PCH acknowledge the error in billing and present to us a new bill

correctly reflecting our $60 co-pay for a regularly scheduled appointment with

an orthopedic dr. Unfortunately, his is not an

issue we alone have had with PCH. As

reflected on the Revdex.com and other sites, many families, like us, have gone through

this headache while trying to care for the medical needs of their children. Unfortunately, PCH appears to be in the habit

of practicing creative billing and deceiving the public for monetary gain. It is for this reason that we, along with

many others, have been forced to file complaints with the Revdex.com, The Department

of Insurance, the Medical Board, Yelp, Google, and our State

Representatives. Additionally, at the

advice of both our insurance agent and our representative at BCBSAZ, we have

filed a case with the BCBSAZ Fraud Department.We

would have never made an appointment at this facility if we had known they

would re-code our appointment upon our arrival in an attempt to collect more

money. We

sincerely hope that PCH will re-consider our plea to correct the error in

billing. Upon their doing so, we are

more than happy to promptly pay our $60 co-pay amount for the standard,

scheduled, middle-of-the-day appointment our son had with the orthopedic dr.

Regards,

Business

Response:

Mrs. XXXX has been given a detailed explaination of her billing. It is accurate. PCH offers have been declined.

Review: I have been taking my children to phoenix children's urgent care facility for years and they have always accepted [redacted] insurance. Upon this visit nothing was out of the norm and we were not made aware of the current negotiations going on between this facility and [redacted] that made it out of network during this period of time. I received the bill for my daughter for over $1600.00 for an urgent care visit. There was no mention at check in and there were no notices posted that [redacted] wasn't being accepted at the time of our visit. A few months after the visit Phoenix Children's billing office sent me the bill and when I called they explained that the urgent care has always done its billing and inventory through the major hospital (phoenix children's hospital). They decided to change this and start doing it on their own and this change triggered the urgent care to go out of network with [redacted]. Each time I've talked with someone from Phoenix Children's billing office I hear the same scenario and I'm always told that they are in negotiation and it will soon be fixed but "unfortunately the customers are the ones who are suffering from this situation". This is what they have told me several times. My account with Phoenix Children's billing office was turned over to collections and I was told it couldnt be given back. I was told by [redacted] to appeal and talk to higher ups at [redacted] to get this claim approved. I have stayed in touch with Phoenix Children's billing office and with the collections agency and both keep telling me that this will soon be resolved. I did as I was told by [redacted] at PCH billing office and my appeal, 2nd level appeal, and my formal complaints have all been denied by [redacted]. After months I was able to get my account returned from collections due to me following the process they told me to follow. Another co-worker of mine is in this same situation and followed the exact process I have. She recently got her claim approved as an exception. I am asking that this be covered since there is a history of my children being seen at this facility and of those visits being approved by [redacted]. name is [redacted]. Also, when I last talked with a rep at [redacted] and told her about this situation she said she has seen this several times now and told me about an actual scenario that she was aware of where an employee of the Phoenix Children's hospital took his child to the urgent care and then also is now in my same situation. Even the employees of the hospital were not aware of this lapse in coverage. Finally, I have talked directly to [redacted] at Phoenix Children's Hospital Billing office and she will be able to confirm this information we are being told. Her phone number is [redacted].Desired Settlement: Im asking that Phoenix Childrens do something to cover this visit. Thank you.

Business

Response:

Please let me know what urgent care center you visited because I'm pretty certain we posted notices advising that [redacted] was non-participating with Phoenix Children's Hospital.

Consumer

Response:

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. For your reference, details of the offer I reviewed appear below.

We visited the [redacted] location. However, this was back in July of 2013 ... almost a year ago I've been dealing with this. When this happened I can assure you that there wer no notices posted anywhere. I even spoke to several [redacted] customer services reps who have told me about many memebers confirming this same thing at that same time. Also, I called the PCH medical billing group to complain and when I told them there were no notices posted they confirmed that there weren't and that they have in fact posted notices since then. There is an urgent care down the street and I would have gone directly there had there been a notice posted or someone told me when I handed them my [redacted] card upon check in. I can assure you that in July 2013 there were no notices posted.

Regards,

Business

Response:

I have investigated this complaint and found that [redacted] Non-Particpating notices were not placed in the PCH urgent care centers until August 2013 so PCH will be reducing the balance on this account to the family's urgent care co-payment amount of $50.00. Please contact me at [redacted] if you have any additional questions.

Review: One year ago, a family member had medical testing at Phoenix Children's Hospital. Prior to the testing, we were required to provide our insurance information. On the day of the testing, we were required to pay in full the determined amount between PCH and our insurance company, which we did. Months later, we received a bill in the mail. Confused by the bill requesting another smaller payment, we contacted our insurance company. They could not explain the bill and recommended that we not pay the bill until an itemized bill was provided. We contacted PCH to inquire about the bill and request an itemized bill. It never came. Instead, threatening collection notices and automatic phone message came requesting payment. We contacted PCH again and offered to pay the bill but we would still like an explanation. The billing employee could not make sense of the bill and suggested that it was incorrect. She told us not to pay the bill and she would have it reviewed. We never received a phone call or letter in the mail about the status of the review. However, we received more threatening collection notices and automatic phone messages. We contacted PCH again. This time, the billing employee told us that the issue was resolved and that we did not owe money. We never received a phone call or letter in the mail verifying this information. However, we received more threatening collection notices and automatic phone messages. We contacted PCH again. This time, I insisted on speaking to a manager. She was impolite. I asked that she review the recorded phone calls and provide training to the workers who provided incorrect information. A patient should never have to go through so much, just to verify correct billing and then to pay a small amount of money. The manager confirmed that she would send an explanation of billing. It was never received. However, we received more threatening collection notices and automatic phone messages. We decided enough is enough and paid the simple bill. However, we still have no idea if it was a valid bill because we still have never received an itemized bill.Desired Settlement: We want an explanation of charges. Ideally, we want to know that training has occurred within the billing office so that other patients won't be put through this horrible experience. It is hard enough to have to be a patient at PCH because you are dealing with the failing health of a child. To endure threatening collection letters and harassing phone calls (sometimes more than one in the same day) for a small amount of money in question, is absurd. I can't imagine if this was for a procedure in which we lost a child. Many people donate their hard-earned money to PCH to ensure a quality children's hospital for the children of the valley. It is extremely disheartening to discover that such discrepancies exist within their billing department.

Business

Response:

I spoke to Ms. [redacted] on 4/25/14 and she confirmed that she spoke to [redacted] on 4/24/14 and the issue is resolved.

Consumer

Response:

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. For your reference, details of the offer I reviewed appear below.

Phoenix Children's Hospital was very quick to respond as soon as a complaint was filed with Revdex.com. However, according to the pattern from the past year, I am still expecting to receive harassing phone calls and collection notices within three weeks. I will consider this issue resolved when I have a letter in writing from the company stating that I have a zero balance and three weeks has past without any phone calls and threatening letters.

Regards,

Business

Response:

Please call me at [redacted] as I need to obtain patient information to provide a zero balance statement.

Review: PCH is trying to over charge me for a bill for my daughter for service on 5/20/2015. per the EOB from the insurance company we owe $1680.00 for account #22206322 but PCH keeps saying we owe $4000.00. I have tried to contact their billing dept numerous times with no resolution.Desired Settlement: I just want a bill reflecting the correct amount of $1680.00 so I can set up the proper payment arrangements.

Business

Response:

This was resolved on 9/1/15. An updated bill will be mailed in the next week to ten days.