Medical Service Organization
One MedicalThis business is NOT BBB Accredited.
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Complaints
This profile includes complaints for One Medical's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 109 total complaints in the last 3 years.
- 59 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.
Initial Complaint
Date:07/12/2024
Type:Product IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I signed up on January 8, 2024, and saw a provider online the next morning. As soon as the provider came online, I said I had just seen an email from One Medical asking me to upload my insurance card. I asked the provider if she could take my insurance info right then. She asked me for the name of my insurance. I said, "******* ****" and she told me to upload the card after the appointment because she and One Medical were in-network for ******* ****. But apparently, that was incorrect. It turns out, ******* **** has more than one network. The provider and One Medical were not in-network for me. One Medical sent me an invoice for $304.20. I disputed the invoice on January 11 and canceled my membership. After several exchanges, I received a message from Laurie Pineda via One Medical's website on April 26, 2024. She said the “first step” would be for me to send my insurance info. I did so immediately (via One Medical phone support; I couldn't reply directly to Laurie because One Medical does not allow non-members to reply to messages, even about billing -- I have a screenshot to prove this), but I never heard back from Laurie or anyone else at One Medical. Instead, I got a call today from a collections agent who said I now owe $507. The best way to ensure that a provider is part of an insurance network is to ask the provider. That is exactly what I did. If I had known she and One Medical were not in-network, I would not have proceeded with the appointment. One Medical’s provider's representations about coverage are 100% One Medical’s responsibility. Inducing people to use One Medical’s services by falsely representing that those services will be covered by insurance is not ok. I don’t know whether this was mere negligence on the provider's part or a practice that One Medical knows about or encourages. Either way, this is 100% One Medical’s responsibility and I do not owe One Medical (or anyone else) any money for the appointment (my in-network copay is $0).Business Response
Date: 07/12/2024
Hello *****,
My name is Melissa, and I'm part of our Patient Relations team here at One Medical - thank you for reaching out. I see our billing team reached out to you today regarding this bill. Please check your account for the most current information from our billing team.
All my best,
Melissa
Customer Answer
Date: 07/15/2024
Complaint: ********
Thank you for your response. Your billing team's communication is unacceptable for two reasons:
1. The communication asks me to respond, but, as I mentioned in my complaint, the One Medical website and mobile apps do not permit non-members (like me) to respond to messages, even about billing concerns. So, it is not possible for me to respond to the message (or any other message). Yes, I could try responding by telephone -- i.e., I could call the billing hotline, wait on hold for several minutes, waste several more minutes explaining everything to a new agent, and hope he/she will accurately pass my response along to the person who sent it, but I have tried that before at One Medical and it didn’t work. For example, I tried responding by phone to the April 26, 2024, message sent to me by Senior Manager Laurie Pineda, but I never heard back from her or anyone from One Medical.
2. More importantly, even if it were possible to effectively respond to your billing department’s message, I do not believe it would help. The latest communication from your billing department says, “the only thing billing can do to help you is offer a self pay rate adjustment...” My visit should already have been coded as self-pay since I didn’t use insurance. Am I understanding correctly that your team’s offer is to do what it should already have done?
This message is typical of the billing department, which has not bothered to provide a response to the dispute I submitted six months ago (on January 11, 2024). The question that I have been waiting six months for the answer to is: Why should I have to pay for a medical appointment that I would not have kept if the provider had not mistakenly told me she was in-network when she wasn’t?
It should not be difficult for you to answer. I can think of four responses you could give. 1. You could agree that I shouldn’t have to pay. 2. You could respond that I have to pay because you don’t believe me – i.e., that you think I am lying that the provider told me she was in-network (I am telling the truth). If this was your position, I would ask why you haven't asked the provider about the conversation. I would also ask whether these kinds of complaints have come up before and whether you have provided any training for your providers about the importance of responding carefully to insurance coverage questions. I would also ask what your basis is for judging my credibility considering you have never spoken with me. 3. You could respond that I have to pay because I am responsible for the invoice despite the fact that the provider gave me the wrong information. I obviously disagree because there is no better way to determine whether a provider is part of an insurance network than to ask the provider. That is exactly what I did. From my perspective, One Medical is 100% responsible for that mistake and I don’t owe One Medical any money.
Which response is yours? Please respond to my question, one way or another, or agree to cancel the invoice.
I would like to resolve this dispute here with the BBB as our mediator, which I think will motivate you to be responsive and honest. Please do not attempt to use HIPPA or privacy as an excuse to avoid communicating with me here. I hereby waive my HIPPA and all other privacy rights with respect to this conversation (but please don’t mention publicly the details about my diagnosis and treatment).
Sincerely,
***** *******Business Response
Date: 07/18/2024
Hi *****,
Thank you for following up. At this point, we have provided all the information we can and the best next step is to reach out to **** directly. I see our Billing manager has been in contact with you as well.
All my best,
Melissa
Customer Answer
Date: 07/18/2024
Complaint: ********
Hi Melissa,
Thank you for your response. You are sending me in circles. You and your billing manager told me to call ****, but **** is a collection agency. **** does not have any information about my dispute with One Medical. Nonetheless, in the interest of resolving this dispute, I called ****. As expected, **** said that only One Medical can resolve this dispute. **** asked me to provide information about the dispute so they can send it to One Medical, but I have already provided all of the info to you and your billing manager. Around and around I go.
As I think you know, you are leaving me with three terrible choices, and you know that most consumers will choose option one (which is not right):
Option 1. Pay a debt that I do not owe.
Option 2. Not pay and risk an impact on my credit report. Yes, your billing manager told me that **** does not report to the credit reporting agencies, but that is not comforting because the disputed debt could be sent to a different collections agency in the future.
Option 3. Commence arbitration or a small claim against One Medical to resolve the dispute. This is too complex, time-consuming, and expensive in light of the small amount of money in dispute.
Bottom line: you are leading me in circles because you know most consumers will just pay you. This is unfair to me and contrary to public interest. Please admit that I do not owe this balance and refrain from further collection efforts, or explain why I should have to pay this debt.
Sincerely,
***** *******
Business Response
Date: 07/18/2024
Hello *****,
I understand this isn't the response you were hoping to receive. Once you have disputed the claim with **** and completed what they need, that is when our team will be able to offer more support. I know it's frustrating, but we do have to follow a certain order of operations for federal complaince with a collections agency.
I would suggest completing the steps **** is asking for, and our billing team can then work with them for next steps.
I appreciate your patience, and thank you for your time.
All my best,
MelissaCustomer Answer
Date: 07/19/2024
Complaint: ********
Hi Melissa,One Medical's provider made a misrepresentation to me. That is serious. I should not have to jump through any hoops to get you to make this right. One Medical should not have sent this matter to collections in the first place. Your federal compliance concerns are your responsibility, not mine.
Nonetheless, in the interest of cooperation, I have done as you asked -- I submitted all of the information to **** just now (see attached).
I look forward to the next steps.
Sincerely,
***** *******Business Response
Date: 07/19/2024
Hello *****,
My name is Amy L********* and I lead our Patient Experience team. Your complaint was escalated to me today. I've reviewed your entire case including the information provided to you in the app.
We did submit your visit to your insurance, however, it was denied by your insurance as out of network. We reviewed your case with the billing team and your scenario does not qualify for a waiver of the charges incurred since you were out of network at the time of the appointment.
Since you did not pay this bill, it was sent to the collections agency (****) and any disputes would need to be reviewed with the **** team, which it sounds like you have started this process. Bills sent to **** do not impact your financial credit rating.
Please reach out to us at *********************** if you have any further questions
Thank you
Amy
Customer Answer
Date: 07/19/2024
Complaint: ********
Hi Amy,Thank you for the response. I think you are saying that I incurred a $507 charge just for joining the call with the provider. In other words, I think you are saying that even if the provider had told me I was out of network, I would have already incurred a charge.
I do not think the law supports your position, but, for the sake of resolution, let us suppose it does. The most I should have to pay is the self-pay rate (because One Medical was not in-network for my insurance) for a simple appointment (because I would have left the call immediately if your provider had told me I was out of network). If you agree, please adjust my bill accordingly. Perhaps it will be easier for us to resolve a smaller disputed debt.
Thank you,
***** *******
Business Response
Date: 07/22/2024
Hello *****,
Thank you for the response. The charges that you received were for the services that were rendered at the time of the appointment and are based on national billing and coding standards. If you had chosen to disconnect from the appointment at the time of the call, before discussing anything with the provider, you would not receive a bill for a visit. However, since you did have a visit with the provider, you were billed based on those national billing and coding guidelines. We did have our team review to be sure it was coded accurately based on what was discussed and we have confirmed that it was coded accurately.
Tasha did reply to you on 7/12/2024, in an in app message stating that we can adjust to your self pay rates, but I don't see a message from you requesting that change. As a courtesy, I have asked our billing team to adjust to the self pay rate and have asked them to communicate this adjustment to ****.
If you have further questions the quickest way to get ahold of the patient experience team is to email us at *********************** - we are always more than happy to help resolve issues. Please email us directly if you have further questions or concerns.
Thank you
Amy
Customer Answer
Date: 07/22/2024
Complaint: ********
Hi Amy,Thanks for your response. I did respond to Tasha, but not via One Medical’s in-app messaging system because (as I pointed out earlier in this BBB thread) One Medical’s in-app messaging system does not allow non-members (like me) to reply to messages, even about billing concerns, which is frustrating and inconvenient. Instead, I had to call the billing hotline, wait on hold for a bit, and then describe the situation to one of your agents who assured me that she would respond to Tasha on my behalf.
You said that if I “had chosen to disconnect from the appointment at the time of the call, before discussing anything with the provider, [I] would not receive a bill for a visit.” Disconnecting is exactly what I would have done, but your provider misrepresented that the visit would be covered by my insurance. One Medical is 100% for that representation. Please tell me why I should have to pay in light of that misrepresentation. Why is One Medical not responsible for that representation?
Thanks,
***** *******
Initial Complaint
Date:07/04/2024
Type:Order IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I have been a One Medical member for over 13 years and have been back and forth on various insurances, including Anthem. They list Anthem as one of the plans that they accept in the **********************. I updated my health insurance and was informed that I will have to pay out of pocket because they don't accept my plan. They continue to list Anthem as an insurance they accept.Business Response
Date: 07/08/2024
Hello,
My name is *************************** and I lead our Patient Experience team at One Medical. Thank you for being a loyal One Medical patient for so many years. I'm sorry that the insurance verification process has been confusing and frustrating for you.
You are correct that we list Anthem as a plan we accept on our website, however, also on the website, is a listing of the specific Anthem plans that are in-network. We do not contract with Anthem for all plans, only the specific ones listed. Unfortunately, the plan you choose is out of network for One Medical. Our membership advisors can assist you with finding a plan that is in network. Please give us a call at 888-ONEMED1 for additional assistance.
Thank you,
***
Initial Complaint
Date:06/24/2024
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
The billing department at One Medical is deceitful and greedy. They billed me for a service day after I got my care, which I paid for in full. A year later they billed me hundreds of dollars due to a mistake on their end for not verifying my insurance when booking me into the office. I am now paying and being billed more money as they continue to change and add more money to the balance. Instead of helping to contact my insurance company I used at the time and disputing the new charges- they are asking me to do their job and pay for their mistakes. I have filed a claim and attempted to dispute this with the billing manager only to get a sob story about how his child had the same issue as me once. Really bringing your child into the explanation of why you are not going to dispute the surprise charges for me is beyond immoral and greedy. I have attempted multiple times to dispute this because I refuse to pay more money for something I was already billed for and paid for. It should be illegal to send more surprise bills and charges due to a mistake in your department. I am fighting for a full refund for things I have been charged and paid for at One Medical. The doctors were ignorant and never even solved my health issues- they requested I do the same exact procedure more than once just to get more money.Business Response
Date: 06/25/2024
Hello Zion,
My name is *** and I lead our Patient Experience team at One Medical. Thank you for reaching out and I'm sorry the billing process has been confusing and frustrating for you. In reviewing your account, it looks like you did not have an active insurance on file at the time of your encounters last year. When we submitted your claims to your insurance for your visit, your insurance carrier processed your claims, in error, as in-network as if you had an active policy.
Your insurance carrier later reprocessed your claims as denied due to the fact that you did not have an active policy at the time of your visit. As a result, you received a new bill at the out-of-network rate. If you did, in fact, have an active policy at the time of those visits, we can reprocess those claims with your insurance carrier once we receive that policy information.
As a courtesy, we have adjusted your balances to reflect our self-pay rate, minus what you have already paid. We are happy to work with you on an interest free payment plan if needed. If you have further questions, our billing hotline is ************.
Thank you,
***
Customer Answer
Date: 06/26/2024
Complaint: 21893986
I am rejecting this response because:I have received the same response from this company as they are not disputing the charges for me- they are still charging me extra money. I am forwarding this complaint to BBB for assistance.
Sincerely,
*******************Business Response
Date: 06/26/2024
Hello Zion,
My name is *** and I am sorry that you were not satisfied with my response to your complaint. We are willing to help you with your insurance claim. In order for us to resubmit your claim, we would need proof that you were insured at the time of your visit. If you would like to send a copy of your insurance card showing that you were in-network on the dates in question to ********************************* we are more than happy to assist you with resubmitting the claim.
If you were not insured at the time of the visit, it looks like your insurance company billed your visit as in network and then later corrected the bill as out of network, which caused you to receive a second bill. Insurance companies sometime do amend their bills if visit occur close to a date that a lapse in coverage begins. As a courtesy, we have reduced your bill to our self pay rates so you do not need to pay the full out of network charges sent by your insurance. We are more than happy to assist you with a payment plan if needed.
Thank you,
***
Initial Complaint
Date:05/24/2024
Type:Billing IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
One Medical offers Impact Provram (health coaching). Before the program they share the exact code that will be used for sessions so the participant can check with insurance.I did that. It was all covered. The bill came with a new, unadvertised code.Instead of paying $30 copay as advertised, I was charged the full price which used my entire $500 deductible.What a joke for 20 min health coaching with a person who is not even a doctor.They won't stand by their own documentation. Such an unethical medical practice. I want to pay as advertised.Business Response
Date: 05/29/2024
Hello *****,
My name is *******, and I'm part of our Patient Relations team here at One Medical. I am sorry to hear about the confusion when it comes to billing for this particular program. I see you have been in touch with our billing team, and you should be receiving a call from our operations team today to discuss this case further.
All my best,
*******
Customer Answer
Date: 05/29/2024
Complaint: 21757856
I am rejecting this response because the ops person had nothing to offer for a resolution although they know and admit they One Medical did not advertise the code for the program as they charged it.They are escalating further and I will not close this complaint until we come to a resolution.
Sincerely,
***********************Business Response
Date: 05/30/2024
Hello,
My name is *** and I work with ******* on our Member and Patient experience team. I'm sorry that you were not satisfied with our initial response to your inquiry. I have also reviewed the billing information with our billing team. The billing team has spoken to your insurance as of 5/30 and your bill has been sent back for review and reprocessing, which normally takes ***** business days. If you have further questions, please reach out to us at *********************************.
Thank you,
***
Initial Complaint
Date:05/22/2024
Type:Billing IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
1/3/24 appt - was not provided service but still trying to charge me. Dr **** stated she did NOT go over what the appointment was for. I am being charged for a service that I did not receiveBusiness Response
Date: 05/23/2024
Hello ******,
My name is *******, and I'm a Manager on our Patient Relations team here at One Medical. Thank you for reaching out regarding your bill.
I see you have been in contact with our Billing team consistently regarding this matter. I've escalated this to our Billing manager, and upon review, the information you have already received is the most accurate and current to date. Please refer to your messages for any additional questions.
All my best and respectfully,
******************
Customer Answer
Date: 05/23/2024
Complaint: 21748091
I am rejecting this response because:exactly what it says on the message she did NOT address the issue I went yo the appointment for. Im not sure where the confusion is.
You cannot charge me for a service I didnt get. The reason I went to the appointment was not addressed specifically if my medications are/were the reason why.
Sincerely,
***************************Business Response
Date: 05/28/2024
Hello ******,
Thank you for following up. We have reviewed the provider's documentation that shows you did received services. At this time, your bill stands, per our Billing and Clinical teams' reviews. I'm sorry this isn't the outcome you were hoping for, but please refer to messages from our billing and clinial leadership teams in your account for additional details.
All my best,
*******
Customer Answer
Date: 05/28/2024
Complaint: 21748091
I am rejecting this response because:I have provided documentation that clearly states what service I requested what not fulfilled.
I just want to make sure I understand your billing practices. If someone request an appointment and the dr says nothing about what they went to the appointment for. Say the dr talks about everything else but the specific reason the patient went to the doctor. You are still going to bill the patient even though they did NOT receive the care that they went to the DR for? I just want to make sure I am understanding because if that is the case, then that is shady business practice for charging someone to hear a dr talk about everything else other than what they went to the DR *******************************************************************Initial Complaint
Date:05/10/2024
Type:Billing IssuesStatus:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
In October 2023 I gave birth at the hospital, which led to me meeting my insurance policy's "out of pocket maximum" for the year. Per my insurance policy, after that is met, I do not owe any co-pays for the rest of the calendar year. I had a visit with One Medical on November 14 2023, and One Medical is claiming I owe a co-pay of $65. Per my insurance, Western Health Advantage, I do not owe anything. I have made several calls back and forth, both to my insurance and to One Medical billing department to attempt to resolve this matter. My insurance has sent the *** to them showing no share of cost, and One Medical continues to say they have not received it, despite them having submitted it to them several times. My insurance even provided the *** directly to me, which I forwarded to One Medical, but they say "we need it directly from the insurance." One Medical is conveniently claiming they have not received the *** and that they can't accept it from me despite it being directly forwarded from my insurance. Please, adjust the bill to reflect what my insurance shows is correct. ie, I do not owe anything.Business Response
Date: 05/15/2024
Hello,
Thank you for reaching out. My name is *** and I lead our Patient Experience team at One Medical. Thank you for reaching out, I'm sorry that you had this frustrating experience with billing. In review of your information, it looks like this has been resolved by our team. If you are still having issues with your bills, please don't hesitate to reach out to ********************************* and we are happy to assist you. Thank you again for your feedback.
***************************
Customer Answer
Date: 05/16/2024
Better Business Bureau:
I have reviewed the response made by the business in reference tocomplaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
*********************************Initial Complaint
Date:04/24/2024
Type:Sales and Advertising IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I didn't receive services from this company but I got a bill for 190$. I received an email that I'm able to check my moles for free. After clicking on this email I got a big button to schedule a call. No information that I will pay 190$ was provided. That working exactly same way - you got email because they obtain my information from employer (and employer pay for this subscription as benefit option), then you click on button where it says to schedule a call, then on this call which last 4 minutes they say "We can check your moles only in our office - you wanna schedule?". Then you got a bill for 190$. From my point of view this is total scum scheme. Because all this flow to make this call happened without real awareness that I will pay something (even if it was somehow hidden with tiny little text which says you will pay for it) I didn't get exact amount I will pay, subtotal or anything that might make me think that I will pay. And after that they wasn't able to provide me consultation about moles, which they advertised in their email (screenshot attached), because it's impossible to make it online. I didnt get to their office and didnt schedule this in person appointment. How they might think after all of that that I need to pay anything for that? Thats just not right from all points of view. Now they are trying to collect this payment using debt collector company ***********************. I was talking with regional manager ******* and she said me something like we can provide you a plan, I said okay If you wan't me to pay for nothing - I will let people know about this scum scheme. Totally insane company and manager.Business Response
Date: 04/24/2024
Hello Artem,
My name is *******, and I'm a Patient Relations Manager with One Medical. Thanks for reaching out, and I'm sorry to hear about the confusion with your bill. After reviewing the case, the information that was shared with you is correct and current. You did receive notice that your visit would be billed to your insurance in the confirmation email, and that your employer only covered the membership fee. At this point, any additional questions regarding your bill will need to be followed up via the contact information already shared with you. I hope this has offered some clarity.
All my best,
*******
Customer Answer
Date: 04/24/2024
Complaint: 21620067
I am rejecting this response because: You just ignored everything in my message (there is no way to check my moles online) and saying that there was an email that I will be billed. First of all I have no idea which email you are reference to. You could send an email that I will be billed for a million dollars same way it won't makes me responsible for your email. You didn't provide me clear information that I will pay anything while I was booking this consultation. And It's clear that this scum is part of your business model.
Sincerely,
***************************Business Response
Date: 04/25/2024
Hello Artem,
I'm sorry that you were not satisfied with our response. We have reviewed your bill and determined that it was correctly submitted for the care you received. Additionally, we confirmed we provided you adequate information that you would be billed for the services you received, per the screenshots you shared of the confirmation email you received.
Best,
*******
Customer Answer
Date: 04/25/2024
Complaint: 21620067
I am rejecting this response because: I didn't received any care - once again. You did nothing at all, and now you just trying to steal my money. That's what you are doing.
Sincerely,
***************************Initial Complaint
Date:04/24/2024
Type:Billing IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
On 2/6/2024, I received medical services from One Medical's office at **************************************************** doctor recommended a ***** test, but informed me that the facility was out of rapid tests. In lieu of the rapid test, the only test available at the office was a *** test. I was not informed at this time anything about billing / insurance or given a decision of whether to move forward.When I received my bill, I was charged $210 for the ***** *** test.I am disputing that One Medical should charge me for a more expensive test when it was their fault for not having the cheaper, rapid test, in supply. The rapid test is best medical practice, the *** test is not best practice; the only reason I was given a *** test was because of a supply issue. I should not be charged for One Medical's supply problems, and especially not without explicit consent from me for an upcharge.I am requesting that One Medical completely waive this fee, or only charge me for what a rapid test would have cost.As a secondary complaint, the One Medical billing and investigations departments processes are completely broken. The billing department has hung up on me, refused to answer my phone calls, and purposefully punted me to other departments that are out of purview for my complaint. After over 10 phone calls and messages, no one has sufficiently answered and explained this charge. And the billing department cannot move the bill to escrow while in dispute.The investigations department is also broken. They are not sufficiently analyzing the complaint and coming back with valid answers. Their only response is "waive request denied", but they have not sufficiently analyzed the complaint to perform a meaningful analysis. They are clicking buttons to get through their queues with 0 quality or oversight.Business Response
Date: 04/24/2024
Hello *****,
My name is *******, and I'm a Patient Relations Manager with One Medical. Thank you for reaching out, and I'm sorry to hear about the experience you've had. I know it can be challenging for us to warn all patients about all costs, as so much of coverage depends on one's specific individual benefits, but we always try to do our best.
Regarding your outstanding bill, please check your account, as I will follow up with you there for your privacy.
All my best,
******************
Initial Complaint
Date:04/24/2024
Type:Order IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
One Medical has incorrectly billed me an astronomical sum for several dates of service. They miscommunicated to me that they would accept my insurance for the treatment, only for me to have my insurance deny the treatment because it was coded as PCP instead of as the psychiatric medication management I requested. After lots of panic back in 2021, I got a retroactive referral for these dates from my insurer, but One Medical failed to resubmit the claims. I asked for confirmation in writing in 2021 that these bills would not be sent to collections. It was given to me. Yet, low and behold, in 2023, this surprise bill has found its way to Mnet, One Medical's debt collections vendor. Mnet is shady. They do not respond to my emails and do not answer my calls. Their emails have broken links and look scammy and non-secure, and their online portal doesn't work. Even if I wanted to pay the debt, I couldn't using the tools Mnet has given me. When I contact One Medical to discuss the billing error, they simply re-direct me to Mnet. Mnet has ignored my emails requesting additional information about the supposed debts. They are now in violation of a federal law which requires they disclose to me the particularities of my debt within a certain time frame and require them to enable me to dispute the debt. I have tried calling and emailing One Medical many times to get them to work with my insurer. This hasn't worked as the agents are unable to open my attachments using their CRM. I also have no access to their tech platform as a non-subscriber. Their phone agents are either hostile or unwilling to help to me over the phone. Both companies are dodging me over a mistake One Medical made, and I want this resolved so that I am no longer in collections or being badgered over a false debt. God forbid they contract some legal services next to *** me for this invalid debt. I am losing sleep over how irate I am that this company will not work with me on remediating the outstanding balance.Business Response
Date: 04/24/2024
Hello ****,
My name is *******, and I'm a Patient Relations manager here at One Medical. I am sorry to hear about the frustrating experience you've had. I do see that our Billing Manager reached out to you this morning. Please review those messages, as she has the most current and up to date information on your case, and will be able to assist further.
All my best,
******************
Customer Answer
Date: 04/24/2024
Complaint: 21617830
I am rejecting this response because: the email I received from your billing specialist this morning was the exact sort that I have already addressed in my complaint. It was unhelpful and parroted the same response One Medical has been giving me for years. Basically, I am still being told: "this is not our problem/ we can't help you." One Medical is continuing in a three year streak of misrepresenting my options related to these specific dates of service. They state they will not address the billing issue as it has been sent to collections. I was finally able to get through to an employee of Mnet who shared with me that One Medical is fully capable of clawing back the debt, appropriately reducing the incorrect amounts being billed, and working directly with my insurer. One Medical owns my debt, and is the agent which has improperly billed me for services that were misrepresented to me and that I rejected. During the call with Mnet today, I disputed the debt. ****** at Mnet advised me to continue working directly with One Medical as your organization is the only entity with power to resubmit claims to my insurer, adjust billing amounts, and access the long history of correspondence I have had with your team over negative experiences with One Medical providers, your continued misrepresentations about what services I was being offered and billed for, and whether I would be at risk of getting sent to collections. If you look in my portal, you will find the message I received from Eve D back in 2021, assuring me that per company policy, that One Medical will never send me to collections. Eve D also had me get my insurance to issue retroactive referrals. Yet, One Medical never resubmitted to my insurer. They engaged in an illegal tactic of holding on to the debt until the *** to re-file with insurance passed. Reading through the mountain of other BBB complaints, and complaints by ****** employees in their knowledge base about One Medical, it is clear this is a systemic issue and not discrete issue. If we cannot reach an agreement directly, I am happy to pursue legal action. The next step would be arbitration, as if I had to hazard a guess, I was made to sign an arbitration agreement with your organization. I have begun the process of reporting One Medical to my insurer and to the ********************* of ********** A settlement I would accept is having the debt written off (without this being reported to a credit bureau, ever), having the balance sharply reduced to match what I would have owed had I only been on the hook for what you represented to me before treatment, and having all dates of service with ************** taken off of my bill because of the horrible, unethical experience I had with her before stopping our visit short. You can easily find a record of my complaint against this provider in my message history and likely with the office where I saw her, because I complained to the office manager about her immediately after ending the visit early.In sum: the way I see it, we have three roads we can go down:
A) I respectfully request that the debt is clawed back from collections by One Medical, and the balance on my account sharply reduced. The reduction will reflect that each of the visits I saw for psychiatric medication management will be billed as if they were specifically coded for psychiatric medication management. The rationale for this reduction is because I verified with One Medical that this was the full scope and clear parameter of the visits and nature of service I would receive before I ever scheduled and commenced these dates of service, because this was the nature of what happened during those visits, and because this is the representation I relied on from your organization in contracting for your services. There is a clear record of all of our communications establishing this expectation in my message history, one easily reviewable by a court. This means I will owe no co-pay or co-insurance for these visits, as this would be fully covered by my insurance if things went down the way you said they would. UCSHIP fully covers mental health care, with no patient responsibility and no copayment. To re-iterate what I have been saying since 2021: I would not have come in to One Medical had I known that the visits would be coded as PCP rather than psychiatric medication management. Why? Because my referral to One Medical was for mental health care. Why? Because your organization was listed as in-network as A MENTAL HEALTHCARE PROVIDER on your website and on my insurance's website in 2021. Why? Because I easily could have gone anywhere else in my insurance network, FOR FREE, for psychiatric medication management. In contracting for your services, I relied on a misrepresentation. Demanding massive sums, after the fact, from an insolvent law student is unconscionable and an arbitrator will clearly see it as such. Furthermore, all billing pertaining to my botched visit with ************** will be fully removed from my bill. As you can easily see from my message history within the One Medical application, and the complaints I made on the date of service to the Office Manager at ***********, I took issue with my treatment by **************. I stopped our visit short due to her misconduct and left the room in tears. She acted unethically and in a way that made me uncomfortable, and I expect to not be billed for her services, which left me worse off than not seeking treatment at all. The fee for her services will be waived, as I have been requesting since 2021 with no helpful or adequate response from the dozens of One Medical employees I have since interacted with. More over, the flu shot she coerced me into getting, therefore ratcheting up my bill by $380 and padding your companies profits, will also be waived from my bill. I receive free vaccines from my university and this was clearly a shady moment where your office was placing profit over your patient's financial wellbeing. I have done some research on past litigation against One Medical and the news coverage that came up around the time you were acquired by Amazon, and it was clear that I am not the only patient who was coerced into getting vaccines at a ridiculous rate. It seems many of your practitioners had a policy of insisting patients receive vaccines, ones that were not covered by insurance, and that these vaccines predicated applying massively inflated charges to unwitting patients' bills, all during a global pandemic where such vaccines were freely given and people were financially insecure and massively vulnerable to misrepresentation about vaccine availability and related insurance coverage.
OR
B) I respectfully request that you claw back my debt from Mnet, and fully write off the *entire* balance. Why? Because I am a financially insolvent law student and so there is no way the debt can even be collected. If we take this route, you will sign a promise to me stating that you will never report this to a credit agency, and the agreement will be between you and me alone. No news regarding this write-off will ever be escalated to any credit bureau or credit reporting agency. This agreement will mark the end of our interactions and I will never subscribe to your services again.
OR
C) I will proceed to take (1) legal action (whether through court or arbitration), (2) complete my formal complaint against your organization with the ********************* of ********** (3) report you to Anthem so that they have fodder to reconsider sending their insured to your organization, (3) report you to the various consumer protection firms in my professional network who may be interested in originating mass arbitration against you for systemic misconduct, and (4) follow up with this NPR reporter to give some insight on how things are going since this article was first published: ***************************************************************************************************************************************** (So odd how the timing of this article almost directly overlaps with the misconduct I experienced from your organization with respect to vaccines!) This step involves a lot of work, time, and expense for both parties, and so I assume it is not the optimal resolution.
I have been in communication with ********* (********) ******** who has informed me that your head of revenue will be reaching out to me shortly. I look forward to hearing a direct response from this contact within your organization. I am also happy to hear of alternative proposals for us to reach an amicable conclusion to this dispute. Otherwise, I will assume you are unwilling to work directly with me on an amicable solution and will proceed to step C as outlined above.
Sincerely,
*****************Business Response
Date: 04/25/2024
****,
I'm sorry that you were not satisfied with our response. We have reviewed your bill and determined that it was correctly submitted for the care you received. Since your bill was outstanding for over 2 years, we have transferred the debt to MNET. I can assure you that MNET will not report you to credit agencies and this will not impact your credit score. You can also work with MNET for a payment plan to resolve this outstanding bill.
Best,
***
Customer Answer
Date: 04/25/2024
Complaint: 21617830
I am rejecting this response because: at this point it is a farce how inadequate the repeated response is from One Medical. Shame on them. I will be pursuing legal action.
Sincerely,
*****************Initial Complaint
Date:04/22/2024
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I had a lingering cough for a couple weeks but otherwise felt fine and just wanted a second opinion so I went in for a check. I had already taken a COVID test prior to the appointment that morning and really felt completely fine despite the cough. I tell doctor *** Latthivongskorn and the front desk that I've already taken a COVID test that morning and it was negative but he insisted that I still test despite knowing that information and that it wasn't a preventative test so wouldn't be covered by insurance. He didn't even try to warn me and urged me to take it as if I'd be crazy not to. The simple COVID test cost me $89.89which of course was negative. Aside from asking to take some other tests which I thankfully managed to avoid, that was all he did. I was actually blown away with how little of his medical knowledge he used. It's actually quite eye opening to know that doctors and institutions like this exist.Ps. I have decent $700 per month health insurance and this was not covered so he must have known what he was doing. Be careful out there.Business Response
Date: 04/23/2024
Hello,
My name is *** and I lead our Patient Experience team at One Medical. Thank you for reaching out with your concerns about the bill for the ***** test. I'm sorry that your experience with our team did not meet your expectations. I was able to review your complaint with our billing and clinical leadership teams and it appears that your visit, including the ***** test, was clinically appropriate. As a result, you were billed for the test you received. Because this claim was documented, billed, and processed by your plan correctly, we are unable to adjust your bill. If you have any further questions, please reach out to us at *********************************
Thank you,
***
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