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Complaint Details
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Initial Complaint
02/02/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I booked in to have *** annual "wellness" exam, and made that clear when booking. At check-in I further stressed I was having my once-a-year "wellness" exam, and did so also with the nurse who saw me first, and then with the actual doctor after that. This was my ONLY appointment during 2021, and I stressed on FOUR occasions that it was a "wellness" visit, covered at 100% by my insurance.The visit was subsequently coded as an "illness" visit, and I was charged through my insurance.I phoned Cigna (my insurance company) and was told to contact Peak Vista to have the error recoded as "wellness". I did that and spent a few hours on the phone with a very reluctant set of rule-followers. I was told that this had to be referred to "the Director" and that I would receive a response later that week. I did not. I then called them again the next week and was guaranteed a reply "within 48 hours". Nothing.So, I then called Cigna back and THEY made a formal request to have the visit re-coded correctly. No response. This is borderline criminal behavior from Peak Vista, and totally inexcusable under any even vaguely reasonable sense of business practice. this is abuse, and I want them censured for it. They need to submit a revised **** to Cigna that accurately reflects the **** that I ONLY made this appointment as it was my once-a-tear wellness checkup. Outrageous behavior on their part, and the fact that they repeatedly LIE in their promises to customers (patients) is reprehensible.
Business response
02/07/2022
Better Business Bureau
Dispute ********** Department
Attn: AjaDae ****** Dispute ********** Specialist
************************************
RE: Better Business Bureau (BBB) Complaint ID # ********.
February 7, 2022
Dear AjaDae ******
Thank you for allowing us the opportunity to address the patient concerns outlined in the complaint submitted on February 1, 2022.
We have contacted the patient and the payor regarding this situation and addressed the documentation and care provided during his visit on December 9, 2021. *** care provided and the supporting documentation does not support a physical exam, nor does the visit meet the parameters of an annual wellness visit as outlined by the payor. We regret that this does not meet the patients request, as our review supports the actual coded visit.
Sincerely,
***************************
Chief Operating Officer
Peak Vista Community Health CentersCustomer response
02/07/2022
Complaint: 16700523
I am rejecting this response because:As explained, my appointment on December 9 was confirmed on no fewer than FOUR occasions as my one and only wellness appointment of the year 2021. I was not sick. There was no illness. The only discussions with the doctor referred to long-term prescriptions and whether I might modify dosage due to new information.**************** verbally agreed that this was just my annual "check-up". Is the patient not allowed to actually discuss his/her health situation at such appointments. To code this visit as "illness" when I was 100% fit and well and no new action was taken regarding my health - especially after FOUR people had confirmed the nature of my visit - is abusive, wrong, and offensive.I spoke to ******************** at Peak Vista today and she is trying to get this charge reversed. Whomever responded to the BBB is fundamentally wrong.
Sincerely,
*******************************Business response
02/16/2022
Better Business Bureau
Dispute ********** Department
Attn: AjaDae ****** Dispute ********** Specialist
************************************
RE: Better Business Bureau (BBB) Complaint ID # ********
Follow-up Response from February 7, 2022
February 16, 2022
Dear AjaDae ******
*** response provided by ******************* was reviewed and our position remains the same regarding this matter. *** care provided and the supporting documentation does not support a physical exam, nor does the visit meet the parameters of an annual wellness visit, as outlined by the payor. ******************** alluded to the idea of inquiring about the charge and what options could be further explored, without a guarantee on any changes to the billed visit.
We regret that this does not meet the patients request to remedy the situation.
Sincerely,
***************************
Chief Operating Officer
Peak Vista Community Health CentersCustomer response
02/17/2022
Complaint: 16700523
I am rejecting this response because:Once again - the respondent is just WRONG. I confirmed this appointment as my ONE wellness visit for 2021 on no fewer than FOUR occasions, including with the doctor involved, ****************. I am sure he has not even been asked about this, which is a disgrace! There was no physical exam conducted during the visit. The doctor did not touch me at all. Not once. I was not unwell, and I did not complain of any symptoms I needed help with. None. I discussed with the doctor about the possibility of reducing the dosage of omeprazole I have been taking for 30 years. We also discussed whether an ORC sleep-aid I am taking was OK. The doctor had never even heard of it (Sominex). The only physical issue mentioned was the fact that I was going to make an appointment with an orthopedic specialist about some knee pain I had. This was nothing to do with **************** as I do not need a referral, and none was requested or given. The discussion - WITH NO PHYSICAL EXAM WHATSOEVER - on that day were totally about my ongoing WELLNESS. I did speak with ******************** about this issue as well at a later date, and she said that she totally "understood my position" in claiming that the visit was a wellness visit and not an illness visit. She then told me that she would try to have the charges to me cancelled. That is what I want to happen. That is the right thing to do. This practice lies to patients. Well, "patients" is not the right word. "Customers" is the right word. They clearly have no concern for a patient's wellness, they are only interested in making money, and they will lie - on FOUR CONSECUTIVE OCCASIONS - to do that. Disgraceful.
Sincerely,
*******************************
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1 total complaints in the last 3 years.
0 complaints closed in the last 12 months.