St. Peter's Hospital

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received, your complaint will be closed Administratively Resolved] Revdex.com, I have reviewed the response made by the business in reference to complaint ID and have determined that this does not resolve my complaintFor your reference, details of the offer I reviewed appear below September 25, Cathy [redacted] Revdex.com Complaint ID Dear Cathy [redacted] , st1\: [redacted] / [redacted] Style Definitions */ Upon reading the page book sent by Medicare, it is true that Medicare states that visits to the ER are processed under Part BFour of my friends who all are on Medicare thought as I did, that the ER facility is covered under Part AI guess there are a lot of us who don’t read the bookNOTE: IT WOULD BE A VERY INFORMATIVE, EASY AND NOVEL THING TO DO IF ER STAFF, CHECKING PEOPLE WITH MEDICARE CARDS INTO THE ST PETER’S ER, TOLD THEM ALL SERVICES ARE COVERED UNDER PART B / [redacted] Style Definitions */ THE FOLLOWING IS MY BIG ISSUEIf I’d found out in April or May that I was going to be paying $I would have taken my chances with bacteria getting into my bones and I would have not gone into the ER for visits in JuneSo w/that, THERE WAS NEVER A CLAIM SUBMITTED TO MEDICARE (OR [redacted] ) BY ST PETER’S ER FACILITY FOR THE MARCH 4, VISIT / [redacted] Style Definitions */ I CALLED MEDICARE TODAY (9/25/2015) AND THEY INFORMED ME THAT THE ONLY CLAIM THAT WAS SUBMITTED FOR 3/4/ WAS FROM THE ER DOCTOR SERVICEAND AS I SAID WHEN THE ER DOCTOR SERVICE’S CLAIM WAS DENIED THEY SENT ME A BILL RIGHT AWAYIt will take business days for Medicare to send me a summary statement for the period starting in March 4, to the present day September 25, I can mail this information to you once I receive it as proof that StPeter’s never sent in a claim for that dayDo you want this info? st1\: [redacted] / [redacted] Style Definitions */ My husband quit his job in February and we forgot to remove [redacted] from the Medicare systemI received an [redacted] Claim Recap in July for x-rays done while at the ER on the June 14, visit and promptly removed [redacted] on July 31, st1\: [redacted] / [redacted] Style Definitions */ I CALLED [redacted] TODAY (9/25/2015), THEY INFORMED ME THAT THE CLAIM FOR X-RAYS ON 6/14/WAS THE ONLY CLAIM THAT WAS SUBMITTED IN in fact the last claim they had for me was in January 16, 2014, the one year visit to the doctor to examine my total knee replacementI can mail this information to you now or wait until I receive the information from Medicare Do you want this info? / [redacted] Style Definitions */ I can send you the bills sent to me by the ER doctor serviceThe one for 3/4/ was sent in April and I paid it 4/15/ The one for 6/12/was sent in July and I paid it on 7/31/ THE BILLING PERSONNEL FOR ST PETER’S ER DOCTOR BILLING WAIVED THE LAST TWO BILLS (6/13/AND 6/14/Do you want these bills? st1\: [redacted] / [redacted] Style Definitions */ I can send you bills sent to me by Dr G [redacted] Visits to Dr G [redacted] on 6/12/15, 6/15/and 6/18/were paid by me on 7/23/The 6/25/visit was paid on 8/15/and the last visit on 7/8/was adjusted by Medicare on 8/20/and paid by me on 9/22/Do you want these bills? st1\: [redacted] / [redacted] Style Definitions */ It is true I called the Financial Advocate personnel of ST Peter’s hospital but not to file for assistanceI would not be eligible for assistanceNo one at St Peter’s Hospital seem to be able to do anything about what I was saying and kept directing to this departmentI need to talk with someone, who has real teeth, someone who will really listen and do something about the lack of timely handling of this ER 3/4/bill, who can give me a financial break both with a decrease of the $6,plus bill and without accruing interest while I pay off the remaining amountI also know I don’t have $6, plus lying around to pay the bill in fullI find the hospital’s response unconscionablePerhaps I should move onto a State/Federal agency that helps when people have issues with hospitals Sincerely, Mary R***

St
Peter’s Hospital
*** *** *
Helena
Montana *** *** ***
March
14,
Revdex.com
*** * ***
*** ***
*** ** ***
RE: *** * ***
ID: ***
account number: ***
To
whom it may concern:
I
have looked into the above concern and found the following information
Date of Services: Patient received services spanning
02/05/thru 05/29/
Final
insurance payment: 06/26/
Statements
mailed: 07/2215, 09/23/15,
10/27/15, and 11/30/
Copies
attached
Interaction
with patient: Representative spoke with
*** 08/06/
Representative
spoke with *** 11/10/
*** left message 12/4/which a return
call was made the same dayMessage had to be left for her to return
representatives callNo record she called back.
Patient payments received: 08/07/15 $
11/13/15 $
01/11/16 $
Account turned to collection: 02/26/
Possible monthly payments after insurance:
Payments received from patient:
Patient claimed not to get statements but
she had received from us. In addition
she would have received Explaination of benefits from her insurance letting her
know what her cost share would have been.
Based on the above information, I would
agree that the account was referred to a secondary collection agency
appropriately. Let me know if you need
any further information
Sincerely
***
***
Director of Patient Business Services
Phone:
*** ***
Fax: *** ***
***
Enclosure:
Copy
of statements

I have attached my summary of what happened The other is a PDF file which shows examples. First the bill they sent ever month (exp) 2nd I requested a statement because I could not figure out the $credit they should have given me and to show what I had paid which I could not understand their codes, etc(exp), 3rd a statement showed they turned me over to collections, 4th a summary sheet which I asked to see who I was paying on and who I was paying (exp) All this did was confuse the issue I had no warning from them that they were going to turn me over to collections, had I known this was going to collection I would have applied my payments to them.
Your help is greatly appreciated I am on disability and it has been difficult I should not have to go to court because of their mistake This hospital is goingn under and for their easy way out , they choose to turn all accounts not only my own but others, to the collection agencies
If you need more information please let me know
Comint: ***I am rejecting this response because:Sincerely,*** ***
***SUPPORTING DOCUMENTS REDACTED BY Revdex.com***

April 16, Revdex.com PO Box Dupont WA PATIENT: *** *** COMPLAINT ID: *** Dear Sirs I have reviewed the below concern
and found we are billing the patient the appropriate amount per her insurance. I have attached the explanation of benefits we received from GEHA to show the amount we are invoicing her matches the amount applied to her deductible by insurance. Original amount billed contract adjusted payment amount to patient 278.42 13.92 0.00 There was an office visit amount for the same day that her insurance did process leaving only her co pay of 35.00, which she paid at the time of service. I have attached the claim history for this visit as well Please let me know if you need any additional information Tell us why here

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received, your complaint will be closed Administratively Resolved]
Revdex.com,
I have reviewed the response made by the business in reference to complaint ID and have determined that this does not resolve my complaintFor your reference, details of the offer I reviewed appear below
September 25,
Cathy ***
Revdex.com
Complaint ID
Dear Cathy ***,
Upon reading the page book sent by Medicare, it is true
that Medicare states that visits to the ER are processed under Part BFour of
my friends who all are on Medicare thought as I did, that the ER facility is
covered under Part AI guess there are a lot of us who don’t read the bookNOTE:
IT WOULD BE A VERY INFORMATIVE, EASY AND NOVEL THING TO DO IF ER STAFF,
CHECKING PEOPLE WITH MEDICARE CARDS INTO THE ST PETER’S ER, TOLD THEM ALL
SERVICES ARE COVERED UNDER PART B.
THE FOLLOWING IS MY BIG ISSUEIf I’d found out in April or
May that I was going to be paying $I would have taken my chances with
bacteria getting into my bones and I would have not gone into the ER for
visits in JuneSo w/that, THERE WAS NEVER A CLAIM SUBMITTED TO MEDICARE (OR
*** *** *** ***) BY ST PETER’S ER FACILITY FOR THE MARCH 4,
VISIT
I CALLED MEDICARE TODAY (9/25/2015) AND THEY INFORMED ME THAT THE ONLY CLAIM THAT
WAS SUBMITTED FOR 3/4/
WAS FROM THE ER DOCTOR SERVICEAND AS I SAID WHEN THE ER DOCTOR SERVICE’S
CLAIM WAS DENIED THEY SENT ME A BILL RIGHT AWAYIt will take business days
for Medicare to send me a summary statement for the period starting in March 4, to the present day September 25, I can mail this
information to you once I receive it as proof that StPeter’s never sent in a
claim for that dayDo you want this info?
My husband quit his job in February and we forgot to
remove *** *** from the Medicare systemI received an *** Claim Recap in
July for x-rays done while at the ER on the June 14, visit and promptly removed *** on July 31,
I CALLED *** *** TODAY (9/25/2015), THEY INFORMED ME
THAT THE CLAIM FOR X-RAYS ON 6/14/WAS THE ONLY CLAIM THAT WAS SUBMITTED IN
in fact the last claim they had for me was in January 16, 2014, the one year
visit to the doctor to examine my total knee replacementI can mail this
information to you now or wait until I receive the information from Medicare
Do you want this info?
I can send you the bills sent to me by the ER doctor
serviceThe one for 3/4/
was sent in April and I paid it 4/15/
The one for 6/12/was sent
in July and I paid it on 7/31/
THE BILLING PERSONNEL FOR ST PETER’S ER DOCTOR BILLING WAIVED THE LAST TWO
BILLS (6/13/AND 6/14/Do you want these
bills?
I can send you bills sent to me by Dr G*** Visits to Dr
G*** on 6/12/15, 6/15/and 6/18/were paid by me on 7/23/The 6/25/visit was paid on 8/15/and the last visit on 7/8/was adjusted by Medicare on 8/20/and paid by me on 9/22/Do you want these bills?
It is true I called the Financial Advocate personnel of ST
Peter’s hospital but not to file for assistanceI would not be eligible for
assistanceNo one at St Peter’s Hospital seem to be able to do anything about what
I was saying and kept directing to this departmentI need to talk with someone,
who has real teeth, someone who will really listen and do something about the
lack of timely handling of this ER 3/4/bill, who can give me a financial
break both with a decrease of the $6,plus bill and without accruing
interest while I pay off the remaining amountI also know I don’t have $6,
plus lying around to pay the bill in fullI find the hospital’s response
unconscionablePerhaps I should move onto a State/Federal agency that helps
when people have issues with hospitals
Sincerely,
Mary R***

This is in response to the above complaintI am missing some information thatwould be helpful, names and dates of birth of patientsI will try to answer to thebest of my ability without this piece.I show we posted payments on Ms***'s account on August 23rdShe is referringto an account with a
date of service in July for her sonAt the time she made thepayment in August, the amount on the July account was still pending with herinsuranceInsurance paid on the claim September 25thThe first statementgenerated on the ba la nee November 11th.Our system is set, based on feedback from our community, not to generate astatement to the patient until there is a balance due from the guarantor.I have attached the audit trail on the account I believe is in questionIf this is notthe correct accountI will need to have additional information in order to investigate.Please let me know if you need any further clarification.Sincerely,Sheri R***Attachments redacted by Revdex.com staff**

StPeter’s Hospital
Broadway * Helena Montana 59601*Ph (406)442-2480* www.stpetes.org
April 11,
Revdex.com
Complaint ID:
***
*** * ***
To whom it may concern:
I am receipt of the above complaint and found the following. I found a total of accounts in the hospital system. Payments received and posted in the hospital system for these accounts are:
5/30/
PSP
PERSONAL PAYMENT THANK YOU
-
5/30/
PSP
PERSONAL PAYMENT THANK YOU
-
6/24/
PSP
PERSONAL PAYMENT THANK YOU
-
6/24/
PSP
PERSONAL PAYMENT THANK YOU
-
6/24/
PSP
PERSONAL PAYMENT THANK YOU
-
8/28/
PSP
PERSONAL PAYMENT THANK YOU
-
8/28/
PSP
PERSONAL PAYMENT THANK YOU
-
2/24/
PSP
PERSONAL PAYMENT THANK YOU
-
8/21/
PSP
PERSONAL PAYMENT THANK YOU
-
10/9/
PSP
PERSONAL PAYMENT THANK YOU
-
10/23/
PSP
PERSONAL PAYMENT THANK YOU
-
12/3/
PSP
PERSONAL PAYMENT THANK YOU
-
1/22/
PSP
PERSONAL PAYMENT THANK YOU
I do show the Physician group getting payments up to August 2015, but stopped after that. I can't tell where the patient intended the payments to go but do not show consistent payment on her hospital billing. I did find that she had applied for patient assistance on her bills and that she was accepted on our programs 10/23/for a 100% write off on her balances. In light of this, I have asked that the account be cancelled out of collection and written off to the patient assistance program.
The account number *** is now considered a zero balance
Please let me know if you need any other documentation
Sincerely
Sheri R***
Director of Patient Business Services
Phone: (406) 444-
Fax: (406) 444-
***

St
Peter’s Hospital
Broadway *
Helena
Montana 59601*Ph (406)442-2480* www.stpetes.org
September
20,
RevDex.com
Re: Mary * R***
#
To
whom it Concerns,
I
am in receipt of the concern filed by Ms R***. My responses to her concerns *re *s follows:
She
is correct in her statement that if * person only has Part A coverage, Medicare
does not pay for services in the Emergency Room. Medicare recipients get a detailed book
explaining what each portion of coverage will pay for. Emergency room services are clearly defined
in their literature as being covered under Part B benefits.
She
is also correct in stating she did not get a statement right away from our
facility. Our facility does not send out
statements to our customers until there is a self pay portion owing on their
bill. We were getting indications from
Medicare Ms R*** had other primary coverage and we were investigating this to
see if the services could be billed to another insurance. Many of our patients that do not have a certain part of Medicare do carry
alternative insurance. Once it was
found the patient had no additional insurance to bill, a statement was sent out
to her
Ms
R*** has since reached out to our Financial advocate team and is in the
process of filing for assistance with her outstanding balances. If she is eligible for our program, her
balances will be reduced between 15-100%
We
are sympathetic to her situation, but it is imperative people understand how their insurance works. If they have questions we do have a team of
people in place to answer questions prior to or after services are done
Please
let me know if you need any additional information
Sincerely
Sheri
R***
Director of Patient Business Services
Phone:
(406) 444-
Fax: (406) 444-
***
Enclosure: