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]
Complaint: [redacted] I am rejecting this response because:when the itemized statement was sent to me, there did NOT reflect an outstanding balance of $It actually showed there was a balance of -$The issue with my HSA card was resolved and I had until March 31, to use the remaining money in my HSA account, which was $At that time, the only document I had been sent reflected an amount of $which would have been owed to me, based on their accounting I did not receive an actual bill in the amount of $until the middle of April (dated April 12) I have a copy of the statement they sent to me in January Regards, [redacted] ***
Complaint: [redacted] I am rejecting this response because:The hospital and I are still in conversationI called back with information Ms [redacted] requested, and probably because it was relatively late on Friday afternoon, she has not yet had a chance to call me back Regards, [redacted]
Dear Mr***, Thank you for the opportunity to respond to your concerns regarding the following referenced Revdex.com Case number – [redacted] B***.In review of your concerns it appears that the Seton Family of Hospitals has already addressed your visit to Seton Williamson for date of service on June 6, Our records indicates that we responded to the complaint on September 02, Please note that during this process the account was sent out for audit regarding the ER level and at that time we received confirmation that services were billed correctly and that the billing met the ACEP criteria.In this case, your coverage is solely based on your individual benefit plan and I would respectfully encourage you to contact your insurance directly if you feel that they have assessed an incorrect amount to be patient responsibility.In summary, our records indicate that you have an outstanding balance of $1,The account balance in this case is part of your deductible in which was assessed by your benefit plan Please contact us at your earliest convenience to discuss a viable payment plan or other available options in order to satisfy your account balance.Sincerely, [redacted] - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Dear Mr***,Thank you for the opportunity to respond to your concerns regarding the following referenced account - Case # [redacted] - [redacted] Upon receipt of your Revdex.com complaint, Below I provided to you direct contacts for the Emergency Medical Group representatives in management that you may contact at your convenience as Seton Family of Hospitals does not conduct billing for the physicians You may contact *** and or *** at [redacted] , as they will be happy to address any concerns that you may have regarding your billing concerns In regards to our conversation held on January 28, 2015, I would once again like to confirm that for the dates of service in question at Dell Children’s Hospital that you have a zero balances Respectfully , [redacted] Revenue Cycle Supervisor - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is being worked however if it is not handled and the account not charged, this will not be settledThank you Regards, [redacted]
after a deep review of the account and several calls to the insurance provider we discovered there was a payment received from Aetna on 07/01/and a debit balance of $was left under the insurance responsibility as the claim was split we ran across an electronic error that left the account in "limbo" for several monthsBecause the balance was less than a cretin dollar amount it was never added to a work list for manual interventionOn 1/12/we received a call from the guarantor where she tried to pay the balanceAt that time the payment was declined and the guarantor stated that she would reach out to her HSA and find out why the card was declined and return the callWe then sent an itemized statement to the guarantor as there was no statement available at the time, the itemized statement would have shown that there was a residual balance of On this call we did advise that we could take the payment, but due to the card declining the payment we could not resolve the balanceWhat caused the account to "sit on the shelf" was several electronic process errors that stemmed from the split claimThis has since been resolvedAfter review with Patient Access managers I have been authorized to offer a settlement of 35% off (352.66) or a one time payment of to close the account
Ms [redacted] , Thank you for allowing us the opportunity to address your concerns about your experience during your visit to Seton Medical Center Williamson on May 1, I would first like to clarify that Austin Regional Clinic (ARC) is not owned or operated by Seton - it is a separately owned and managed company apart from SetonAfter reading through your description of your visit this appears to be a quality of care issue in which you are most concerned about your interactions with the physician and the registration staffBecause this is not a true billing question, I cannot immediately address this issueHowever, I have escalated this matter to the appropriate departments to review your account and respondThis information was forwarded on May 6, Please allow 15-days for them to investigate and replyIn the interim I have placed your account on hold with the billing process for days to give us the opportunity to research and respond to your concernsWe apologize that you had a negative experience at our facilityWe pride ourselves on providing a positive interaction and look forward to the opportunity to address your complaint Thank you, [redacted] Customer Service SupervisorPatient Financial ServicesSeton Family of Hospitals
Dear Mr [redacted] , Thank you for the opportunity to respond to your concerns regarding the following referenced account – [redacted] – Revdex.com # [redacted] Our records indicate that your insurance was billed timely and correctly for the services rendered and your insurance processed our claim based on your benefit plan coverageIn this case, your coverage is solely based on your individual benefit plan and I would respectfully encourage you to contact your insurance directly if you feel that they have assessed an incorrect amount reflected as patient responsibilityIn summary, our records indicate that you have an outstanding balance of $1, Based on your benefit plan which indicates that you had a remainder of $as part of your deductible along with co-insurance in the amount of $1, Please note that this information was communicated via your health plan to Seton Please except our sincere apologies for any extended waiting time during your visit in our ER as it is our goal to provide the best care possible Please contact us at your earliest convenience to discuss a viable payment plan in order to satisfy your account balance [redacted] Revenue Cycle Supervisor - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Dear Mr***, In review of your concerns regarding your visit to Seton Southwest on January 1, 2014, please note that your account has not been credit reported at this time The total outstanding amount due by you is $1,reflecting a 21% discount with no payments reflected on account Please note that on December 19, 2014, our office received your request via telephone regarding an itemized statement to be mailed to the address on file In regards to your son’s visit to Seton Southwest on March 04, 2014, our review indicates that we have updated our records to reflect the correct guarantor’s information, please note that this account has also not been credit reportedPlease contact us at your earliest convenience to discuss a viable payment plan in order to satisfy your account balance.Thank you for the opportunity to respond to your concerns regarding the following referenced account – Case # [redacted] [redacted] Revenue Cycle Supervisor - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Thank you for the opportunity to respond to your concerns regarding the following referenced account - Case # [redacted] - [redacted] In review of your concerns, I reached out to our Manager [redacted] @ Seton Shoal Creek – in order to discuss confidential details of billing and addressing any possible concerns you may have regarding this matter Please note that billing for Shoal Creek is handled directly by facility In addition I am providing contact information for Ms [redacted] @ [redacted] for your records.Respectfully, [redacted] Revenue Cycle Supervisor - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Mr [redacted] , Thank you for allowing us the opportunity to address your concerns about your experience during your visits to Seton After research into your complaint I have verified that you were seen by a Seton provider in May for multiple medical concerns and ultimately had an internal device implanted to monitor any cardiac eventsUnfortunately, I have confirmed that the monitor was not activated upon your discharge from the hospital, as you have stated Upon discovery of the issue and notification to [redacted] , she assisted in facilitating your visit to one of the Seton Electrophysiology providers for consultation at no charge to youShe then worked with the hospital to waive copays for the procedure to remove the internal device and wrote-off the outstanding balances and refunded your copay for your clinic visits Since your complaint to the Revdex.com has been received, Ms [redacted] has worked with the facility to also refund your copay for the initial procedure and waive your outstanding ER balances as well, though they were determined not to be related to the initial cardiac eventsThe refund is scheduled to mail out Friday, October 28, Seton Heart Institute and Seton Patient Financial Services has worked diligently to ensure this issue has been resolved to your satisfaction We apologize that you had a negative experience with our providersWe pride ourselves on providing a positive interaction and have appreciated the opportunity to address your complaint Thank you, [redacted] Customer Service Supervisor Patient Financial Services Seton Family of Hospitals
I apologize for my lingo; prior to a refund we needed to create a credit on your accountI was just emailed stating that the credit was approved and is on the accountI emailed the individual who is responsible for the refund and asked that this refund get escalatedThere are now managers on this refund and as I type this I was just advised that the refund was approved by one of themThe Ascension group processes the actual check and from what I am told they mail them every week on Fridays, mail has already came so I have been told that this refund should be put in the mail this next Friday the 27thYou are free to call Seton Customer Service at [redacted] and ask for [redacted] and we will be happy to speak with you
Mr [redacted] , I'm sorry to hear you are having trouble getting an answer to your inquiryI will take a look at your account and reach out to the appropriate person to get a resolution.Please allow me a day or so to research the issue and take actionMy contact information is below.Thank you, [redacted] Manager, Revenue Cycle [redacted] phone
Complaint: [redacted] I am rejecting this response because:Thank you for your reply, Mr. [redacted] . I reviewed the ACEP Tool guidelines, and here are my observations:1. An instruction to take an OTC is not listed among Level 2 "Possible Interventions." In fact, "Instructions" is listed as a Level 1 intervention. 2. The website also states that "each hospital may utilize its own unique system for assignment of E/M levels, provided that the services are medically necessary." Taking ibuprofen is not "medically necessary," it is an optional medication that patients may choose to use at their own discretion but is not critical to treating the illness itself. 3. Furthermore, "each hospital may utilize its own unique system for assignment of E/M levels, provided that...the coding methodology...correlates with institutional resources utilized to provide a given level of service." And, "The coding guidelines should be based on hospital facility resources. The guidelines should not be based on physician resources." What extra "institutional" and "hospital facility" resources did a doctor's recommendation to take OTC require?4. Finally, the website states that Medicare will pay "the 'average' US hospital" $59.30 for a Level 1 and $109.50 for a Level 2 Emergency Room Visit. You have charged us over 6 times that amount and over $300 extra for the OTC recommendation alone. Is it 6 times more expensive for you to facilitate a one minute physician consultation along with ibuprofen recommendation than for an "average hospital"? Can you provide any reasonable grounds for charging additional $300 for an OTC recommendation?Based on these criteria, we believe that my husband's case was not coded consistently with ACEP guidelines and that your price is several times multiple to the actual costs incurred by the facility. Please adjust my husband's case to a Level 1 code and adjust our bills to a fair level.I know your hospital holds itself to a high level of ethical standards in many areas. Please revise your billing practices to more accurately reflect those standards and prove to patients that you are here to do "human-care" and not "financial exploitation of human misfortune." Thank you, I hope we can work this out. [redacted]
Complaint: ***
I am rejecting this response because:
Regards,
*** Matter is not resolved until all monies are retuned that I spent on this failed and careless operation, should be asking for time and travel considering I live in Johnson City, about hour from my home, all for not
I have checked the patients account and for some reason there are no notes or any requests that came through on this accountThis would imply that either a) agents picking up the phone are not processing requests or leaving notes b) the correct department was never reached by the caller c) agents
were not available to take the call during the time the caller is trying to call our departmentThe phone number for the Customer Service Department (billing) is either *** or ***(local)I had a complete itemized statement printed today to be placed in the mail on Wednesday, of MarchThese are mailed from ***, ** and should take about to days to arrive at the patients houseI attempted to call the phone number provided but was not able to speak with a person, I did leave a voicemail with my phone number so that I can be reached if there is anything further we can doAdditional follow up was made with the departments supervision staff.*** *** ***Customer Relations Manager
Patient was billed in error, this account is still processing with insuranceUntil insurance is done with the account I cannot request an adjustment to any balancesOnce insurance is done processing the balance and until insurance instructs us of what the patient responsibility is I cannot process
this complaint furtherThe hospital provides estimates to patients of what their service might cost out of pocket which should have been communicated at the time of service that it is just an estimate, if this communication was not given it should have beenWe cannot provide an accurate true patient responsibility until the insurance provider has fully processed the claim as all patient responsibilities come from the patients insurance providerWe utilize various tools to obtain a patient estimated responsibility but in some cases there might be more services needed from a clinical standpoint while the patient is in the hospital that we can not anticipate.I will reach out to Mr*** to address this and the statement listed above
Complaint: ***
I am rejecting this response because:Seton's (Contracted) Billing department advised me that the $amount was for my actual hospital stay $X days = - $I have paid already as my "Co-Pay" leaves me with a balance and what Seton says I owe $885.00I was never informed of these charges AT ALL if I knew I would have stayed or days instead of due to the pain and rather deal with the intense pain then pay $295.00This really sounds like "ENTRAPMENT" to me, having this charge not explained to me given Seton has had my Insurance information for well over a Month and should be well aware of what *** Pays and not paps for, in this surgery and to inform and prepare me properly what my responsibility isout of pocket...Now if this conversation was in error by Seton's Billing department and I am all for waiting, BUT I am not wanting on a worthless effortThis needs to be resolved either covered 100% by *** or "Written off" due to being misrepresented and misinformed by Seton...This decision on these ONLY options are up to Seton...This is FRAUD
Regards,
*** ***
Mr***, I am sorry you are not satisfied with the resolutionSeton has processed your refund to be mailed out Friday, October 28, thus you should receive the funds the following weekIf you need any further assistance or have additional questions, please feel free to contact our Patient Financial Services via the Customer Service department at *** ***, Monday through Friday between a.mand 4:p.m Thank you,*** ***Customer Service Supervisor Patient Financial ServicesSeton Family of Hospitals
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]
Complaint: [redacted] I am rejecting this response because:when the itemized statement was sent to me, there did NOT reflect an outstanding balance of $It actually showed there was a balance of -$The issue with my HSA card was resolved and I had until March 31, to use the remaining money in my HSA account, which was $At that time, the only document I had been sent reflected an amount of $which would have been owed to me, based on their accounting I did not receive an actual bill in the amount of $until the middle of April (dated April 12) I have a copy of the statement they sent to me in January Regards, [redacted] ***
Complaint: [redacted] I am rejecting this response because:The hospital and I are still in conversationI called back with information Ms [redacted] requested, and probably because it was relatively late on Friday afternoon, she has not yet had a chance to call me back Regards, [redacted]
Dear Mr***, Thank you for the opportunity to respond to your concerns regarding the following referenced Revdex.com Case number – [redacted] B***.In review of your concerns it appears that the Seton Family of Hospitals has already addressed your visit to Seton Williamson for date of service on June 6, Our records indicates that we responded to the complaint on September 02, Please note that during this process the account was sent out for audit regarding the ER level and at that time we received confirmation that services were billed correctly and that the billing met the ACEP criteria.In this case, your coverage is solely based on your individual benefit plan and I would respectfully encourage you to contact your insurance directly if you feel that they have assessed an incorrect amount to be patient responsibility.In summary, our records indicate that you have an outstanding balance of $1,The account balance in this case is part of your deductible in which was assessed by your benefit plan Please contact us at your earliest convenience to discuss a viable payment plan or other available options in order to satisfy your account balance.Sincerely, [redacted] - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Dear Mr***,Thank you for the opportunity to respond to your concerns regarding the following referenced account - Case # [redacted] - [redacted] Upon receipt of your Revdex.com complaint, Below I provided to you direct contacts for the Emergency Medical Group representatives in management that you may contact at your convenience as Seton Family of Hospitals does not conduct billing for the physicians You may contact *** and or *** at [redacted] , as they will be happy to address any concerns that you may have regarding your billing concerns In regards to our conversation held on January 28, 2015, I would once again like to confirm that for the dates of service in question at Dell Children’s Hospital that you have a zero balances Respectfully , [redacted] Revenue Cycle Supervisor - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is being worked however if it is not handled and the account not charged, this will not be settledThank you Regards, [redacted]
after a deep review of the account and several calls to the insurance provider we discovered there was a payment received from Aetna on 07/01/and a debit balance of $was left under the insurance responsibility as the claim was split we ran across an electronic error that left the account in "limbo" for several monthsBecause the balance was less than a cretin dollar amount it was never added to a work list for manual interventionOn 1/12/we received a call from the guarantor where she tried to pay the balanceAt that time the payment was declined and the guarantor stated that she would reach out to her HSA and find out why the card was declined and return the callWe then sent an itemized statement to the guarantor as there was no statement available at the time, the itemized statement would have shown that there was a residual balance of On this call we did advise that we could take the payment, but due to the card declining the payment we could not resolve the balanceWhat caused the account to "sit on the shelf" was several electronic process errors that stemmed from the split claimThis has since been resolvedAfter review with Patient Access managers I have been authorized to offer a settlement of 35% off (352.66) or a one time payment of to close the account
Ms [redacted] , Thank you for allowing us the opportunity to address your concerns about your experience during your visit to Seton Medical Center Williamson on May 1, I would first like to clarify that Austin Regional Clinic (ARC) is not owned or operated by Seton - it is a separately owned and managed company apart from SetonAfter reading through your description of your visit this appears to be a quality of care issue in which you are most concerned about your interactions with the physician and the registration staffBecause this is not a true billing question, I cannot immediately address this issueHowever, I have escalated this matter to the appropriate departments to review your account and respondThis information was forwarded on May 6, Please allow 15-days for them to investigate and replyIn the interim I have placed your account on hold with the billing process for days to give us the opportunity to research and respond to your concernsWe apologize that you had a negative experience at our facilityWe pride ourselves on providing a positive interaction and look forward to the opportunity to address your complaint Thank you, [redacted] Customer Service SupervisorPatient Financial ServicesSeton Family of Hospitals
Dear Mr [redacted] , Thank you for the opportunity to respond to your concerns regarding the following referenced account – [redacted] – Revdex.com # [redacted] Our records indicate that your insurance was billed timely and correctly for the services rendered and your insurance processed our claim based on your benefit plan coverageIn this case, your coverage is solely based on your individual benefit plan and I would respectfully encourage you to contact your insurance directly if you feel that they have assessed an incorrect amount reflected as patient responsibilityIn summary, our records indicate that you have an outstanding balance of $1, Based on your benefit plan which indicates that you had a remainder of $as part of your deductible along with co-insurance in the amount of $1, Please note that this information was communicated via your health plan to Seton Please except our sincere apologies for any extended waiting time during your visit in our ER as it is our goal to provide the best care possible Please contact us at your earliest convenience to discuss a viable payment plan in order to satisfy your account balance [redacted] Revenue Cycle Supervisor - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Dear Mr***, In review of your concerns regarding your visit to Seton Southwest on January 1, 2014, please note that your account has not been credit reported at this time The total outstanding amount due by you is $1,reflecting a 21% discount with no payments reflected on account Please note that on December 19, 2014, our office received your request via telephone regarding an itemized statement to be mailed to the address on file In regards to your son’s visit to Seton Southwest on March 04, 2014, our review indicates that we have updated our records to reflect the correct guarantor’s information, please note that this account has also not been credit reportedPlease contact us at your earliest convenience to discuss a viable payment plan in order to satisfy your account balance.Thank you for the opportunity to respond to your concerns regarding the following referenced account – Case # [redacted] [redacted] Revenue Cycle Supervisor - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Thank you for the opportunity to respond to your concerns regarding the following referenced account - Case # [redacted] - [redacted] In review of your concerns, I reached out to our Manager [redacted] @ Seton Shoal Creek – in order to discuss confidential details of billing and addressing any possible concerns you may have regarding this matter Please note that billing for Shoal Creek is handled directly by facility In addition I am providing contact information for Ms [redacted] @ [redacted] for your records.Respectfully, [redacted] Revenue Cycle Supervisor - Customer Service Patient Financial ServicesSeton Family of Hospitals Administrative Offices
Mr [redacted] , Thank you for allowing us the opportunity to address your concerns about your experience during your visits to Seton After research into your complaint I have verified that you were seen by a Seton provider in May for multiple medical concerns and ultimately had an internal device implanted to monitor any cardiac eventsUnfortunately, I have confirmed that the monitor was not activated upon your discharge from the hospital, as you have stated Upon discovery of the issue and notification to [redacted] , she assisted in facilitating your visit to one of the Seton Electrophysiology providers for consultation at no charge to youShe then worked with the hospital to waive copays for the procedure to remove the internal device and wrote-off the outstanding balances and refunded your copay for your clinic visits Since your complaint to the Revdex.com has been received, Ms [redacted] has worked with the facility to also refund your copay for the initial procedure and waive your outstanding ER balances as well, though they were determined not to be related to the initial cardiac eventsThe refund is scheduled to mail out Friday, October 28, Seton Heart Institute and Seton Patient Financial Services has worked diligently to ensure this issue has been resolved to your satisfaction We apologize that you had a negative experience with our providersWe pride ourselves on providing a positive interaction and have appreciated the opportunity to address your complaint Thank you, [redacted] Customer Service Supervisor Patient Financial Services Seton Family of Hospitals
I apologize for my lingo; prior to a refund we needed to create a credit on your accountI was just emailed stating that the credit was approved and is on the accountI emailed the individual who is responsible for the refund and asked that this refund get escalatedThere are now managers on this refund and as I type this I was just advised that the refund was approved by one of themThe Ascension group processes the actual check and from what I am told they mail them every week on Fridays, mail has already came so I have been told that this refund should be put in the mail this next Friday the 27thYou are free to call Seton Customer Service at [redacted] and ask for [redacted] and we will be happy to speak with you
Mr [redacted] , I'm sorry to hear you are having trouble getting an answer to your inquiryI will take a look at your account and reach out to the appropriate person to get a resolution.Please allow me a day or so to research the issue and take actionMy contact information is below.Thank you, [redacted] Manager, Revenue Cycle [redacted] phone
Complaint: [redacted] I am rejecting this response because:Thank you for your reply, Mr. [redacted] . I reviewed the ACEP Tool guidelines, and here are my observations:1. An instruction to take an OTC is not listed among Level 2 "Possible Interventions." In fact, "Instructions" is listed as a Level 1 intervention. 2. The website also states that "each hospital may utilize its own unique system for assignment of E/M levels, provided that the services are medically necessary." Taking ibuprofen is not "medically necessary," it is an optional medication that patients may choose to use at their own discretion but is not critical to treating the illness itself. 3. Furthermore, "each hospital may utilize its own unique system for assignment of E/M levels, provided that...the coding methodology...correlates with institutional resources utilized to provide a given level of service." And, "The coding guidelines should be based on hospital facility resources. The guidelines should not be based on physician resources." What extra "institutional" and "hospital facility" resources did a doctor's recommendation to take OTC require?4. Finally, the website states that Medicare will pay "the 'average' US hospital" $59.30 for a Level 1 and $109.50 for a Level 2 Emergency Room Visit. You have charged us over 6 times that amount and over $300 extra for the OTC recommendation alone. Is it 6 times more expensive for you to facilitate a one minute physician consultation along with ibuprofen recommendation than for an "average hospital"? Can you provide any reasonable grounds for charging additional $300 for an OTC recommendation?Based on these criteria, we believe that my husband's case was not coded consistently with ACEP guidelines and that your price is several times multiple to the actual costs incurred by the facility. Please adjust my husband's case to a Level 1 code and adjust our bills to a fair level.I know your hospital holds itself to a high level of ethical standards in many areas. Please revise your billing practices to more accurately reflect those standards and prove to patients that you are here to do "human-care" and not "financial exploitation of human misfortune." Thank you, I hope we can work this out. [redacted]
Complaint: ***
I am rejecting this response because:
Regards,
*** Matter is not resolved until all monies are retuned that I spent on this failed and careless operation, should be asking for time and travel considering I live in Johnson City, about hour from my home, all for not
I have checked the patients account and for some reason there are no notes or any requests that came through on this accountThis would imply that either a) agents picking up the phone are not processing requests or leaving notes b) the correct department was never reached by the caller c) agents
were not available to take the call during the time the caller is trying to call our departmentThe phone number for the Customer Service Department (billing) is either *** or ***(local)I had a complete itemized statement printed today to be placed in the mail on Wednesday, of MarchThese are mailed from ***, ** and should take about to days to arrive at the patients houseI attempted to call the phone number provided but was not able to speak with a person, I did leave a voicemail with my phone number so that I can be reached if there is anything further we can doAdditional follow up was made with the departments supervision staff.*** *** ***Customer Relations Manager
Patient was billed in error, this account is still processing with insuranceUntil insurance is done with the account I cannot request an adjustment to any balancesOnce insurance is done processing the balance and until insurance instructs us of what the patient responsibility is I cannot process
this complaint furtherThe hospital provides estimates to patients of what their service might cost out of pocket which should have been communicated at the time of service that it is just an estimate, if this communication was not given it should have beenWe cannot provide an accurate true patient responsibility until the insurance provider has fully processed the claim as all patient responsibilities come from the patients insurance providerWe utilize various tools to obtain a patient estimated responsibility but in some cases there might be more services needed from a clinical standpoint while the patient is in the hospital that we can not anticipate.I will reach out to Mr*** to address this and the statement listed above
Complaint: ***
I am rejecting this response because:Seton's (Contracted) Billing department advised me that the $amount was for my actual hospital stay $X days = - $I have paid already as my "Co-Pay" leaves me with a balance and what Seton says I owe $885.00I was never informed of these charges AT ALL if I knew I would have stayed or days instead of due to the pain and rather deal with the intense pain then pay $295.00This really sounds like "ENTRAPMENT" to me, having this charge not explained to me given Seton has had my Insurance information for well over a Month and should be well aware of what *** Pays and not paps for, in this surgery and to inform and prepare me properly what my responsibility isout of pocket...Now if this conversation was in error by Seton's Billing department and I am all for waiting, BUT I am not wanting on a worthless effortThis needs to be resolved either covered 100% by *** or "Written off" due to being misrepresented and misinformed by Seton...This decision on these ONLY options are up to Seton...This is FRAUD
Regards,
*** ***
Mr***, I am sorry you are not satisfied with the resolutionSeton has processed your refund to be mailed out Friday, October 28, thus you should receive the funds the following weekIf you need any further assistance or have additional questions, please feel free to contact our Patient Financial Services via the Customer Service department at *** ***, Monday through Friday between a.mand 4:p.m Thank you,*** ***Customer Service Supervisor Patient Financial ServicesSeton Family of Hospitals