Umass Memorial

Unethical Billing PracticesI received a collection notice from [redacted] for a bill from UMass Memorial [redacted] I called to let them know that I was disputing the bill. I then called UMass [redacted] and spoke to [redacted]. She looked at my account and began telling me the dates the claim was sent to my insurance, to me, back to my insurance, to me. I explained that I had not received any bills and was upset about being put in collections. I asked for copied of the bills she said they had sent me, one in [redacted] and one is [redacted] 2015. She said she was not able to provide me with copies and offered an itemized statement. I told her that if bills were mailed to me she should be able to provide copies. She told me, in an intimating manner, that they were a large billing company and if she said they mailed me bills then they did. I tried to comment but each time I did she interrupted me and cut me off. When I asked her to let me speak and not to interrupt me she told me she wasn't going to deal with me any longer and was transferring me to her supervisor. I was connected to her supervisor's voicemail. I left a message stating how [redacted] had treated me and that I did not dispute the charges but didn't think it was right for them to put me in collections without sending me a bill. And that I believe the charges were due to a car accident and should have been billed to workman's comp. I also told her that I was going to contact you. A few minutes later [redacted] called me and asked for the information regarding the car accident. At this point I was back to work, unable to speak about personal matters, and quite offended by the way she had treated me earlier. I told her I couldn't talk and would follow through with my plan to contact you.Desired SettlementI would like my account removed from collections.I would like copies of the bills [redacted] said were sent to me in [redacted] and [redacted] of 2015. I can't request workman's comp pay it without a bill.Business Response Contact Name and Title: [redacted] Contact Phone: XXXXXXXXXXContact Email: [redacted]Good morning, the UMass business office has contacted the Radiology billing vendor with regards to thsi matter. We have forwarded a copy of the complaint to them to address and resolve asap. We have asked that all billing stop and that the payment be researched and posted. We apologize for any inconvenience this may have caused you. Please let us know if there are any further concerns, thank-you

I had a cortisone shot in my right knee this spring 06/05/2014. I was supposed to see a [redacted] Boisvert, but she was still out on Maternity leave. I had a nurse practitioner administer the shot into my right knee. She did a great job and I have no complaints. But I started getting a bill for services from the medical group with Dr. [redacted] listed as the doctor of record for my treatment. I did not have Dr. Manalan treat me! I have called several times to try and get this straightened out. I am not sure if this is the right bill or not. The last call I made a couple of weeks ago I spoke to a women at the # XXX-XXX-XXXX. I asked her to explain why I should pay a bill with the wrong info on it. After getting the run around she told me "Pay the Bill, your insurance company paid their portion, you pay yours, it is your obligation" Why should I pay a bill with the wrong information on it. And why cant I get a reason for the wrong info on the bill ? Why would they bill my insurance company with the wrong info on it? Doesn't this constitute medical fraud?Desired SettlementAn honest explanation of how and why what they did is legal, moral and professional? And why cant I get an answer or explanation from the billing office, where I called at least 3 times during the summer and fall.Date of service 06/05/2014 invoice # XXXXXXXX medical record #XXXXXXXXX total charges [redacted]Business Response Dear Mr. [redacted], I sincerely apologize for my delay in responding to you. We contacted the doctor office to inquire why [redacted] was used as the billing provider for your visit. The medical notes indicate that you were seen by the Physician assistant Kelsey Byron. Dr. [redacted] was the supervising physician in the office that day as Dr. Boisvert was on maternity leave. Your health insurance Blue Cross requires that the billing be done under the supervising physician and not the Physician assistant. We have been in touch with your insurance to verify benefits and I am having the claim information verified to ensure everythign was submitted appropriately. This is being done today. I will respond again with the additional information today.Final Business Response Good evening Mr. [redacted]. We contacted your physician office again as well as your health insurance. There was another covering physician in the office on the day of your visit. We are submitting a request to have that physician billed as the supervising physician. Once the correction is made we will resubmit a claim to your insurance company for processing. This may reduce the amount owed by you. We can refund the full payment that you have made or we can wait for the insurance to reprocess and then review your accoutn for refund. Please let me know how you would like us to proceed. Thank-you for your patience and again I wish to apologize for the delay in responding.

I am writing to you today because I am very upset with UMass Memorial Hospital billing practices.On 3/26/12 I had some routine lab work done as ordered by my doctor. I have health insurance and have always had to pay $100 or $150 for lab services. This time my doctor sent me to an UMass lab. I received a bill for $1854 !! (copy enclosed).I called UMass regarding the bill and got no results. I called my insurance company who stated I owed $106.43 per my plan allowance. The insurance company sent this letter to UMass with no results. They claimed they didn't get it. I sent it to them 2 more times with subsequent bills with no results. (Copy of insurance letter enclosed.)After speaking with my Doctor in March 2013, she told me to give my information regarding the bill to her [redacted] because they had many problems with UMass billing of labs and he may be able to help. I did this on 3/7/13 and received no further bills from UMass. I assumed the matter was resolved.However, this week I received a letter from a collection agency for the amount the hospital claims I owe.Not only is this harassment, but I made multiple calls etc. to UMass with no one being able to answer my questions. I really feel they are incorrectly billing and committing fraud in the process. I would truly appreciate your attention to their billing practices as I am sure there are thousands of other people with the same issues. Thank you for your time.Sincerely, [redacted]Business Response Good afternoon, UMass Memorial has been in contact with Laboratory Billing Services regarding the billing issue for date of service 3/26/12 for this patient. Per the patient's insurance company,an adjustment has been made to the amount of the bill, leaving a patient responsibility of $106.43We have canceled the account with the collection agency and want to assure the patient that this has had no adverse effect on her credit standing. The patient may remit payment of $106.43 to the following address:[redacted]

I am writing to you today because I am very upset with UMass Memorial Hospital billing practices.On 3/26/12 I had some routine lab work done as ordered by my doctor. I have health insurance and have always had to pay $100 or $150 for lab services. This time my doctor sent me to an UMass lab. I received a bill for $1854 !! (copy enclosed).I called UMass regarding the bill and got no results. I called my insurance company who stated I owed $106.43 per my plan allowance. The insurance company sent this letter to UMass with no results. They claimed they didn't get it. I sent it to them 2 more times with subsequent bills with no results. (Copy of insurance letter enclosed.)After speaking with my Doctor in March 2013, she told me to give my information regarding the bill to her [redacted] because they had many problems with UMass billing of labs and he may be able to help. I did this on 3/7/13 and received no further bills from UMass. I assumed the matter was resolved.However, this week I received a letter from a collection agency for the amount the hospital claims I owe.Not only is this harassment, but I made multiple calls etc. to UMass with no one being able to answer my questions. I really feel they are incorrectly billing and committing fraud in the process. I would truly appreciate your attention to their billing practices as I am sure there are thousands of other people with the same issues. Thank you for your time.Sincerely, [redacted]Business Response Good afternoon, UMass Memorial has been in contact with Laboratory Billing Services regarding the billing issue for date of service 3/26/12 for this patient. Per the patient's insurance company,an adjustment has been made to the amount of the bill, leaving a patient responsibility of $106.43We have canceled the account with the collection agency and want to assure the patient that this has had no adverse effect on her credit standing. The patient may remit payment of $106.43 to the following address:[redacted]

I was charged for a physical that never happened and my insurance company refused to pay leaving me with a [redacted] bill. They refused to fix the chargesI went in to see [redacted] because my primary was out on maternity leave. I have asthma and had gotten sick and it went to my lungs requiring me to have a nebulizer treatment, so instead of visiting the ER I called up to visit with her. When I arrived they escorted my wife and I to a room and the she came in and asked what was going on, when my last physical was etc. I told her that I had just had one a couple of months ago and that my cholesterol had been high. She immediately got me someone to start the treatment so I could breath. My wife and I were very happy with their office until we received a bill some months later. We called our insurance company and asked why it wasn't covered, they said that the doctors office charged for a physical. We tried for 9 months to talk to someone at the hospital to no avail. Not a single person was able to give us an appropriate answer why we were charged for a physical and not a visit. Someone "suggested" it was because he was a new patient but again no blood tests were done, I was never weighed or my height checked, nothing was performed that a physical would entail. I also would like to note we received 2 separate bills for use of the facility and for the treatment. Both of which were paid. The bill has now been sent to collections because I was unable to resolve this with anyone which I am very unhappy about. Desired SettlementI would only like for them to bill our insurance company for what was actually done; an office visit not a physical. Business Response Good Afternoon, I will be placing Mr. [redacted]'s balance on hold to be further reviewed. Once we receive resolution should we update this case or respond to Mr. [redacted] directly? Consumer Response (The consumer indicated he/she DID NOT accept the response from the business.)Resolution has not been met yet. I will accept when they respond with an answer, after they review it. Please update this case instead of contacting me directly, that way I will not get the runaround for another year. Final Business Response Dear Mr. [redacted], after your last response I escalated the review for your visit. A charge correction was completed and your current balance is [redacted] copay. Please let me know if this is unsatisfactory for you. Thank-you for your patience in this matter. [redacted] servicesUmass Memorial Central Business OfficeFinal Consumer Response (The consumer indicated he/she DID NOT accept the response from the business.)Can you please explain to me how it was a physical? No height or weight was taken. No blood tests requested. Nothing that I have ever had done in a physical was conducted. And I told the doctor that I had just had one conducted. I am very confused by UMASS's idea of what a physical entails.

I had a cortisone shot in my right knee this spring 06/05/2014. I was supposed to see a [redacted] Boisvert, but she was still out on Maternity leave. I had a nurse practitioner administer the shot into my right knee. She did a great job and I have no complaints. But I started getting a bill for services from the medical group with Dr. [redacted] listed as the doctor of record for my treatment. I did not have Dr. Manalan treat me! I have called several times to try and get this straightened out. I am not sure if this is the right bill or not. The last call I made a couple of weeks ago I spoke to a women at the # XXX-XXX-XXXX. I asked her to explain why I should pay a bill with the wrong info on it. After getting the run around she told me "Pay the Bill, your insurance company paid their portion, you pay yours, it is your obligation" Why should I pay a bill with the wrong information on it. And why cant I get a reason for the wrong info on the bill ? Why would they bill my insurance company with the wrong info on it? Doesn't this constitute medical fraud?Desired SettlementAn honest explanation of how and why what they did is legal, moral and professional? And why cant I get an answer or explanation from the billing office, where I called at least 3 times during the summer and fall.Date of service 06/05/2014 invoice # XXXXXXXX medical record #XXXXXXXXX total charges [redacted]Business Response Dear Mr. [redacted], I sincerely apologize for my delay in responding to you. We contacted the doctor office to inquire why [redacted] was used as the billing provider for your visit. The medical notes indicate that you were seen by the Physician assistant Kelsey Byron. Dr. [redacted] was the supervising physician in the office that day as Dr. Boisvert was on maternity leave. Your health insurance Blue Cross requires that the billing be done under the supervising physician and not the Physician assistant. We have been in touch with your insurance to verify benefits and I am having the claim information verified to ensure everythign was submitted appropriately. This is being done today. I will respond again with the additional information today.Final Business Response Good evening Mr. [redacted]. We contacted your physician office again as well as your health insurance. There was another covering physician in the office on the day of your visit. We are submitting a request to have that physician billed as the supervising physician. Once the correction is made we will resubmit a claim to your insurance company for processing. This may reduce the amount owed by you. We can refund the full payment that you have made or we can wait for the insurance to reprocess and then review your accoutn for refund. Please let me know how you would like us to proceed. Thank-you for your patience and again I wish to apologize for the delay in responding.