Vitamin Cottage Natural Grocers

April 21, 2017   Revdex.com 2800 Euclid Avenue 4th Floor Cleveland, Ohio 44115-2408   Complaint Number: [redacted]  Patient Name: [redacted] Patient Account # E14041796257   Dear [redacted],   This letter is in response to the...

complaint filed in your office by [redacted] on April 20th, 2017. The complaint was sent to the Financial Ombudsman department to review and responded back to you.   I would like to offer my sincere apology for the continued frustration this may have caused [redacted]. I understand the pre-cert and insurance authorizations approval prior to her scheduled procedure have caused unwarranted distress and difficulty.   The patient stated in her complaint, that she was scheduled for a procedure on 4/21/17 and was just notified on 4/19/17 by a Patient Financial Advocate who left a message, that there was insurance coverage issues and her procedure would need to be rescheduled. The patient states her insurance provider advised her that no pre-authorization is required. Several attempts were made by both [redacted] and the Financial Ombudsman to reach the Patient Financial Advocate to have this corrected, but with no success.   Upon investigation, pre authorization for a procedure can take up to 30 days for the process, since we have to wait for the insurance company to respond. This delay can be very frustrating for patients who are prepared for a procedure and told just days before that there is an issue with the insurance approval. Our pre-cert department was able to get clarification of insurance approval for the patient’s procedure on 4/21/17 and contacted the patient this morning advising her of this.   Once again, we sincerely apologize for any inconvenience or difficulty [redacted] experienced while trying to resolve this issue. We thank you for bringing this matter to our attention.       Best regards,   Tina N[redacted]   Financial Ombudsman Unit Revenue Cycle Management, CCHS   Cc [redacted]

October 6, 2016   Revdex.com 2800 Euclid Ave, 4th Fl Cleveland, Ohio 44115-2408 Attn: [redacted]   Complaint Number: [redacted]   Patient Name: [redacted]      Patient Account #[redacted]   Dear Ms. [redacted],   This letter is...

in response to a complaint filed with your office by [redacted] in reference to receiving a collection notice for balances she claims she did not received Cleveland Clinic billing statements for.   In my investigation of the patient’s complaint, I have worked through our archives and had found a Cleveland Clinic billing statement dated January 15, 2014. Confirming with the patient of her residence at that time, the billing statement was mailed to the correct address. I advised the patient per the January 15, 2014 billing statement, her responsibility was showing as $3,362.00. While speaking with the patient she confirmed coverage with [redacted] Insurance.   Reviewing our registration for the patient’s visit on September 30, 2013, I show [redacted] listed, but unable to be used or applied. I verified the member ID number listed and found that the patient’s eligibility begin date was on 09/24/2013. Due to error in verifying patient’s insurance information, I have made the decision to write off the patient’s balance of $3,362.00. We are not able to submit back to [redacted] as it is past timely filing.   I want to sincerely apologize for any inconvenience you experienced in trying to resolve this matter. Thank you for allowing me the opportunity to investigate the above concern.   Respectfully, Jamie A[redacted], Financial Ombudsman Triage 216-445-5134 Revenue Cycle Management, CCHS Cc: [redacted]   Need help paying your [redacted] bills? Call 866.621.6385 or go to www.ccf.org/financialassistance for information on our financial assistance policy.

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Regards,
[redacted]
As was mentioned previously this complaint was wrongly sent to collections and I need to see that my credit history is not damaged and that the account is back at the clinic and that a new statement showing the changes is submitted and documented so that the debt collector will not try to sell the debt to another before this is closed out!  Thank you eric shane

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.  Thank you for taking the time to look into the matter for me. 
Regards,
[redacted]

July 22, 2016Revdex.com 2800 Euclid Avenue 4th Floor Cleveland OH 44115-2408 Complaint Number: [redacted] CCF: [redacted] Dear Ms. Means, This letter is in response to the complaint filed with your office by Mr. [redacted] with regard to his Cleveland Clinic account...

balance. I would first like to extend my sincere apology for any frustration this may have caused. A thorough review has been completed of Mr. [redacted]’s account. Mr. [redacted]’s concern is being billed for an outpatient procedure; with regard to the Endoscopy performed in Dr. [redacted]’ office. Although Cleveland Clinic does understand how frustrating this is for our patient’s, provider based billing has been practiced for years by hospitals nationwide. Cleveland Clinic facilities bill in two separate components, a professional charge (outpatient procedures) and a technical charge (facility fee). All procedures performed in a doctor’s office are billed as out- patient procedures.The Endoscopy performed in Dr. [redacted] office was billed correctly and the balance is patient liability. The remaining patient balance of, $200.21 for the professional charge; as well as the $14.28 for the facility portion are applying towards patient deductible. I would encourage Mr. [redacted] to follow-up with [redacted] should he have further questions with regard to his yearly deductible, as well as any out of pocket expenses. Thank you for allowing the Financial Ombudsman office to assist with this patient’s concern. Please feel free to contact our office at 216-445-5134 should you require further assistance. Best regards, Sonya W[redacted] Financial Ombudsman RCM

May 2nd, 2017   Revdex.com 2800 Euclid Avenue 4th Floor Cleveland, Ohio 44115-2408   Complaint Number: [redacted]  Patient Name: [redacted] Patient Account # [redacted]   Dear [redacted],   This letter is in response to a rebuttal filed in your office by [redacted] on April 20th, 2017. The complaint was sent to the Financial Ombudsman department to review and respond back to you.   I would again like to offer my sincere apology for the frustration [redacted] experienced with our pre-cert and insurance authorizations approval process.   As previously explained, the pre authorization process for a procedure can take up to 30 days, since our pre-cert department has to wait for the insurance company to respond. This delay can be very frustrating for patients who are prepared for a procedure and told just days before that there is an issue with the insurance approval. Our pre-cert department was able to get clarification of insurance approval for the patient’s procedure on 4/21/17 and contacted the patient on 4/20/17 advising her of this.   In regard to [redacted]’s concern relating to the call with our Ombudsman representative; we appreciate her feedback and have shared her concerns with that representative’s supervisor. We welcome all feedback as a way to improve the service we provide.   Again, we apologize that [redacted] does not agree with the outcome of our review, however this has been fully reviewed and the findings remain the same. This is the final review on this matter.     Best regards,   Tina N[redacted]   Financial Ombudsman Unit Revenue Cycle Management, CCHS   Cc [redacted]

Please forward this complaint to CCF Medical Ombudsman. The Medical Ombudsmen have already reviewed this patient's complaint and have the information about the offered resolution the patient is disputing through the Revdex.com. Thank you!

Revdex.com:
The CCF has failed twice to address the issue.  I will wait for the money to be refunded before I comment on the resolution.
Regards,
[redacted]

Cleveland Clinic June 11, 2016 Revdex.com 2800 Euclid Avenue 4th Floor Cleveland OH 44115-2408 Complaint Number: [redacted] CCF: [redacted] Dear Ms. [redacted], This letter is in response to the complaint filed with your office by Ms. [redacted], with regard to a...

Cleveland Clinic balance which transferred to collections. I would first like to extend my sincere apology for any frustration this may have caused. A thorough review has been completed of Ms. [redacted]'s account. Per my review, it has been determined that Cleveland Clinic received Ms. [redacted]'s payment on December 31, 2015. Therefore; this payment should have applied to Ms. [redacted]'s outstanding balance, preventing the charge from transferring to collections. Ms. [redacted]'s payment in the amount of $50.19 has been allocated to the outstanding charge and this balance has been closed with the agency. Although this balance did transfer to collections this will in no way impact Ms. [redacted]'s credit rating. Again, I offer my sincere apology concerning this matter. Thank you for allowing the Financial Ombudsman office to assist with this patient's concern. Please feel free to contact our office at 216-445-5134 should you require further assistance. Best regards, Sonya W[redacted] Financial Ombudsman RCM

Attached is the original response that was sent for [redacted]. As I explained, no further review will be completed as the outcome will not change. The facility she was seen at in Dec 2015, was not an Express Care Clinic at that time but was an Emergency Room. The facility did not change over to an Express Care Clinic until Aug 2016.Patient is responsible for the balance due. She should contact our Customer Service department to establish a payment plan.

August 14, 2017   Revdex.com 2800 Euclid Avenue 4th Floor Cleveland, Ohio 44115-2408   Complaint Number: [redacted] Patient Name: [redacted] Patient Account # [redacted]   Dear [redacted],   This letter is in response to the complaint filed in...

your office by [redacted] on August 14, 2017. The complaint was sent to the Financial Ombudsman department to review and responded back to you.   First, I want to offer my sincere apology for any frustration [redacted] has encountered regarding his billing concerns. [redacted] received services on 5/17/17 at Cleveland Clinic Euclid Hospital. The charges for this date of service in the amount of $1227 have been billed, and are currently pending with his insurance. [redacted] contacted our ombudsman’s office on Friday and spoke with one of our agents who was able to review his account for him, and confirm that the charge has been billed to his insurance.   Once again, we sincerely apologize for any inconvenience or difficulty [redacted] experienced while trying to resolve this issue. We thank you for bringing this matter to our attention.       Best regards,   Tina N[redacted]   Financial Ombudsman Unit Revenue Cycle Management, CCHS   Cc [redacted]

January 26th, 2016 Revdex.com 2800 Euclid Ave 4th Floor Cleveland OH 44115 Complaint Number: [redacted] Re: [redacted] CC# [redacted] Dear Ms. [redacted], This letter is in response to the complaint filed with your office, with regard to the above patient...

[redacted]. I would first like to extend my sincere apology for any frustration this may have caused. A thorough review has been completed of Ms. [redacted]’s account. Per review completed by department, Ms. [redacted]’s visit with Dr. M[redacted] was coded with diagnosis code E66.9 (obesity) per documentation submitted by Dr. M[redacted]. Mrs. [redacted] presented to have paperwork filled out for her employer and the only assessment plan documented was discussion of risk factors, healthy eating and exercise to maintain healthy weight. During this visit Ms. [redacted] was scheduled for a routine physical for a wellness visit which took place on 01/19/2016. Unfortunately, based on the review per supporting physician documentation we are unable to change the submitted diagnosis code. Per Medical Mutual the billed diagnosis code E66.9 is a non-covered benefit per patient’s policy; therefore Ms. [redacted] will remain liable for the charged amount of $213.00. Once again, my sincere apology for any frustration this may have caused. Thank you for contacting the Financial Ombudsman office to assist with this patient’s concern. Please feel free to contact our office at 216-445-5134 should you require further assistance.  Sincerely,Sonya W[redacted] Financial Ombudsman RCM

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 12178389, and find that this resolution is satisfactory to me. 
Regards,
Joseph [redacted]

May 22, 2017   Revdex.com 2800 Euclid Avenue 4th Floor Cleveland, Ohio 44115-2408   Complaint Number: [redacted] Patient Name: [redacted] Patient Account # E[redacted]   Dear [redacted],   This letter is in response to the complaint filed...

in your office by [redacted] on May 22nd, 2017. The complaint was sent to the Financial Ombudsman department to review and responded back to you.   The Cleveland Clinic offers Financial Assistance to support patients who have the greatest medical and financial needs. This process is determined by the Federal Poverty income guidelines. Unfortunately, [redacted]’s income exceeds these guidelines and she does not qualify for our financial assistance program.   [redacted] sent in financial assistance application for date of service 5/13/16, along with a hardship exception letter. [redacted]’s case was reviewed and it was still determined that her exceptional circumstance did not qualify for our financial assistance.   [redacted] was sent a denial letter on 10/18/16, and was encouraged to contact our customer service department to take advantage of one of our payment plan options. Unfortunately, [redacted] did not contact us and her balances aged and were sent to collections. We do not report to the Credit Bureau so this will have no negative impact on her credit rating.   [redacted] can contact our customer service department and set up an external payment plan with our partner Commerce Bank. Once, the payment plan is set up we can contact the collection agency and cease collections.   We understand the stress, emotional and financial toll that [redacted] may be experiencing, especially in today’s economic environment, but we must follow the requirements set up for Financial Assistance Approval.       Best regards,   Tina N[redacted]   Financial Ombudsman Unit Revenue Cycle Management, CCHS   Cc [redacted]

Revdex.com [redacted] Cleveland, Ohio 44115-2408 Attn: [redacted]   Revdex.com Complaint Number: [redacted] Patient Name: [redacted] Patient Account # [redacted]   Dear Mr. T[redacted]   This letter is in response to a complaint filed with your office by [redacted]...

[redacted] on behalf of his daughter, patient [redacted]. This complaint was received in the Financial Ombudsman unit on February 1, 2018. We hope you find the following information to be helpful.   I would like to first offer my sincere apology for any aggravation this may have caused Mr. B[redacted]  I understand the billing concerns he presented in his letter of complaint are stressful.   In his written complaint, Mr. B** mentions his frustration at being billed for services that were not included in his estimate.  In my review of the account, Mr. B** also made mention of the fact the Cleveland Clinic is a part of the Vaccines for Children program.   Mr. B** is correct, the Cleveland Clinic does participate in this program.  Mr. B** should not have been charged for the vaccinations.  Th**e charges have been removed, and Mr. B** is no longer being billed for them, and will only be billed for the charges on his estimate, which have already been paid.   I sympathize with the frustration the patient experienced in seeking to resolve this complaint. Our efforts are focused on bringing all aspects of each patient encounter to a level of World Class Care. If you have any additional questions or concerns, please feel free to call me directly at [redacted] or email me at [redacted]   Respectfully,   Mark J[redacted] Financial Ombudsman   Cc: [redacted] Tell us why here...

Revdex.com2800 Euclid Avenue 4th FloorCleveland OH 44115-2408Complaint Number: [redacted]CCF: [redacted]Dear Ms. [redacted],This letter is in response to the complaint filed with your office by Mrs. [redacted] with regard to her account balance for date of service 09/14/2015.I would first...

like to extend my sincere apology for any frustration this may have caused. A thorough review has been completed of Mrs. [redacted]’s account. Mrs. [redacted] was charged in error for two office visits. Per my review only one office visit was billable to Mrs. [redacted]’s insurance; therefore, I have adjusted the additional office visit which billed in error.Mrs. [redacted]s called our office on 05/13/2016 and was advised that the office visit in the amount of $213.00 has been adjusted.Again, I offer my sincere apology concerning this matter. Thank you for allowing the Financial Ombudsman office to assist with this patient’s concern. Please feel free to contact our office at 216.445.5134 should you require further assistance.Best regards,Sonya W[redacted]Financial Ombudsman RCM

September 28, 2016     [redacted] 2800 Euclid Avenue 4th Floor Cleveland, OH 44115-2408     Complaint Number: [redacted] Patient Name: [redacted] Patient MRN #: [redacted]       Dear [redacted],   This letter is in response to a rebuttal by Mrs. [redacted], filed in your office on September 27, 2016. The complaint was forwarded to The Office of the Financial Ombudsman to review and respond back to you.   Again, I would like to offer a sincere apology on the part of The Cleveland Clinic for the frustration and anxiety this has caused you for the better part of 2 years now.   Speaking to your settlement request from The Revdex.com, I can assure you that after this amount of time, this institution will NOT hold you liable for any of the amounts for the December and February 2015 charges that have been in a pending status for some time now. Regardless of how the insurance responds, we WILL NOT hold you liable.   I hope this response finds you pleased and of course, if you have any future questions or concerns, you can feel free to contact me directly at my office phone of: 216-442-1113.   Thank you for your recent inquiry and I hope you find the following information to be satisfying.   Sincerely,       Bradley C[redacted] Financial Ombudsman The Cleveland Clinic Foundation

January 26, 2017Revdex.com, Inc.  2800 Euclid Ave, 4th Floor[redacted]           Cleveland, OH 44115RE: [redacted]Complaint ID:[redacted]CCF # [redacted]Dear [redacted],This letter is in response to a complaint filed in your office by...

[redacted] on January 16, 2017. The complaint was sent to the Financial Ombudsman department to review and respond back to you.First I would like to take this time to offer my sincere apologies for Ms. [redacted]’s concerns about the diagnosis code we used for her visit on 02/25/2016. A thorough review of the above referenced account was performed. Ms. [redacted] went to the emergency room at [redacted] on 02/25/2016  believing she was having a heart attack. Once Ms. [redacted] was examined, she was diagnosed with possible [redacted]. When  the patient began receiving statements in May of 2016, she requested we have the dx changed to [redacted] because she thought that’s what she came in for. This was reviewed by our Reimbursement Specialist and a letter was sent to the patient explaining we were unable to change the coding based on the medical documentationMs. [redacted] has [redacted] insurance; they denied paying for the emergency room charge of $765.00. According to the denial they deemed the diagnosis ([redacted]) was not ‘medically necessary’ by the payer. In addition, the patient had a deductible to meet with her insurance I have enclosed a copy of the explanation of benefits with this letter to the patient.Ms. [redacted] has a remaining balance of $833.06 on the date of service 02/25/2016 that is in collections with The [redacted]. At this time the patient can contact them directly to make payment at (800) 305-5702.Once again we sincerely apologize for any inconvenience or difficulty Ms. [redacted]   experienced while trying to resolve this issue. Thank you for bringing this matter to our attentionRespectfully,[redacted] Financial Ombudsman Revenue Cycle Management, CCHS Cc: [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 complaint.  For your reference, details of the offer I reviewed appear below.While the Cleveland Clinic did successfully look up and type the details of the visit that caused my balance, this unfortunately was not the cause of my complaint. My complaint was and is still that Cleveland Clinic refuses to bill insurance correctly to receive proper payment. Cleveland Clinic arrogantly refuses to communicate with my insurance and expects me to compensate them when they bill incorrectly. My insurance company has no way to verify that an 'outpatient service' is a specialist visit without verification from Cleveland Clinic. Rather than simply contact my insurance and offer required information to receive proper payment, they double-charge me.CC's financial department, like their customer service, does not seem serious about addressing this issue. Out of respect for my time, I will make the payment requested and hold my records for the inevitable class action suit against CC.
Regards,
[redacted]

January 15, 2015Revdex.com2800 Euclid Avenue 4th FloorCleveland, Ohio 44115-2408Attn: [redacted]Complaint Number: [redacted]Patient Name: [redacted]Patient Account # [redacted]Dear Ms. [redacted], This letter is in response to a complaint filed with your office by the above named...

patient in reference to the way his 8/26/15 visit was billed.We have contacted the department where the patient was seen and requested a review of the charges entered. Upon review, there was an error identified with the way the visit was billed and it is in the process of being corrected. The Office Visit, Level 4 has been reversed and corrected to an [redacted] visit. The patient’s payment of $110 was payment in full and the amount due has been corrected to $0.00.   We sincerely apologize for any inconvenience the patient experienced in trying to resolve this matter and thank you for allowing us the opportunity to investigate Mr. [redacted]’s concerns. Respectfully,Morgan C[redacted]Financial OmbudsmanRevenue Cycle Management, CCHS