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August 1, 2017     Revdex.com 2800 Euclid Ave, 4th FL Cleveland, Ohio 44115-2408 Attn: [redacted]     Revdex.com Complaint Number: [redacted] Patient Name: Bethany [redacted] Patient Account # [redacted]     Dear Mr. [redacted],   This letter is in...

response to a complaint filed with your office by patient Bethany [redacted]. This complaint was received in the Financial Ombudsman unit on August 1, 2017. Thank you for allowing me the opportunity to review this patient’s complaint.   When the patient visited the Cleveland Clinic on September 14, 2016, she was presenting for ongoing treatment of her allergies by immunotherapy injection. On August 17, 2016, the patient scheduled a series of appointments for immunotherapy injection: 9/14/16; 10/12/16; 11/7/16 and 12/7/16.   In the chart for the patient’s visit 9/14/16, there is no documentation of a conversation with the nurse about cancellation of this series of treatment. The nurse noted the patient’s intention to proceed with immunotherapy injections and dispensed treatment. The next day, the allergy specialist prescribed the mixture for the patient’s next injection and it was mixed in anticipation of the patient visit October 12, 2016.   This is the common practice of the Department of Allergy and Clinical Immunology at the Cleveland Clinic. The ordering and preparing of the allergy serum is done in advance. If the patient had kept her appointment, she would have been charged separately for the serum created 9/16/16 reference #[redacted] and then for the injection 10/12/16 on another reference number.   On Sept 21, the patient called to cancel her appointments. At that point, the serum was already prepared and charges were entered into the billing platform. This was not an error, but normal billing for ongoing treatment immunotherapy injections. The charge cannot be voided because the medical procedure to mix the serum was in fact completed.   In her complaint, the patient mentions that she did not receive notice that the serum was created and billed until May 8, 2017. In review of the patient’s statements and the claim sent to insurance, I find that the correct charge did appear on a statement Feb 2017, but it was still pending with insurance at that time. The charge did not bill as a patient responsibility until May 8, 2017.   A 9 month delay between the date of the medical service and the correct bill to the patient is within the timely billing guidelines of the medical industry. However, since this delay resulted in expired serum by the time the patient knew the serum was created, I find the patient’s request for balance adjustment reasonable.   As a courtesy from the Financial Ombudsmen, today I adjusted the patient’s 49.50 balance related to ref#[redacted] for DOS 9/16/16. This is a one-time courtesy from our unit. The procedure of advance preparation of the serum is now known to the patient, and no comparable future adjustment could be authorized by this department.   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,     Christine [redacted]  Financial Ombudsman   Cc: [redacted], Bethany

July 15, 2016   Revdex.com 2800 Euclid Avenue 4th Floor Cleveland, Ohio 44115-2408   Complaint Number: [redacted] Patient Name: [redacted]. [redacted] Patient Account # [redacted]   Dear [redacted],   This letter is in response to the rebuttal filed in your office by Mr. [redacted] M. [redacted] on July 19, 2016. The complaint was forwarded to the Office of the Financial Ombudsman to review and reply to our patient.   Mr. [redacted], please know that as of today, I have placed all of your current active balances onto a monthly payment plan with The Cleveland Clinic but, please be aware that if any new balances fall over to your responsibility in the next 6 months (the term of the payment plan), they will not automatically fall into your payment plan. It will be up to you to contact our customer service department to add any new balances into the plan, update the payment amount and move forward.   I do see that there was some payment activity from you on or about July 19, 2016 that satisfied the collection balances and they are closed, I verified that today with J.P. Recovery service.   I hope that you are satisfied with this resolution and of course, if this office may be of any assistance to you in the future, please feel free to reach out either by phone or in writing.   Best regards,   Bradley C[redacted]   Bradley C[redacted] Financial Ombudsman Revenue Cycle Management Cc [redacted] M. [redacted]

Revdex.com: the responce is wrong, I was told three payments was accepted, therefore the public should know that just because your payment is accepted the clinic will ignore it and send to collections anyway. typical clinic with horrible customer service, this complaint should act as a warning to people not to trust what Cleveland clinic employees tell people. 
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 complaint.  For your reference, details of the offer I reviewed appear below.
 So what they are saying is that if you think you are having a [redacted] you had better be having a [redacted] or they will code what your final diagnoses is? How is this right? If I knew it was [redacted], I would have gone to my doctor. They say if you suspect a [redacted] get to the ER ASAP! I thought that's what they are for. So next time I could possible be having a [redacted] and be afraid to go to the ER because of this and die.  All I was asking was for the ER to use the code That states why I came in. I will definitely not use the [redacted] again. I will go where they know what the are doing! They have never used final diagnosis codes before ao what changed other than a so called non profit hospital making profit. Mane I should be taking this matter elsewhere. 
Regards,
[redacted]

Cleveland Clinic February 4th 2016 Revdex.com 2800 Euclid Ave 4th Floor Cleveland OH 44115 Complaint Number: [redacted] Re: [redacted] CCF: [redacted] Dear Ms. [redacted], This letter is in response to the rebuttal filed with your office with regard to the above patient [redacted]. I have reviewed the rebuttal submitted by Mrs. [redacted] and would like to address Mrs. [redacted]'s concern with regard to the payment made in the amount of $58.27. There are two phases in which balances are transferred to collections. The first phase of an out for collection balance is when the balance transfer's to one of the collection agencies that have partnered with Cleveland Clinic to collect [redacted] owed to Cleveland Clinic. This balance has not been "sold" to the collection agency and all monies collected are due Cleveland Clinic. The second phase is when the collection agency has failed to collect the outstanding balance in the allotted time given by Cleveland Clinic. This balance is then transferred back to Cleveland Clinic. Once Cleveland Clinic receives the uncollected balance; at that time it may be "sold" to an outside collection company. Any monies collected by the outside collection company, are due to the outside collection company, and no monies will be transferred to Cleveland Clinic. The balance of $58.27 for [redacted] had not been sold; only sent out for collections, with any monies collected to be submitted to Cleveland Clinic. I have mailed a detailed itemized statement to Mrs. [redacted] to reflect the allocation of all patient payments. 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. Best regards, Sonya W[redacted]Financial Ombudsman RCM

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.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
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 complaint.  For your reference, details of the offer I reviewed appear below.
My doctor's nurse has given me the name of Ivana B[redacted]. She is a reimbursement specialist. I left her a voicemail yesterday and have not received a call back. I gather from the lack of assistance that the Revdex.com plans on standing idly by as I get the shaft in this matter. I have seen no effort in the Revdex.com's part to resolve this matter. They are serving as nothing more than an spectator providing no input in the dispute. I thought the Revdex.com was established to protect the consumer. I was obviously very wrong in that assumption.
Regards,
[redacted]

(The following was copy/paste by Revdex.com staff - [redacted]11/08/2017 Revdex.com Serving Greater Cleveland C/O [redacted] 2800 Euclid Ave. 4th Floor Cleveland Ohio 44115 RE: [redacted] complaint Mr. [redacted], Thank you for your inquiry regarding the concern raised by Mr. [redacted]. Mr. [redacted], the husband of a Cleveland Clinic patient, requested review of care and billing concerns. The Cleveland Clinic also received a concern directly from the patient. As a result of the concern, the care was reviewed in full and involved caregivers notified. A formal grievance was filed on behalf of the patient. Insurance re-processing also occurred which caused multiple account adjustments. We apologize that this is not a more timely process and regret any confusion this may have caused the patient and her husband. The patient obligation related to this encounter is $0. An itemized statement is available for the patient and this is the amount reflected on current billing. The patient has also been made aware verbally of this adjustment. Thank you for the opportunity to review and respond to your inquiry. If you have any questions, I can be reached at [redacted]. Best wishes, [redacted] Director, Ombudsman

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. 
Regards,
**. [redacted]

Cleveland Clinic March 17th 2016 Ms. [redacted]
[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 my review, it has been determined that date of service 11/23/2015 was paid by insurance on 02/29/2016 leaving no patient liability. Date of service 01/12/2016 has been rebilled to insurance and is no longer showing as patient liability. Again, I offer my sincere apology concerning this matter. We know that all of our patient's time is valuable, and letting us know about their experience is always welcome and beneficial as we continue to review all patient experiences. 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

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.My concern in the response is that it clearly represents the failure of the representative to review my case thoroughly. This is a repeating event of which the most recent is the 2nd time I have had this outpatient procedure scheduled and Cleveland Clinic called me to say this was an insurance coverage issue. I rescheduled my last appointment over a month ago so even if a pre-cert was required for this visit, which is was not because it was an outpatient procedure, the clinic had more than ample time to obtain the pre-certification for the current one scheduled for 4/21/2017. My previous appointment was in early March which I rescheduled the same day to the 4/21/2017 appointment that this issue refers to. To begin the process of gaining a pre-certification a mere 3 days prior to the appointment which was the case for this date and 2 days in the prior instance (they called me Thursday for an appointment scheduled on a Friday) when the clinic knows (which is confirmed in their response) that it will in fact take 30 if needed is clearly not a customer focused process. If the person in the ombudsman office which I called had given me time to provide her this history instead of dismissing me and stating "I needed to give the financial advocate time to call me back" in a less than professional tone I might add, perhaps this situation would have been remedied without need for a complaint to be filed. There is no misunderstanding on my part on the process of pre-certification my frustration is with the unprofessional manner in which I was spoken to by the representative from the ombudsman' office who made me feel as if I was interrupting her day and the short time line that the clinic appears to be operating under to get pre-certifications done. Seems to me the system is broken that should not mean frustration for the patient. The financial office confirmed that there was no pre-certification required for my appointment as it was outpatient which it appears in both instances no one verified.      
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
Chandra Dull

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Address: 2464 US Highway 6 & 50, Grand Junction, Colorado, United States, 81505

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