St. Luke's Regional Medical Center

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 Sincerely, [redacted] PS Although the response said " 05/05/2017- A request was sent to the urgent refund team stating this needs to be refunded this day to Mr [redacted] and the refund was processed" , I did not finally receive it in the mail until 5/!

Please see attached response for our patient [redacted] If you have additional questions, please don't hesitate to contact usThank you To whom it may concern, We are in receipt of the communication sent to us by your office on 11/17/regarding [redacted] After review of the concerns, the following is a summary of our findings and next steps:Claim was processed by insurance on 6/29/leaving patient with a $balanceStLuke’s mailed statements (7/16/16, 8/13/16, 9/10/& 10/8/16)A pre-collect letter was mailed on 10/6/StLuke’s contacted Mr [redacted] via phone on 9/23/16, 10/12/& 11/2/to try and resolve balance, a message was left each timeStLuke’s received a $patient payment on 10/6/The account was assigned to collections on 11/6/Mr [redacted] failed to contact Customer Service to set up payment arrangementsBoth the statements and the pre-collect letter advised Mr [redacted] to contact Customer Service if unable to pay the balance in fullThis account was sent to collection appropriately StLuke’s will not be returning account from collectionsIf you have any questions, please feel free to reach out to us.Thank you

Complaint: ***
I am rejecting this response because: I requested information months ago so that I understood why I was being billedI paid the bulk of the bill and only waited to pay the portion of the bill I didn't understandNow I a being sent to collectionsI am happy to pay my bill in full but do not want a collections notation on my credit reportIf I my request was honored months ago as requested, I would not have to go to the Revdex.com and St Lukes would be paid in full. In addition, my health information about my specific procedures were released to the Revdex.com without my consentThis seems like a violation of my privacy.
Sincerely,
*** ***

Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to meSincerely, *** ***

This is in response to the complaint sent by our patient *** ***Mrs*** was set up on an auto payment with St Luke’s for $monthlyOn 12/15/the patient paid the balance in fullIn January the auto pay processed an additional payment of $causing the patient to over draft
their checking account balance and be charged an overdraft fee of $by their bank. StLuke’s issued a refund to the patient 2/1/2016, and since the account was over drafted the bank also returned the payment on 2/8/which caused the patient to have a balance due to St Luke’s of $The patient asked that we refund them the $over draft fee, because we withdrew an auto payment after the balance had been paid in fullThe patient spoke with our Customer Service department on 4/14/who agreed to reduce the patient’s balance owed to us by the $We posted that adjustment and the patient balance due to St Luke’s is now $An itemized statement was mailed to the patient to show the adjustment for the $on 4/14/2016.Patient Financial Services left the patient a voice mail on 5/11/to please contact them to make sure her concerns had been resolved with that adjustment.My hope is that this information helps to resolve the complaint that *** *** has filed with your officeIf there are any further questions, please feel free to contact me at 706- 7383.Thank you,Amanda R***Quality Assurance & Risk Mitigation CoordinatorPatient Financial ServicesSt Luke’s Health System***@slhs.org

This is in follow up to the concerns expressed by our patient *** ***, regarding the billingof her steroid injection at StLuke’s on 3/7/Our Patient Financial Services departmentalong with the Manager of StLuke’s Pain Management Clinic have conducted a thoroughreview.Upon review of the
account processing, the following actions occurred with the account:? 4/21/2017- StLuke’s received a denial from Ms***’s insurance, stating the “injuryor illness is the fault of a liability carrier.” Therefore, this balance was moved to be thepatient’s responsibility.? 5/10/2017- Ms*** was sent an electronic statement, advising her of the balanceowing.? 5/30/2017- Ms*** was informed if there was no other party responsible, she wouldneed to contact her insurance carrier with this informationShe called back later that dayto inform StLuke’s that her insurance was reprocessing the claim.? 6/16/2017- Ms***’s insurance processed the claim and denied the charge of$for procedure code due to lack of authorization.? 6/27/2017- This account automated to collections.? 6/29/2017- Ms*** called StLuke’s, informing us of her updated EOB and theaccount should have been routed to the proper review team at this time.After review by the Patient Financial Services team, the account has been removed fromcollections and Ms***’s credit has not been affected.In review with the Pain Management Clinic leadership, when the original order by JuliaM***, PA-C for the injection was placed, it was for a right L5-S1, with billing code 64483and this is the procedure the prior authorization was requested forAfter the original order wasplaced, an additional level was added of S1-S2, for billing code 64484, which did not get preauthorized.The Pain Management Clinic has requested a retro authorization from Ms.***’s Regence Insurance for this codeIf this retro authorization is denied, this patientbalance will be adjustedThe appropriate follow up and education has taken place with staff to ensure seamless billingpractices in the futureWe apologize for any frustration this may have caused.If there are any further questions, please don’t hesitate to contact me *** *** or thePatient Financial Services department at (208) 706-2333.Sincerely,JenniferManager, Patient Relations

This letter is in follow up to the concerns shared by our patient *** ***, regarding her9/8/procedure at StLuke’sThis procedure was performed by Dr*** *** withObstetrics and Gynecology Associates (OGA)Of note, Dr*** is not employed by St.Luke’s and bills for his
services separately.While under anesthesia, Dr*** identified and removed endometriosis tissue, which isthe additional charge Ms*** is referencingThe surgical consent that was signed on9/8/indicates “I understand that unforeseen conditions may arise during the course of theprocedure that, in the judgment of my Provider, may call for treatments or procedures in additionto or different from those named aboveIn that event, I authorize my Provider to do whatever, intheir medical judgment, they consider to be in my best interest.”As Ms*** indicates, she did not have duplicative charges for the surgical prep, anesthesiaor medications from StLuke’sThe additional charge is for code 58662, which is the code usedfor the removal of the endometriosis tissueMs***’s insurance has a co-pay of forthis procedure, which is her current outstanding balance on this account.If Ms*** has additional questions about the necessity of the surgical procedure, we wouldencourage her to speak with Dr*** about thoseThe charges associated with heraccount accurately reflect the services performedPayment arrangements can be made on theaccount by contacting 208-706-Please let us know if there are any additional questionsand thank you for allowing us the opportunity to review

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** *** PS Although the response said " 05/05/2017- A request was sent to the urgent refund team stating this needs to be refunded this day to Mr*** and the refund was processed" , I did not finally receive it in the mail until 5/!

Please see attached response for our patient *** ***If you have additional questions, please don't hesitate to contact usThank you
To whom it may concern, We are in receipt of the communication sent to us by your office on 11/17/regarding *** ***After review of the
concerns, the following is a summary of our findings and next steps:Claim was processed by insurance on 6/29/leaving patient with a $balanceStLuke’s mailed statements (7/16/16, 8/13/16, 9/10/& 10/8/16)A pre-collect letter was mailed on 10/6/StLuke’s contacted Mr*** via phone on 9/23/16, 10/12/& 11/2/to try and resolve balance, a message was left each timeStLuke’s received a $patient payment on 10/6/The account was assigned to collections on 11/6/Mr*** failed to contact Customer Service to set up payment arrangementsBoth the statements and the pre-collect letter advised Mr*** to contact Customer Service if unable to pay the balance in fullThis account was sent to collection appropriately StLuke’s will not be returning account from collectionsIf you have any questions, please feel free to reach out to us.Thank you

This letter is in follow up to the concerns shared by our patient *** ***, regarding hercomplaint to the Revdex.com and our subsequent response.Ms***’s account has been pulled back from collectionsWithin two business days she cancall 208-706-to payment arrangements on this accountThe account will automate back tocollections after days of non-payment.Her additional concerns have been referred to the StLuke’s Privacy Officer for reviewPleaselet us know if there are any additional questions and thank you again for allowing us theopportunity to review

Complaint: ***
I am rejecting this response because: I am not rejecting the response as much as I am awaiting response from the StLuke's Privacy Office I have sent the remaining balance via US Post requesting a return receiptStLuke's should receive the balance in full within the next weekI appreciate the time and attention to my concerns.
Sincerely,
*** ***

This is in follow up to the concerns expressed by our patient *** ***, regarding the billing ofhis visitOur Patient Financial Services department has provided the following timeline relatedto the reimbursement of Mr***’s charges.-07/20/2016- Insurance denied the claim, stating the benefit
maximum had been met on thisservice for the year.-10/28/2016- Insurance re-processed and left Mr*** with $co-insuranceStLuke’ssent a statement to Mr*** on 11/3/2016.-11/30/2016- Mr*** set up a payment plan for $per month and he paid on 11/30/2016and 01/16/2017.-01/31/2017- Insurance re-processed paying the charge in fullThis payment was posted to theaccount two days past the payment date.-02/01/2017- Mr*** called in to say that he should have a credit soon for what he paidTherepresentative stated she would follow up with the account and request the refund as soon asshe saw it postedThis was not completed and we have taken the appropriate steps to addressthis with staff.-03/31/2017- Mr*** called in again to see if the payment had postedThe credit wasexplained, however the account was not sent to the refund team to process the refund back tothe patient.-04/04/2017- The account was placed on the refund teams work queue for the patient to berefunded.-05/05/2017- A request was sent to the urgent refund team stating this needs to be refundedthis day to Mr*** and the refund was processed.We sincerely apologize for any delay in receiving this refund that was owed and please knowthat we have completed the appropriate follow up and education with staff to prevent this fromoccurring in the futureIf there are any further questions, please don’t hesitate to contact me*** *** or the Patient Financial Services department at (208) 706-

Dear Ms***, This is in follow up to the
concerns expressed by our patient *** ***, regarding the billing of his
2/3/appointment with StLuke’s Family MedicineOur Patient Financial
Services department along with the Manager of StLuke’s Family Medicine Clinic
have conducted a
thorough review. In review of the scheduling of
Mr***’s appointment, the notes for scheduling say the appointment is to
establish care and check testosterone levels due to prior testosterone
replacementIf an appointment is for specific symptoms or problems, it is not
ever considered a wellness examA wellness exam is only for prevention and
screening purposes. In addition, this visit has been
reviewed by the coding team who confirmed the coding is correct for what was
completed during this visitThe diagnosis and treatment of the 2/3/visit
are consistent with a problem focused visit. Based on this review, we
respectfully decline Mr***’s request for an adjustment to his account,
as there is no indication this visit was completed or coded inappropriatelyOn
behalf of StLuke’s, we apologize if there was any confusion surrounding what
a wellness exam consists of. If there are any further
questions, please don’t hesitate to contact me (208) 381-or the Patient
Financial Services department at (208) 706-

Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to meSincerely, *** ***

This letter is in response to the complaint sent by our patient *** ***These concerns were referred to our Quality Assurance department within Patient Financial Services for a thorough reviewBased on this review, it was determined that StLuke's received notification from United Healthcare
on 2/29/2016, indicating they showed another insurance needed to be billed firstStandard protocol is to notify our patients and a letter was sent to Ms*** on 3/1/indicating her current claim was pending and "your insurance company needs to know if you have other insurance coverage in order to process the claim." Ms*** responded to this request on 3/12/and on 3/14/the account was sent to the billing department to update the order of insurances, to reflect Blue Cross as the primary insuranceThis updated claim was sent out on 3/16/Unfortunately, on the morning of 3/14/2016,prior to noticing the request had already been processed, another letter was generated to Ms*** indicating the same information was still neededOn 3/21/Ms*** sent an e-mail through the bill pay system indicating the entities that she was filing complaints with based on this billThis e-mail was responded to notifying Ms*** "I have reviewed the account identified, and the information was updated on March 16, Visit *** was billed to Blue Cross Federal on March 16, and is pending their processingI appreciate your patience and apologize for the inconveniencePlease contact me if you have any further questions or concerns." The Quality Assurance Department attempted to contact Ms*** with this update on 3/21/and again for the next days, with her phone not accepting messagesA message was able to be left on 3/25/indicating to Ms*** the claim had been resubmittedAs of 3/16/all claims have been processed appropriately and as Ms*** had requestedAny balance that remains after insurance has processed would remain the patient responsibilityWe do apologize for the duplicate letter that was sentOur hope is that this information helps to resolve the complaint that Mr*** has filed with your office