Texas Health Resources

Complaint: [redacted] I am rejecting this response because: I appreciate your response and offer to discount the billI did notice that you referred to your facility as an Emergency room, but your facility is listed as a health and wellness centerYour not a stand alone ERYou have other medical facilities attached and commingling, so what is a and reasonable person to conclude when arriving at your facility Also if by chance you could be recognized as a stand alone Emergency Room facility, then by demanding insurance and payment before services were rendered may violate Texas and Federal laws concerning Insurance and payment before services renderedTexas Health must have a policy to automatically place blame on the patient for knowing if a certain facility or provided is in network, as you may or may not know providers and facilities come and go all the time so it is up to the professionals to inform the patients especially when the have checked insurance and collected monies for the services up front before services were renderedYou have also not answered what would be reasonable and customary for a visit where the patient was misdiagnosed and not treated for the symptom that they were having on arrival and departure of your facilityI would be happy to discuss this with you further on the phone or in personI do feel that Texas Health and Wellness Center has acted in bad faith and has acted with maliciousness in a attempt to deceive me as well as possible malpractice in the treatment of my sonIn an attempt to resolve this matter I feel you should clear my account for the $dollars that your representatives specifically told me that I would owe for the visit and nothing moreI think any other conclusion other than to honor what I was told the night of service could possibly again fall under the Deceptive Trade Practices Act both state and federal not to mention failure to honor statements from your employees on the night of serviceI look foreword to speaking with you on this matter soon Regards, [redacted] ***

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my dispute Please enter your reason(s) for rejecting the business response below.I agree with THR contacting the debt collecting company and getting them to send me a letter in the mail showing zero balance on my account and making sure they no longer contact me by telephone Yes I still want THR to reach out to them and I still want the letter I do not agree in the response the payment plan called for monthly payments and a payment was required every month for months as that information was not made clear over the phoneNor was it made clear my telephone number and information would be handed over to THR debt collector company if a monthly payment was missed nor did your staff communicate this when the payment plan was pursued The problem I am having is the fact THR employee wanted to get by with not communicating any of this and then claim a simple regurgitation of my responses made to staff when I contacted them regarding my account would suffice to address the Revdex.com complaint excluding the THR' employees liability and negligence in Failing to communicate more clearly I got no acknowledgement from your staff in this complaint acknowledging their wrongdoing or responsibility in the fact they made errors communicating or claimed to do something like get my name and phone number removed from debt collector company's contact list when in fact the employee did not follow through with it What I am most concerned with is the lack of information and laziness on behalf of the staff If for instance I hadn't bothered to contact THR after I submitted the e-check then by all means I would still be having this nightmare of a billing issue since THR wasn't about to contact me regarding the issue the e-check had a problem instead Your employee would have left me hanging Yet I am the one who proactively pursued contacting THR It is not my position to clean up or improve the communication skills of your company or problem solve for healthcare staff THR has a lot of guts using a debt billing collection agency to facilitate collecting outstanding balances in my opinion I give your company a grade of F minus Regards, [redacted] ***

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my dispute Please enter your reason(s) for rejecting the business response below.When I was contacted hospital was told I don't owe them any remaining balance as I was not provided a detail balance of how I was quoted and what the balance they say I owe I'm not paying for any bill I don't owe Regards, Delilah Thomas

[redacted] The account has been reviewed and determined that an audit has been performed and results show that medication that is charged is accurate and reflects in the patient medical record The patient may order copies of these records to see the information pertaining to the date and time these medications were administered The phone number for the medical record department is 1/855/681/ This account does reflect a zero balance, payment was paid on 4/3/and posted to the account on 4/4/ At the time of payment being made the account was placed with Computer Credit Incat midnight on 4/2/17, due to payment being received it was recalled from their office This agency does not report anything negative on our patients credit record Thanks, [redacted] ***Customer Service Supervisor

*** * ***
*** ***
***
*** Patient was quoted a deposit amount of $to pay as an estimate of her cost for delivery, this was not a final patient share as that is not determined until the claim is submitted to the patient insurance company and response received indicating patient true responsibility. Texas Health Resources does not determine the amount the patient will owe, the patients insurance company determines that once they receive the claim and process it based on the patients insurance benefits. The insurance company sends the hospital their payment along with the Explanation of Benefits that outlines what amount is patients share and that is the amount that the hospital bills the patient. The patient should receive a copy of this as well from their insurance co either by mail or electronically however the insurance company provides it to them, to match that we are billing the accurate amount they owe Aetna states for this claim patient total share due is $for coinsurance and deductible ($coinsurance + $deductible) because the patient did pay the deposit amount we requested at the time of service $we are billing her the difference due of $534.90. Payment options are available if this cannot be paid in full by contacting the billing office. ***
*** *** *** ***
*** *** ***

Attached you will find the letter that has been mailed to the mother regarding the billing concerns and letter that was sent from the patient advocate regarding their concerns on treatment/medical portion*** *** *** | Customer Service SupervisorT ***.***.*** | F
***.***.***e@*** Texas Health ResourcesEBorder Street Arlington, Texas 76010March 23, 2017Rosemary WallPO Box 2763Weatherford, TX 76086RE: Account# Patient: James Wall Dear MsWall,Thank you for contacting us with your account inquiry We value the opportunity to address your concern.Research has been done regarding your concerns with there being no notification of this being out of network In the Emergency Room the priority is to treat the patient however benefit information is checked with the insurance company The information we obtained does not state that this service would be out of network but did report that for the Emergency Room patient would have a $copay therefore that is what was collected at the time of serviceThe hospital will accept and bill any insurance that the patient has coverage with and provide an estimate/deposit based on benefit information provided by the insurance company, however we do not have a final bill until the claim has been submitted to the insurance company The insurance company should have information available to you as to what hospitals they consider to be preferred so that patients can seek treatment for the best insurance coverage The hospital is only given information regarding the patient benefits and unfortunately it is not always complete or correct, so patients should speak with their insurance company directly for the best coverage and benefit information This information is not guaranteed to us and therefore we cannot guarantee the information we provide as it is based directly on what we are given and is why we collect estimated/deposit amounts at the time of service and bill the final patient share after the claim has been submitted to the insurance company.Due to Scott and White not being in network with Texas Health Resources we cannot honor any discount amount the insurance company has utilized The account was submitted for possible approval of an underinsured discount due to the insurance company being out of network which was approved, so we have discounted the balance by $leaving the new patient due amount of $ If payment in full is not possible at this time you may contact our office to establish payment plan, or if there is a financial need the hospital financial assistance program may be applied for that may further be able to assist with the outstanding balance. In regards to the concern with the care received at the hospital, your letter was forwarded to Rhonda Larsen the patient advocate who would address any of the medical concerns with treatment.Please contact the hospital customer service department to discuss payment on the new patient share or if you are in need of the hospital financial assistance application (***)***- Monday-Friday 8am-5pmSincerely,*** *** *** *** *** ***Customer Service Supervisor

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 dispute
Please enter your reason(s) for rejecting the business response below. I would like to see the details of what was included in initial payment and final payment creating the additional amount This will explain why the hospital feels there is a balance due I was originally told coinsurance was $and will need details medical services provided to the explain difference
Regards,
*** ***

Revdex.com #*** *** ***
*** service 5/18/ Account details Bill date 6/25/$Patient called on 7/17/and agreed to month payment plan of $with first payment due 7/27/No July payment Payment post 8/31/$No September payment 10/1/
delinquent letter sent due to missed payment 10/26/no response from letter indicating missing payments so account was sent to Bad debt, due to the account showing delinquent for missed paymentsPayment post 11/4/$ Patient call on 11/13/and providing information for electronic check in the amount of $824.74, representative would have indicated information was accepted in the system and provided confirmation, however electronic check does not process immediately in the same way a credit card payment would. Payment returned on 11/25/with no further indication other than it was a return item12/1/patient called our office and advised that she made payment prior to thanksgiving and has not received an itemized statement. The representative informed her that day that the last payment of $returned so the outstanding balance showing is $824.74. The patient stated that she would mail a payment to our office for the balance and then make sure it goes through the bank and then call back for itemized statementPayment post 12/15/$leaving balance showing of zero12/23/Bad debt agency notated payment in full and we show no further action by them on the account by mail or phone Due to your information indicating agency is still contacting you I have submitted request to their office to confirm that their records show this account reflecting a zero balance and I will also ask them mail letter of confirmation to you that they have closed the account. The Bad debt agency office known as Firstsource/One Advantage is the agency this account placed with 10/26/15. Please check to confirm that it may not be another agency contacting you that is not in relationship to this. The agency has made no action on this account since the final payment reported to them in December Payment plans that are set up over a period of months require payment each month for the agreed upon amount. A month payment plan does not mean you have months to pay the total balance due in different increments or different times. Payments are due each month for the amount of agreed upon payment and date Please feel free to call or email me if you are in need of any further information regarding this Thanks, *** *** *** * *** *** ***
* *** * * ***
***
*** ** ** *** ***

Complaint: ***
I am rejecting this response because: The complaint had three parts. #was that I was being billed for medications that I did not take, #was the extremely high price of medications that I did take ( Renexa), and #was the timing of the account being sent to collection when I was told to not pay until a response was made from Harris. Their response was dated 3/and it was received at my residence on 3/29. I was out of town until 4/and upon return I promptly made payment on 4/3. It is my opinion that when the medications that I didn't take were scanned by the nurse in my room, once they are scanned then I'm charged regardless of whether I took them or not. This complaint is about poor customer service and an inappropriate professional way of doing business.
Regards,
*** ***

File# ***
Account# ***
*** ***
Thank you for bringing the call on November 15th to our
attention, the recording will be
reviewed and addressed with representative where neededOur goal is to provide
the highest quality service possible,
I regret not meeting your expectations
Account # *** is for service provided to the patient
at the Plano Pediatric Imaging Center which is owed and billed by Texas Health
Resources Plano. The privacy laws only
allow for details of the services to be provided over the phone to the patient
or in the case of a minor to the guarantor.
The guarantor is not the person who holds the insurance for a patient,
the guarantor is who signed all the acknowledgement forms and consented for
treatment. The guarentor has been provided this information.
The insurance company issued
an explanation of benefits showing how the claim was processed, their statement
may or may not show a description. As the insurance policy holder we can confirm billing information with youThe amount due is $for coinsurance, the patients percentage per the insurance policy
Thank you,
*** ***
*** *** ***
***

Complaint: [redacted]
I am rejecting this response because: I appreciate your response and offer to discount the bill. I did notice that you referred to your facility as an Emergency room, but your facility is listed as a health and wellness center. Your not a stand alone ER. You have other medical facilities attached and commingling, so what is a normal and reasonable person to conclude when arriving at your facility.  Also if by chance you could be recognized as a stand alone Emergency Room facility, then by demanding insurance and payment before services were rendered may violate Texas and Federal laws concerning Insurance and payment before services rendered. Texas Health must have a policy to automatically place blame on the patient for knowing if a certain facility or provided is in network, as you may or may not know providers and facilities come and go all the time so it is up to the professionals to inform the patients especially when the have checked insurance and collected monies for the services up front before services were rendered. You have also not answered what would be reasonable and customary for a visit where the patient was misdiagnosed and not treated for the symptom that they were having on arrival and departure of your facility. I would be happy to discuss this with you further on the phone or in person. I do feel that Texas Health and Wellness Center has acted in bad faith and has acted with maliciousness in a attempt to deceive me as well as possible malpractice in the treatment of my son. In an attempt to resolve this matter I feel you should clear my account for the $250.00 dollars that your representatives specifically told me that I would owe for the visit and nothing more. I think any other conclusion other than to honor what I was told the night of service could possibly again fall under the Deceptive Trade Practices Act both state and federal not to mention failure to honor statements from your employees on the night of service. I look foreword to speaking with you on this matter soon.
Regards,
[redacted]

Revdex.com File # [redacted]
With the information provided I am not able to locate the specific account the patient is referring to for TEXAS HEALTH RESOURCES.  Please provide if this is one of the Presbyterian Hospitals, Harris Methodist Hospitals or Arlington Memorial Hospital billed for...

Texas Health Resources and the patients date of birth so that we may locate the account and respond accordingly. Thanks,  [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my dispute.
Please enter your reason(s) for rejecting the business response below.I agree with THR contacting the debt collecting company and getting them to send me a letter in the mail showing zero balance on my account and making sure they no longer contact me by telephone.  Yes I still want THR to reach out to them and I still want the letter.  I do not agree in the response the payment plan called for monthly payments and a payment was required every month for 6 months as that information was not made clear over the phone. Nor was it made clear my telephone number and information would be handed over to THR debt collector company if a monthly payment was missed nor did your staff communicate this when the payment plan was pursued.  The problem I am having is the fact THR employee wanted to get by with not communicating any of this and then claim a simple regurgitation of my responses made to staff when I contacted them regarding my account would suffice to address the Revdex.com complaint excluding the THR' employees liability and negligence in Failing to communicate more clearly.   I got no acknowledgement from your staff in this complaint  acknowledging their wrongdoing or responsibility in the fact they made errors communicating or claimed to do something like get my name and phone number removed from debt collector company's contact list when in fact the employee did not follow through with it.  What I am most concerned with is the lack of information and laziness on behalf of the staff.  If for instance I hadn't bothered to contact THR after I submitted the e-check then by all means I would still be having this nightmare of a billing issue since THR wasn't about to contact me regarding the issue the e-check had a problem instead Your employee would have left me hanging.  Yet I am the one who proactively pursued contacting THR.   It is not my position to clean up or improve the communication skills of your company or problem solve for healthcare staff.  THR has a lot of guts using a debt billing collection agency to facilitate collecting outstanding balances in my opinion.  I give your company a grade of F minus.  
Regards,
[redacted]

[redacted] The account has been reviewed and determined that an audit has been performed and results show that medication that is charged is accurate and reflects in the patient medical record.  The patient may order copies of these records to see the information...

pertaining to the date and time these medications were administered.  The phone number for the medical record department is 1/855/681/8243.  This account does reflect a zero balance, payment was paid on 4/3/17 and posted to the account on 4/4/17.  At the time of payment being made the account was placed with Computer Credit Inc. at midnight on 4/2/17, due to payment being received it was recalled from their office.  This agency does not report anything negative on our patients credit record.   Thanks,  [redacted]Customer Service Supervisor

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my dispute.
Please enter your reason(s) for rejecting the business response below.When I was contacted hospital was told I don't owe them any remaining balance as I was not provided a detail balance of how I was quoted and what the balance they say I owe.  I'm not paying for any bill I don't owe.
Regards,
Delilah Thomas

[redacted]
[redacted]
[redacted]
[redacted]
Patient was quoted a deposit amount of $1351.00 to pay as an estimate of her cost for delivery, this was not a final patient share as that is not determined until the claim is submitted to the patient insurance company and response...

received indicating patient true responsibility.  Our records indicate that on 3/15/2016 @ 10:54 am we did contact patient and advise of the deposit amount of $1351.00, this call has been pulled by the director of patient access and reviewed to determine that full scripting was used to explain that the amount given was only an estimate that after its final billed any balance left would be billed to the patient.  Phone attempt was made to discuss this with the patient who did not want to speak with us in regards to this, we are billing based on the amount that patients insurance Aetna states is the patent due.  Aetna states for this claim patient total share due is $1885.90 for coinsurance and deductible ($1639.10 coinsurance + $246.80 deductible) because the patient did pay the deposit amount we requested at the time of service $1351.00 we are billing her the difference due of $534.90.  Payment options are available if this cannot be paid in full by contacting the billing office.  [redacted] Thanks,  [redacted]
[redacted]