U.C. Davis Medical Center

I am writing to acknowledge arid respond to the concerns you expressed in your fax to cur office today, November, 19, 2014 regarding your client’s frustration, with being unable to obtain a cost estimates prior to accessing emergent care on 9/21/2014 at the UC Davis Medical Center’s Emergency...

Room.
Revdex.com Case ID #: [redacted]    Patient  Relations case # [redacted].
Please note that your client’s concerns were already brought to our office’s  attention  directly  by the patient  himself and documented In the above case, on November 14 by another Patient Relations analyst. An inquiry has already been forwarded to our Patient Billing office and to the ER Registration manager. Your client had already spoken with our billing office some weeks ago and an audit of his care and the related billing level has been initiated. The patient will be sent a letter with the outcome of the audit, and a description of the billing level assigned to his care. A breakdown of his fees was also sent to him, as well as a financial hardship screening package in order to determine if the patient is eligible to receive financial assistance to aid him in paying his balance. Emergency services are focused on providing emergent care and their role is not to estimate the potential cost involved for a patient. This cannot be determined until the acuity of a patient’s Illness or injury has been determined, along with identification of the resources and complexity of providing the appropriate care. Financial counselors are available to patients to discuss payment options after that care has been provided,  and this patient is already in communication with appropriate  UC Davis Medical Center staff.
If you have questions our office can be reached at [redacted]

Review: My son was seen by a dr at this clinic on 11/21/2013. we were sent her by a referral from his regular doctor. We arrived to this office for the appointment as scheduled. We were advised of a $25.00 copay which we paid at the time. We were seen by a dr for no more than 15 minutes. No services were done. Months later we received 2 seperate bills. One in the amount of $226.35 and one in the amount of 51.98. I caled the billing dept to ask why we received 2 bills and what they were for. they explained that they are considered an outpatient facility and they charge for the dr services and a facility fee. They did not disclose any of this information to me prior to scheduling the appointment. Their response is they do not know what our insurance would cover so they do not disclose. It should not matter what our insurance covers, if they are an outpatient facility and they have facility usage charges it should be disclosed of the possibility. This type of practice is unfair.Desired Settlement: I believe that the bill should be waived or compromised. I paid my copayment and was not properly disclosed of possibility of any other fees.

Business

Response:

Thank you for your inquiry. This complaint is currently under investigation and assigned to case # [redacted]. A further response will be forthcoming.

Patient Relations, UC Davis Medical Center

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Consumer

Response:

I am rejecting this response because:

I will wait for the review. Thank you

Business

Response:

The UC Davis Medical Center’s Patient Billing office has reviewed and now responds to your Revdex.com complaint. The balance you have been billed was determined by your insurance to be your responsibility in accordance with your benefit plan. However, as a courtesy to you, Patient Billing has agreed to adjust the balance due for your 11/12/2013 and 5/7/2014 dates of service. This is because you were unaware that the services your son received in the ENT clinic are considered by your insurance to be an ‘Outpatient Hospital Service’ and that you have an annual deductible to meet for these services, in addition to an office visit co-pay. On 5/16/2014 you were advised of this information by your insurance, United Healthcare and the UC Davis Patient Billing office, therefore any services received after 5/16/2014 in any UC Davis Health System clinics, will remain your responsibility to pay in full. Case [redacted] is now closed.

Consumer

Response:

I have reviewed the response made by the business in reference to my concern, and find that this resolution is satisfactory to me. Thank you for reviewing the complaint and handling this. I do think clinics should disclose that they are an "outpatient facility" when we check in.

Thank you

Review: I recently went to the emergency room at the uc davis medical center, and asked for a rough estimate of costs prior to treatment. I've never been to an ER and rarely visit the doctor, so I had no idea what potential costs could be. It turns out that they classify visits in increments of 1000 dollars within a five tiered system depending on type of treatments. My swollen testicle (which resulted in an ultrasound and antibiotics- amounting to half an hour's attention) was considered level 3 care and cost $3,400 in addition to the ultrasound and antibiotics- total of around $5,500. The woman at the front desk said she could give no indication of potential charges due to insurance differences. This makes some sense, but she should have been able to at least give me their five tiered charge system for just walking in the door. I would have taken my chances elsewhere.Desired Settlement: I would like hospital emergency rooms to be required to list potential charges for just the visit, and/ or have my bill reduced to something that resembles sanity- or the national average for such a visit. This is the only business I know of that doesn't have to give any type of estimate before service, and apparently they can charge whatever they feel like. Thank you, UC Davis Med Center, for literally taking me by the [redacted] and [redacted].

Business

Response:

I am writing to acknowledge arid respond to the concerns you expressed in your fax to cur office today, November, 19, 2014 regarding your client’s frustration, with being unable to obtain a cost estimates prior to accessing emergent care on 9/21/2014 at the UC Davis Medical Center’s Emergency Room.

Revdex.com Case ID #: [redacted] Patient Relations case # [redacted].

Please note that your client’s concerns were already brought to our office’s attention directly by the patient himself and documented In the above case, on November 14 by another Patient Relations analyst. An inquiry has already been forwarded to our Patient Billing office and to the ER Registration manager. Your client had already spoken with our billing office some weeks ago and an audit of his care and the related billing level has been initiated. The patient will be sent a letter with the outcome of the audit, and a description of the billing level assigned to his care. A breakdown of his fees was also sent to him, as well as a financial hardship screening package in order to determine if the patient is eligible to receive financial assistance to aid him in paying his balance. Emergency services are focused on providing emergent care and their role is not to estimate the potential cost involved for a patient. This cannot be determined until the acuity of a patient’s Illness or injury has been determined, along with identification of the resources and complexity of providing the appropriate care. Financial counselors are available to patients to discuss payment options after that care has been provided, and this patient is already in communication with appropriate UC Davis Medical Center staff.

If you have questions our office can be reached at [redacted]

Review: I was billed incorrectly for an office visit on 6-6-2012. When I notified the UCD billing department I was billed in error I was told they would remove the incorrect code and resubmit the claim for payment to my insurance company. On 5-14-2014 when paying a current UCD bill I was notified that I had an account in collections that was from DOS 6-6-2012. I told the collector that this was an error. That I had called almost 2 years ago and notified them they billed in error and it was supposed to be corrected. I have spoken to 4 collectors including a manager in the billing department. They have been extremely rude. They have admitted they billed in error but never submitted a corrected claim to my insurance for reprosessing but instead continued to send me a bill for $144. $100 of which they knew was incorrect and the $44 had they resubmitted to my insurance would've been paid. I was told today that I should have known that although they continued to send me a bill for $144 I should have known to pay the $44 which is incorrect. I have since paid the account that was sent to collections in error.Desired Settlement: I want an apology for sending me to collections in error; not billing my insurnace correctly and for the rude service I have received when trying to resolve this. I also want to be reimbursed for the money I paid to the collections agency when they sent the account to collections. I had to pay $60 because of interest.

Business

Response:

Patient was originally charged for an injection for date of service 6/6/2012. Patient called Billing office to advise the charge for the medication injected was in error because she had brought her own generic meds to clinic and had a nurse administer the injection. Verification of this was obtained from the clinic site and the clinic administration agreed. Patient was then credited this $100.00 charge. That left the injection administration charge which clinic confirmed was still the patient’s responsibility. Patient was called on 11/07/2012 to advise her of this and notified that she would receive a corrected bill. The patient was subsequently mailed 3 statements and 2 letters prior to her assignment to collections. The patient called the Billing office several times after the account was assigned to collections to state that she never got the bill; however, none of the 5 above mailings were returned as undelivered. The patient requested the Billing staff to appeal the insurance denial (administration of the injection was a non-covered benefit) and the patient was advised that it would be her responsibility to appeal any denied claims through her health plan. A copy of the first statement and the last statement that was sent out to the patient showed she owed the $44.00 for the injection administration fee. There will be no refund to the patient.

My son was seen by a dr at this clinic on 11/21/2013. we were sent her by a referral from his regular doctor. We arrived to this office for the appointment as scheduled. We were advised of a $25.00 copay which we paid at the time. We were seen by a dr for no more than 15 minutes. No services were done. Months later we received 2 seperate bills. One in the amount of $226.35 and one in the amount of 51.98. I caled the billing dept to ask why we received 2 bills and what they were for. they explained that they are considered an outpatient facility and they charge for the dr services and a facility fee. They did not disclose any of this information to me prior to scheduling the appointment. Their response is they do not know what our insurance would cover so they do not disclose. It should not matter what our insurance covers, if they are an outpatient facility and they have facility usage charges it should be disclosed of the possibility. This type of practice is unfair.