ComplaintsforSimply OBGYN

• Initial Complaint

  05/23/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I visited Dr. ******* N'gouamba on 3/5/2024 and was charged a $66 co-pay upfront, despite my insurance (Blue Shield) later confirming that no co-pay should have applied. The Explanation of Benefits (EOB) I received stated that I was not responsible for any payment for this visit. Upon learning this, I immediately sought clarification and a refund for the incorrect charge.I contacted Blue Shield for assistance. They reached out to Dr. *********** ****** at **************, only to be directed to a different number *************) for billing issues. However, attempts to connect with someone at this second number were unsuccessful, with no one answering and no return call provided.This situation has left me unfairly out of pocket and without a clear recourse to recover the funds that I should not have been charged. My attempts to resolve this directly with the healthcare provider have been stymied by a lack of response. I am now seeking assistance to get a refund for the $66 co-pay erroneously charged to me, in accordance with the terms of my insurance policy.I am looking for guidance on how to proceed in this matter to ensure that it is resolved fairly and promptly. Thank you for your attention to this issue.

  Business response

  06/07/2024

  To Whom It May ***************** response to this complaint for refund of $66.00, this is the first letter received, no prior notice was sent to the office. Dr. ************************ has been taking care of patients in this practice since 2019, has never had any issues with refunding any patients request, on the date of her office visit patient paid $65.00 office copay and paid $1.00 for a face mask total of $66.00.The patient sent a dispute to her credit card company which she was already refunded back to her credit card of $66.00, at a loss of $1.00. There have been recent significant delays in processing due to insurance claims in the medical industry due to clearance house malfunction that were outside of our control.  which has already been resolved. On billing statements there is a phone number for patients to call for any questions. I already spoke to the billing team, we are reviewing in our side all messages and received and left by this patient regarding this matter. we have the same small staff that we have always had, never had this type of complaint and very upsetting. We have discussed this issue as well with our off-site medical billers to close any gaps or concerns with these types of issues.

  We would like to know if there are any steps we can take to make sure this report gets cleared from our BBB file. It appears that the patient first course of action was to contact her credit card company and the BBB. Please feel free to contact the office via US postal or my email: ************************************ will also follow up with the patient. 

  Thank you for your time in this matter.

  ********************* (Office Manager) 

   

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