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December 20, 2017 Revdex.com2800 Euclid Ave, 4th FLCleveland, Ohio 44115-2408Attn: [redacted] Revdex.com Complaint Number: [redacted] Patient Name: [redacted]Patient Account # [redacted] Dear Mr. [redacted], This letter is in response to a letter of complaint...

filed with the Revdex.com by [redacted]. On December 19, 2017, this matter was received in the Financial Ombudsman unit for review on behalf of the Cleveland Clinic. Mr. [redacted] was quoted $452.00 on 9/7/17 for [redacted] with diameter less than 0.5 cm, which is CPT [redacted]. Due to infection, he did not have this performed on this date of service which is why his $452.00 pre-payment was refunded that day. Instead, he had an [redacted] of the infection (CPT [redacted]) which ironically has exactly the same charge of $452.00. I am sorry his $452.00 pre-payment was voided vs. being applied to the CPT [redacted] drainage procedure. Please see separate attachment. I have included the itemized breakdown of the charges to show CPT [redacted] is also $452.00. He proceeded with the excision on 11/9/17. He again prepaid the $452.00 for CPT [redacted] - [redacted] with diameter less than 0.5 cm. However, this time, he had CPT [redacted] performed - [redacted] with diameter 2.1-3.0 cm. This CPT carries a higher charge of $685. While we strive to accurately quote a procedure, occasionally a provider may perform more or less than what was quoted.  I can however extend a 35% discount off each charge, including the pathology charges. This is our self-pay discount we offer when a service is either prepaid or paid within first statement cycle: Reference # [redacted] $452 less 35% discount ($158.20) = $293.80Reference # [redacted] $685 less 35% discount ($239.75) minus $452 patient pre-payment = $0 (patient $6.75 credit here transferred to Ref # below)Reference # [redacted] $71 less 35% discount ($24.85) minus $6.75 patient credit from above Ref # = $40.40Reference # [redacted]  $172 less 35% discount ($60.20) = $111.80So in total, his current balance would be reduced from $928.00 to $446.00.I want to sincerely apologize for any inconvenience experienced in trying to resolve this matter. While we cannot remove these charges because both the [redacted] in Sept and [redacted] removal in Nov were performed, we are happy to offer the 35% self-pay discount to lessen the financial burden. Please reach out to me directly at 216-445-9020 to make payment arrangements, or if you have any additional questions or concerns. Respectfully,  Jennifer [redacted] Financial OmbudsmanRevenue Cycle Management, CCHS Cc: [redacted]  Need help paying your medical bills? Call 866.621.6385 or go to www.ccf.org/financialassistance for information on our financial assistance policy./financialassistance for information on our financial assistance policy.

December 18, 2017     Revdex.com 2800 Euclid Ave, 4th FL Cleveland, Ohio 44115-2408 Attn: [redacted]     Revdex.com Complaint Number: [redacted] Patient Name: [redacted] Patient Account # [redacted]   Dear Mr. [redacted],   This letter is in...

response to a complaint filed with your office by [redacted], on behalf of her son, patient [redacted]. This complaint was received in the Financial Ombudsman unit on December 15, 2017. We hope you find the following information to be helpful. Please know we take all concerns seriously and strive to provide World Class Care.   I would like to first offer my sincere apology for any frustration this may have caused Ms. [redacted].  I understand the billing concerns she presented in her letter of complaint are stressful.   In her written complaint, Ms. [redacted] mentions many frustrations she has had regarding Cleveland Clinic’s billing.   First, Ms. [redacted] states that the Cleveland Clinic has been charging her for bills that should have been run through her insurance.   In my investigation of her accounts, I can find no instance where the Cleveland Clinic sent Ms. [redacted] a statement showing a charge due by her that was not initially billed to her insurance.    Ms. [redacted] also lists in her complaint that she was charged for two discharges.  While she is correct that initially the patient was charged for a Discharge Day Management charge for both February 4, 2016 and February 5, 2016, this was corrected, and the February 4 charge was adjusted in August of 2016.   Insurance billing can be complex, and if Ms. [redacted] has any questions about anything she does not understand about her statement, she is free to call Cleveland Clinic Customer Service at 216-445-6249 Monday through Friday from 8:00 a.m. to 6:00 p.m.   As to Ms. [redacted]’s reference to random fees and additional fees, it is the Cleveland Clinic finance department’s goal to accurately process patient claims through their insurance carrier.  While it appears that there may have been two instances of a coding issue, the first was the above-mentioned complaint, and was corrected when brought to our attention.   The second occurrence pertains to the August 14, 2017 date of service that is the subject of this complaint.  While the patient did not see that specific doctor, that doctor did review the lab work that was done.  However, the [redacted] was incorrect.  After review, that charge has been adjusted, and Ms. [redacted] will have her payment refunded to her.    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 [redacted] Financial Ombudsman   Cc: [redacted], [redacted]

January 27, 2015Revdex.com2800 Euclid Avenue 4th FloorCleveland, Ohio 44115-2408Attn: [redacted]Complaint Number: [redacted]Patient Name: K[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 a bill for services that were previously paid.We have thoroughly reviewed the patient’s account and can confirm that the balance is $0.00. A refund is being processed to the patient in the amount of $88.20 due to overpayment on the account. The collection agency has been notified to cease all collection efforts due to the resolved balance. In no way will this action impact the patient’s credit rating as the balance is not reported to any credit reporting agency. 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 Need help paying your medical bills? Call 866.621.6385 or go to www.ccf.org/financialassistance for information on our financial assistance policy.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and while the resolution is not satisfactory to me, I have no additional means in which to prove that the visit was scheduled as a physical other than what I have already provided. I will pay the amount charged and will  be very hesitant to do business with the Cleveland Clinic in the future as I learn more about others having similar problems with this business.
Regards,
[redacted]

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.
after reading the letter... it comes off as a pacifying form letter,... not an actual attempt to resolve anything. if this is how they resolve their issues, than I think the status of who they have become seriously has outweighed their honest attempts to be the best.... I'm appalled at how I was spoke with and have and will continue to share my experience with others

January 23, 2017   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...

billing complaint from [redacted], filed in your office on January 21, 2017.This was sent to the Financial Ombudsman department to review and respond back to you. I would first like to offer my sincere apology for any frustration this may have caused Mr. [redacted]. I understand the billing concerns have caused unwarranted distress and difficulty. In my investigation of the patient’s complaint, I have found there to be a charge of $179.00, which in error was not included on the claim that had been submitted to the insurance company. The claim that was submitted reflects an explanation of benefits stating patient responsibility of $103.75, which the patient had paid on 10/24/16. There was an error in posting the adjustment of the $179.00 that lead to it being placed to the patient’s responsibility and therefore going to collection. The collection balance was placed with our agency, the [redacted], who is contracted with the Cleveland Clinic and have an agreement not to report to the credit bureau. I have corrected these errors and have confirmation that it has been closed with the [redacted] and the balance now reflects zero liability to the patient. This concludes my investigation, all balances have been paid and no further collections activity will be taken for the services provided on April 14, 2016.   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 Unit 216-445-5134 [redacted] Cycle Management, CCHS Cc: [redacted] C   Need help paying your medical bills? Call 866.621.6385 or go to www.ccf.org/financialassistance for information on our financial assistance policy.     Tell us why here...

Dear Ms. [redacted],Thank you for facilitating this discussion. I appreciate Ms. R[redacted]'s clarification of the charges and will have a check cut shortly for $75.96 due on the account. I wish to inform Ms. R[redacted] that I do not recall having ever received a phone call from the Cleveland Clinic at the number which I left on my letterhead, 440-533-5519. It may be possible that a person from the billing department may have called a different phone number and reached a family member, although, had they called my cell phone as written, they could have easily contacted me. Please update it to the correct number above in your system. I duly appreciate receiving a copy of the letter Ms. R[redacted] wrote in the mail yesterday. Written correspondence from the Cleveland Clinic with a similar explanation and an itemized billing statement would have averted this complaint. I am certain that Ms. R[redacted] will take this matter into account and encourage the billing department representatives to address the concerns of their clients more seriously by responding to correspondence in writing as expected, or at the very least calling the phone number mentioned in the correspondence to them.Sincerely yours,[redacted]

This was reviewed by our Senior Ombudsman and Legal Department and reimbursement has been denied as the service was appropriate.  Patient will remain dissatisfied.

June 12, 2017     Revdex.com 2800 Euclid Ave, 4th FL Cleveland, Ohio 44115-2408 Attn: [redacted]     Revdex.com Complaint Number: [redacted] Patient Name: [redacted] Patient Account # [redacted]     Dear [redacted],   This letter is...

in response to a complaint filed with your office by [redacted]. Our efforts are focused on bringing all aspects of each patient encounter to a level of World Class Care.   In his complaint, the patient states that he called the Cleveland Clinic Customer Service department to “negotiate payment on bill.” When the patient has responsibilities like copays, deductibles and coinsurance based on their insurance policy benefits, those balances are due in full. The Cleveland Clinic does not offer negotiation of patient balances.   I have reviewed all balances currently owed by the patient. The balances billing to the patient are his copay, deductible and coinsurance amounts. Some patient payments have been credited to the account.   The patient states in his complaint that the balances Cleveland Clinic is billing are different than the amounts UHC Choice Plus confirms that he owes. This is true, because due to the application of patient payments, balances are lower for these three references:   CCF REFERENCE DATE OF SERVICE INSURANCE PT PMTS AMOUNT BILLING [redacted]
[redacted] 1.96 $14.11 [redacted]
[redacted] 35 + 14.85 $679.33 [redacted]
[redacted] 35 $10.00   I found one financial error on the patient’s account, reference #[redacted]. On that date of service [redacted], the patient was uninsured and eligible to receive a charity adjustment. That reference is now being adjusted by $95. The patient payment $24.61 which had applied to this reference has been instead applied to the patient balance for reference # [redacted].   While the Cleveland Clinic cannot offer the patient negotiation of his correct balances, his accounts that are now in collection with [redacted] are still eligible for a 36 month interest free loan program. Customer service can assist the patient with initiation of this loan, 216-445-6249.   I have mailed to the patient address this letter and an itemized statement showing his account balances. While I sympathize with the patient’s wish to avoid stress and I sincerely hope this information will not aggravate his medical condition, these balances were correctly billed to the patient and are his responsibility.   If you have any additional questions or concerns, please feel free to call me directly at 216-445-6968. Thank you for providing me with the opportunity to investigate the above complaint.     Respectfully,   Christine J[redacted] Financial Ombudsman       Cc: [redacted] Cc: [redacted]

These concerns were addressed by our office (8/2016) and then this was appealed (9/2016.)  The patient has been notified of the outcome.

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]

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]

This case has been investigated by the Ombudsman office and officially closed.

** spoke with the consumer via phone.  He stated he feels this issue at this point is resolved and he feels confident Cleveland Clinic Upper Management will get this taken care of for him

Good afternoon [redacted], This office has already received and responded to a complaint by the patient's husband ([redacted]) on September 2, 2016. The complaint was received by The office of our President and CEO, Dr. Delos C[redacted]. In the letter that was mailed to the...

patient, [redacted] explained that there was confusion between charges for 2 dates of service and their needing to be prior authorized, the dates of February 10, 2015 and December 7, 2015 were addressed. We are continually monitoring the account and awaiting responses from our internal denials team and also from insurance.  The appeals have been filed with insurance and we are waiting for responses for both dates. [redacted] also placed a bill hold on the account but, it was cancelled and allowed a statement to generate and be mailed to our patient, showing a current active balance of $94,374.88 which we know is not true at this point. The patient should not have received this statement and I placed the hold back on the account today, while we resolve this in the background. If your office has further questions or concerns, please feel free to contact me personally at 216-442-1113 any weekday from 8:30am until 5:00pm. Regards, Bradley C[redacted]Financial OmbudsmanThe Cleveland Clinic Foundation

May 31, 2017   Revdex.com, Inc. 2800 Euclid Ave, 4th Floor Cleveland, OH 44115   Complaint Number: [redacted] Patient Name: [redacted] Spouse [redacted] Patient Account: [redacted]   Dear Ms. [redacted],   This letter is in response to the complaint filed in your...

office by Mr. [redacted], the spouse of patient [redacted] on May 15, 2017. The complaint was forwarded to the Financial Ombudsman department to review and respond back to you.   I would like to first offer my sincere apology for any frustration this may have caused Mr. [redacted]. I understand the billing concerns have caused much warranted distress and difficulties.   According to the complaint filed by Mr. [redacted], he had to make numerous calls to Cleveland Clinic to reconcile his wife’s bill. Mr. [redacted] states when he receives a bill he always pays it from his [redacted] online banking service. In return, the [redacted] bank will send a check to Cleveland Clinic for each service that he owes on the bill. Mr. [redacted] states the money does not get applied correctly and he spends hours on the phone with customer service reps trying to sort out his bill.   A thorough review of the above referenced account has been completed. Payments were not applied as Mr. [redacted] had intended. I went through each date of service making sure the correct payments applied according to the statements the patient received each month, and made the proper corrections. According to the explanation of benefits the insurance company provided, there were over payments made by Mr. [redacted]. The credit totaled $415.08. This amount can remain a credit on the account for upcoming balances or can be refunded. Mr. [redacted] can contact our Customer Service department at 216-445-6249 to request the refund.  Once again, we sincerely apologize for any inconvenience or difficulty Mr. [redacted] experienced while trying to resolve this issue. Thank you for bringing this matter to our attention   Respectfully,   Kathy R[redacted] Financial Ombudsman Revenue Cycle Management, CCHS   Cc: [redacted]

June 18, 2015Revdex.com2800 Euclid Avenue 4th FloorCleveland, OH 44115-2408Attn: [redacted]Complaint #: [redacted]Patient Name: [redacted]Patient Account #: [redacted]Dear [redacted], This letter is in response to the rejection filed in relation to complaint ID [redacted] filed by [redacted]. In light of the documentation provided we are in the process of contacting the patient’s insurance to see if the lab charges can be reprocessed under a preventative service. Typically if a medical condition exists and labs are ordered because of the medical conditions, they are not considered “preventative” services. We will contact the patient if any change can be made. Thank you for contacting the Financial Ombudsman department to assist with your concern.  Please feel free to contact our office at [redacted] if you require any further assistance. Respectfully, Morgan C[redacted]Financial OmbudsmanRevenue Cycle Management, CCHS

Please know that the information that I provided is true and accurate and was taken specifically from the patient's medical record and physician interviews.  Should he have a dispute with this response, I would encourage him to please order his medical records and review them.

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.

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]