Valley Health Winchester Medical Center Reviews (%countItem)
Valley Health Winchester Medical Center Rating
Address: 1840 Amherst St, Winchester, Virginia, United States, 22601-2808
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I was seen in the ER on 10/30/2019 at Valley Health in Winchester VA, I am self-pay. I would never go to the ER but suffered from an extreme headache that would not go away so I had no other choice but to go there. While in the ER a CT scan was performed. I was never notified of the cost of this. I received a bill in the amount of 3200.00 for the scan. Fast forward, I had a CT scan done at the same hospital yesterday and was only charged 500.00. I was told that self-pay patients are only charged a maximum of 500.00 for a CT scan. I contacted Vally Health and asked why I was charged 3200.00 in October and 500.00 yesterday. I was told that because it wasn't a 'scheduled" CT in October they charge more. This is insane to charge this much when clearly they acknowledge that they shouldn't be charging more than 500.00 for self-pay patients. I need assistance resolving this because I should not have to pay more than the 500.00 for the scan in October. This appears as price gouging!
May 19, 2020
Dear Sir or Madam:
I am writing in response to complaint ID.
In April of 2017, Valley Health adopted a policy to assist patients with out of pocket expenses related to Advanced Imaging Services performed in an outpatient diagnostic imaging department setting. The policy clearly states imaging services performed as part of an emergency room visit, observation stay, outpatient surgery, inpatient stay or as part of another more complex service are excluded and do not qualify for the Payment Assurance discount. In order to qualify for the discount, the patient must pay at or before time of service or initial the health service finance program enrollment form at time of service indicating their approval for Valley Health to enroll them in the program.
The patient did have imaging services on 4/29/2020 that qualified for the Payment Assurance discount and she did take advantage of this offering. On 4/30/2020 the patient called and requested the same discount be applied to a CT scan that was performed as part of an emergency visit on 10/30/19. It was explained, the CT scan on 10/30 was part of an emergency visit and did not qualify for the discount per policy. She was not satisfied and did state she would notify the "Revdex.com".
The patient indicates in the complaint, "self pay patients are only charged a maximum of $500 for a CT scan." The Payment Assurance Discount is not specific to "self pay" patients only. The policy is for any patient, including those with insurance coverage, which have an out of pocket expense greater than $500 for Advanced Imaging Services that are performed in an outpatient diagnostic imaging setting.
Uninsured patients also receive a 30% discount that is applied to total charges per Valley Health policy. The patient received this discount for the emergency department visit on 10/30/19 and also on the 4/29/2020 outpatient diagnostic imaging visit.
In review of this complaint, the Payment Assurance Discount policy was followed appropriately. I am enclosing a copy of the policy for your review. Please contact me if anything further is needed regarding this complaint.
Sincerely,
Sherry T.
Director, Patient Accounts
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
Complaint: ***
I am rejecting this response because:
I have read over the policy, however, how is someone that has been taken to the Emergency Room and given pain medication able to know that this is not the policy if receiving the scan via the ER? If it is not explained, which it wasn't, then the discount should be given.
Regards
HANDING OUT FORMS TO SIGN IS NO DEFENSE FOR WHAT SHOULD BE "FULL DISCLOSURE".
PATIENTS ARE SOMETIMES IF NOT MOST OF THE TIME IN NO CONDITION TO PROCESS THE DETAILS OF CO-PAYS, DEDUCTIBLES AND SHARED EXPENSES BASED ON NON-INSURED OR INSURED, LET ALONE ABORTRARY DISCOUNTS DUE TO WHEN AND WHERE YOU ENTERED OR RECEIVED TREATMENT WITHIN THE HOSPITAL.
YES, YOU NEED TO FILL OUT THE REQUIRED FORMS BUT JUST HANDING OUT THE FORM AND SAY, SIGN HERE, IS JUST NOT THE WAY TO CONDUCT ANY FORM OF FINANCIAL BUSINESS.
SOMEONE MUST EXPLAIN THE OPTIONS, I.E., "YOU CAME IN AS AN EMERGENCY PATIENT, IF YOU GET THIS MRI NOW YOU WILL HAVE TO PAY THIS AMOUNT, HOWEVER IF WE CAN SCHEDULE IT FOR, LET'S SAY TOMORROW, THEN THE COST AS AN OUTPATIENT WILL BE CONSIDERABLY LESS. NOW ARE YOU WILLING TO WAIT AND PRAY YOUR HEAD DOESN'T EXPLODE FROM THESE GOD-AWFUL HEADACHES, OR DO YOU WANT IMMEDIATE SERVICE AND PAY THROUGH THE NOSE?"
THIS IS THE KIND OF DISCUSSION WHICH SHOULD HAVE OCCURED.
SINCERELY,
T. F. HILLS
I was seen in the ER on 10/30/2019 at Valley Health in Winchester VA, I am self-pay. I would never go to the ER but suffered from an extreme headache that would not go away so I had no other choice but to go there. While in the ER a CT scan was performed. I was never notified of the cost of this. I received a bill in the amount of 3200.00 for the scan. Fast forward, I had a CT scan done at the same hospital yesterday and was only charged 500.00. I was told that self-pay patients are only charged a maximum of 500.00 for a CT scan. I contacted Vally Health and asked why I was charged 3200.00 in October and 500.00 yesterday. I was told that because it wasn't a 'scheduled" CT in October they charge more. This is insane to charge this much when clearly they acknowledge that they shouldn't be charging more than 500.00 for self-pay patients. I need assistance resolving this because I should not have to pay more than the 500.00 for the scan in October. This appears as price gouging!
May 19, 2020
Dear Sir or Madam:
I am writing in response to complaint ID.
In April of 2017, Valley Health adopted a policy to assist patients with out of pocket expenses related to Advanced Imaging Services performed in an outpatient diagnostic imaging department setting. The policy clearly states imaging services performed as part of an emergency room visit, observation stay, outpatient surgery, inpatient stay or as part of another more complex service are excluded and do not qualify for the Payment Assurance discount. In order to qualify for the discount, the patient must pay at or before time of service or initial the health service finance program enrollment form at time of service indicating their approval for Valley Health to enroll them in the program.
The patient did have imaging services on 4/29/2020 that qualified for the Payment Assurance discount and she did take advantage of this offering. On 4/30/2020 the patient called and requested the same discount be applied to a CT scan that was performed as part of an emergency visit on 10/30/19. It was explained, the CT scan on 10/30 was part of an emergency visit and did not qualify for the discount per policy. She was not satisfied and did state she would notify the "Revdex.com".
The patient indicates in the complaint, "self pay patients are only charged a maximum of $500 for a CT scan." The Payment Assurance Discount is not specific to "self pay" patients only. The policy is for any patient, including those with insurance coverage, which have an out of pocket expense greater than $500 for Advanced Imaging Services that are performed in an outpatient diagnostic imaging setting.
Uninsured patients also receive a 30% discount that is applied to total charges per Valley Health policy. The patient received this discount for the emergency department visit on 10/30/19 and also on the 4/29/2020 outpatient diagnostic imaging visit.
In review of this complaint, the Payment Assurance Discount policy was followed appropriately. I am enclosing a copy of the policy for your review. Please contact me if anything further is needed regarding this complaint.
Sincerely,
Sherry T.
Director, Patient Accounts
[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
Complaint: ***
I am rejecting this response because:
I have read over the policy, however, how is someone that has been taken to the Emergency Room and given pain medication able to know that this is not the policy if receiving the scan via the ER? If it is not explained, which it wasn't, then the discount should be given.
Regards
I had a scheduled surgery on 01/16/2019. The preauthorization and estimate were completed on 12/31/2018. Before my surgery, I paid my maximum out of pocket expense ($2,500) for my in-network coverage. By the time the hospital processed my claim with my insurance, there was only $ 740.06 left for my out of pocket expense. After multiple attempts, the processing was done on 03/27/2019. I am due a refund of $ 1759.94 (which will pay my other providers who completed their billing first). Early in April, I was told by the billing department that I would receive my refund in two or three weeks. The hospital still has not provided my refund.
Dear ***:
Tam writing in response to complaint ID. Below is an outline of what has transpired on the patient's account as of 7/12/19.
Prior to surgery, the patient was given an estimated out of pocket liability of $2500. He received a 10% pre-payment discount and made a payment of $2250.00
1/23/19-Claim was billed to *** for processing in the amount of $40,438.15 2/22/19-*** pended claim requesting copy of itemized bill 3/22/19-*** made payment of $725.40. Denied $15,870.00 as experimental and indicated patient liability. Also patient coinsurance liability of $80.60. 3/25/19-Reconsideration/appeal was sent to *** with medical records 4/4/19-*** reprocessed claim and made payment of $23,022.09 leaving patient liability of $740.06 as coinsurance. 4/4/19-*** retracted original payment of $725.40 and patient coinsurance liability of $80.60. 4/4/19-*** made additional payment of $14,156.00 and denied $2520.00 as patient liability. $2520.00 deemed experimental.
Now in addition to the $740.06 coinsurance, the patient also has a liability of $2520.00 bringing total liability to $3260.06
4/9/19-Patient spoke with VH customer service rep. requesting a refund. 4/9/19-VH insurance rep. called and spoke with *** at ***, who confirmed the $2520.00 denial and stated a reconsideration could be submitted. 4/11/19-Received communication from the patient via "***" asking when billing issue would be resolved and asking when refund would be sent. Response from VH informed the patient we were sending back to *** for reconsideration, 4/17/19-VH insurance rep. spoke with *** from *** who stated reconsideration was reviewed and patient is responsible for $2520.00 which was deemed experimental. EOB received confirming patient liability. 5/17/19-Patient called asking where his refund was. Customer service rep. told him there was no credit on his account. He indicated he was told he would receive a refund within 2 weeks but when researched it appears the patient was told a reconsideration was sent to insurance as they denied $2520.00 as experimental. He stated he was due a refund. Concern referred to customer service supervisor, 5/20/19-Supervisor spoke with patient who is upset he has not received a refund. She explained the *** denial and that his payment would be applied to the patient liability after insurance. He insisted VH had coded it wrong and did not believe VH had contacted insurance to have it corrected. He was advised to contact insurance for an updated EOB if he had not received one that would show patient liability. He stated this was our issue and not insurance and he was going to contact the Revdex.com. 5/31/19-Per *** at ***, denial is upheld and patient is responsible for the $2520. 5/31/19-*** from *** called requesting copy of signed consent form. Pt gave permission and consent was faxed. 6/6/19-Conference call with patient, supervisor, VH insurance rep and *** from ***. *** explained to the patient that he had signed the consent and the balance stands as is. *** and VH insurance rep. discussed specific coding on claim and the possibly of further appeal for payment. 7/1/19-Account given to denials management R.N. to review for possible appeal of denied charge(s). 7/1/19-Appeal and medical records sent to *** to review for further consideration, 7/3/19-Supervisor called and left message for patient advising account has been sent back for further appeal. No refund is due at this time.
If the appeal is again denied, the patient is liable for the full amount the payer (***) has indicated is patient liability.
VH staff has made every attempt to assist with getting the experimental denial overturned on behalf of the patient
Please contact me if there is anything further that is needed on this patient's account,
Sincerely,
Sherry T ***
Director,
Patient Accounts
Valley Health
220 Campus Blvd. Suite 210
Winchester, VA. 22601
I had a scheduled surgery on 01/16/2019. The preauthorization and estimate were completed on 12/31/2018. Before my surgery, I paid my maximum out of pocket expense ($2,500) for my in-network coverage. By the time the hospital processed my claim with my insurance, there was only $ 740.06 left for my out of pocket expense. After multiple attempts, the processing was done on 03/27/2019. I am due a refund of $ 1759.94 (which will pay my other providers who completed their billing first). Early in April, I was told by the billing department that I would receive my refund in two or three weeks. The hospital still has not provided my refund.
Dear ***:
Tam writing in response to complaint ID. Below is an outline of what has transpired on the patient's account as of 7/12/19.
Prior to surgery, the patient was given an estimated out of pocket liability of $2500. He received a 10% pre-payment discount and made a payment of $2250.00
1/23/19-Claim was billed to *** for processing in the amount of $40,438.15 2/22/19-*** pended claim requesting copy of itemized bill 3/22/19-*** made payment of $725.40. Denied $15,870.00 as experimental and indicated patient liability. Also patient coinsurance liability of $80.60. 3/25/19-Reconsideration/appeal was sent to *** with medical records 4/4/19-*** reprocessed claim and made payment of $23,022.09 leaving patient liability of $740.06 as coinsurance. 4/4/19-*** retracted original payment of $725.40 and patient coinsurance liability of $80.60. 4/4/19-*** made additional payment of $14,156.00 and denied $2520.00 as patient liability. $2520.00 deemed experimental.
Now in addition to the $740.06 coinsurance, the patient also has a liability of $2520.00 bringing total liability to $3260.06
4/9/19-Patient spoke with VH customer service rep. requesting a refund. 4/9/19-VH insurance rep. called and spoke with *** at ***, who confirmed the $2520.00 denial and stated a reconsideration could be submitted. 4/11/19-Received communication from the patient via "***" asking when billing issue would be resolved and asking when refund would be sent. Response from VH informed the patient we were sending back to *** for reconsideration, 4/17/19-VH insurance rep. spoke with *** from *** who stated reconsideration was reviewed and patient is responsible for $2520.00 which was deemed experimental. EOB received confirming patient liability. 5/17/19-Patient called asking where his refund was. Customer service rep. told him there was no credit on his account. He indicated he was told he would receive a refund within 2 weeks but when researched it appears the patient was told a reconsideration was sent to insurance as they denied $2520.00 as experimental. He stated he was due a refund. Concern referred to customer service supervisor, 5/20/19-Supervisor spoke with patient who is upset he has not received a refund. She explained the *** denial and that his payment would be applied to the patient liability after insurance. He insisted VH had coded it wrong and did not believe VH had contacted insurance to have it corrected. He was advised to contact insurance for an updated EOB if he had not received one that would show patient liability. He stated this was our issue and not insurance and he was going to contact the Revdex.com. 5/31/19-Per *** at ***, denial is upheld and patient is responsible for the $2520. 5/31/19-*** from *** called requesting copy of signed consent form. Pt gave permission and consent was faxed. 6/6/19-Conference call with patient, supervisor, VH insurance rep and *** from ***. *** explained to the patient that he had signed the consent and the balance stands as is. *** and VH insurance rep. discussed specific coding on claim and the possibly of further appeal for payment. 7/1/19-Account given to denials management R.N. to review for possible appeal of denied charge(s). 7/1/19-Appeal and medical records sent to *** to review for further consideration, 7/3/19-Supervisor called and left message for patient advising account has been sent back for further appeal. No refund is due at this time.
If the appeal is again denied, the patient is liable for the full amount the payer (***) has indicated is patient liability.
VH staff has made every attempt to assist with getting the experimental denial overturned on behalf of the patient
Please contact me if there is anything further that is needed on this patient's account,
Sincerely,
Sherry T ***
Director,
Patient Accounts
Valley Health
220 Campus Blvd. Suite 210
Winchester, VA. 22601
I completed an application for medical assistance. I sent a month's worth of copies of my pay stubs and a copy of my IRS taxes. I was advised by my bank not to give out my checking account number being that my account had been compromised several times.
I am on a fixed income with three children I provide for. I explained to the staff at Valley Health that $10.00 a month is all I could afford at this time and that I have been paying on my account.
I recieved a call this morning at 924am advising me even though I had made payments my account was going to be sent to collections for possible wage garnishment. I was advised I need to take out a interest free loan to pay off the account. 45.00 monthly for 12 months which I cannot afford.
I completed an application for medical assistance. I sent a month's worth of copies of my pay stubs and a copy of my IRS taxes. I was advised by my bank not to give out my checking account number being that my account had been compromised several times.
I am on a fixed income with three children I provide for. I explained to the staff at Valley Health that $10.00 a month is all I could afford at this time and that I have been paying on my account.
I recieved a call this morning at 924am advising me even though I had made payments my account was going to be sent to collections for possible wage garnishment. I was advised I need to take out a interest free loan to pay off the account. 45.00 monthly for 12 months which I cannot afford.
I have health insurance with a very high deductible and my family and I have had some unfortunate health issues and injuries in the past couple of years. I have a payment plan with Valley Health, I pay $100 per month. I also have other medical bills as the hospital is not the only place we've had to go. I had a procedure done in September 2017 and when I received the bill, I called to just get it added on to my current payment plan. I have been paying on this plan for about two years, because there has never been an issue with adding any new balances, as long as I was paying my $100 per month.I was told no unless I paid more. I explained I can not pay more as they are not the only ones I'm paying. I can't afford any more in my budget. I received no sympathy at all. I'm trying to pay my bills and satisfy my obligations, but you can't squeeze blood from a turnip. In the four months that I've received a bill, I have made two small payments. I went to pay on it yesterday, on the online bill payment option and it says I have no active bills. The account has been turned over to collections. I just want it to be added to my current payment plan so that I can actually pay it off and not have to worry about being garnished or going bankrupt.
BEWARE...I felt taken advantage of. Had issue in my center/lower chest area (not pain even though doctors and nurses kept referring to it as such). "any type discomfort in that area is chest pains" I expressed that it couldn't be a heart attack since I had the symptoms for a few weeks. Told them I wanted tested for hiatal hernia since I had just finished building and moving into a new house. (note: I am only 33 years old) They "strongly" recommended I stay overnight for more tests. They said it could take up to a day for blood to determine if it was a heart attack. Spent all next morning doing tests none of which were explained. (have yet to see the actual doctor at this point). finally sent back to room doctor comes in says everything looks fine your are "free" to go, to which I replied "well then what is the issue". His response was what do you mean you came in for a heart attack? I then explained the symptoms to him which he kind of shrugged it off as to say well we know it is wasn't a heart attack and we recommend you see a cardiologist but they can't see you for another month and a half. Got a Bill for almost $17,000 dollars and wouldn't you know that didn't include the tests I asked for. When I complained and told them it was insane to have to pay that much for basically nothing and threatened to get an advocate they decided to review and were so sorry to find that they had overbilled me over $2,500. "Sorry Sir, but please realize that we accidentally double billed a few things." It just happened to be the most expensive procedures on the bill. This place is looking out for their own profits more than the patients. I have had weekend stays with surgeries that didn't cost this much. Why does it cost almost $15,000 dollars to have chest concerns looked at?