ComplaintsforCasa Serena

• Initial Complaint

  07/12/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Casa Serena charged my FSA card $1009.31 before any insurane claims had been processed. Once they were all processed, they owe me a refund of $594.61, per Optum Financial who the FSA is issued through and Premera Blue Cross my insurance company. On Jun 28, I was sent an email by M**** ******* the person in charge of billing for Casa Serena. She stated a refund had been issued and it would take 5-7 business days to process. She said it was for the amount of $414.70. It is July 11th and no refund has been issued. Now she is out of the office until Jul 16. No one there is able to do anything or is willing to talk to me about it. The refund should be $594.61, per Optum and Premera. They also said they administered a TB test for $30 that is not billable to my insurance. Premera said it would be covered and my full out of pocket max has been met so that should be put through my insurance and I would get the full amount back to me. Premera can't see that it was ever given. So that seems like a scam. I am asking that $594.61 be refunded to me and the $30 charge billed to my insurance so I can get that back.

  Business response

  07/18/2024

  On May 21, 2024 Ms. Wall called the facility to inquire about insurance billing and claims status for her inpatient stay at Casa Serena, stating that her insurance company had advised her that no claims had been received yet from Casa Serena.  I sent a claim status inquiry to our third party billing company and it was determined there was an error with the claims submitted.  I requested resubmission of the corrected claims on May 21, 2024.  
  I followed up on claims status weekly on Fridays.  On Friday June 28, after confirming all claims had processed, I was able to confirm the total amount applied toward Ms Wall’s insurance out-of-pocket was $765.60 and a refund was issued in the amount of $414.70. Ms. Wall also sent an email to me this same day identifying the same amount applied toward her coinsurance. 
  On June 28, 2024 Ms. Wall was notified that the refund had been issued and was asked to allow 5-7 business days for processing.  
  Ms. Wall emailed on July 11, 2024 stating she had not received her refund.  This was the 8th business day after issuance of the refund.  The bank holiday on July 4 likely factored into the delay.  
  I emailed Ms. Wall on July 17 again providing the details of the refund amount, as well as the receipt confirming the refund issuance on June 28, and asking that she contact me if she has still not received her refund so I can look further into the matter.  Ms. Wall was also referred back to her Admission Agreement regarding her TB test fee, which was agreed upon at the time of admission and is not billed by Casa Serena to insurance companies.  I have not yet heard back from Ms. Wall.
  
  Sincerely,
  M**** *******
  Director of Admissions
  ********@casaserena.org 
  ###-###-####
  
  

  Business response

  07/18/2024

  Please see additional email exchange.  Ms. W*** initiated several email exchanges and I was unable to include them all in the initial response to her complaint.

*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. ↩