St. Bernardine Medical Center

Dear. Mr. [redacted], This letter is in response to your concerns regarding your hospital bill for your visit on 10/28/13.     The following steps were taken to investigate your complaint: Your concerns were forwarded to Patient Financial Services.   Your concerns and the results of...

the investigation determined: It was confirmed that you have been seen at SBMC 4 times from 2009 through 2014.   1. ER visit 12/14/2009 2. ER visit 03/28/2012 3. ER visit 10/28/2013 4. ER visit 07/29/2014   You did not have insurance to provide with each visit. According the account review and documentation, you also did not have insurance and stated that you could not afford to leave a deposit.   Due to the circumstances our contracted self-pay vendor IHMS initiated contact with you to explore uninsured options to help. This included Dignity Health payment assistance application and applying for Medi-Cal. SBMC followed the provisions outline in the AB 774 (Hospital Fair Pricing Policies) as evidenced by an uninsured discount of 25% that was applied to total charges of patient's accounts.   In 2012, SB County MIA program was replaced with Arrowcare program. There is no documentation to support that your claims were being approved for Arrowcare. You did not provide information to registration, PFS, Call Center and our self-pay vendor IHMS.   1. You were offered Dignity Health Payment Assistance Application. 1 single application was forwarded directly to PFS in 2009. It could not be further reviewed because you did not supply the requirements to be considered. 2. In 2012, you were discharged before further registration was complete. You did not respond to Call Centers process of calls and or data mailer.   3. In 2013, you disputed a charge of splint. Revenue nurse auditor reviewed the medical chart and reached out to you. She concluded with you that she could not find evidence that you were provided with a splint. It was medically documented that you refused the recommendation. Revenue nurse auditor made it clear that you were not charged for one. She attempted to explain the professional components are billed separately from facility charges. You indicated you would provide updated insurance information.  You failed to do so. 4. In 2014, you indicated you were Medi-Cal pending. You did not respond or provide information to support this.   Your accounts have been transferred to bad debt collections. PFS followed the policies of transferring each accounts only after 181 days from first bill statement.   If you have any further questions, comments about the resolution, your contact person is: [redacted]- Patient Financial Services- Department Coordinator [redacted]

I am rejecting this response because:
I applied for the assistance program either it be arrow care or Mia and I submitted paper work directly to  the proper dept and was assured one it was processed it would be retro paid and now I'm being billed I guess I will obtain a legal representation for this matter this is outrageous and wrong I will pressure this all the way

This letter is in response to a letter received by Risk Management at Dignity Health St. Bernardine Medical Center regarding [redacted]'s Emergency department visit This case was handled in-house, therefore I will attach the response that we provided to the patient. I have had several telephone...

conversations with Ms, [redacted] in regards to her copayment. I explained that while I understood the level of frustration of $984 as a copayment. I explained to her that she willingly went into a contract with her insurance company and for that reason, we are not responsible for the amount that she has to pay per visit. I also explained to her that if she were due a refund, it would be completed by the Business Office based on the services rendered such as the ultrasound where sbe would still have a financial responsibility. As far as being told that she would need to re-register, in the event that a patient is discharged in error, Admitting can reactivate the new account and merge it with the previous account. We appreciate the opportunity to address all patient complaints_ We take these complaints seriously and strive to provide the best care possible to all patients.