ComplaintsforBaycare Medical Group, Inc.

• Initial Complaint

  03/26/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  February 26, 2024 I reached out to my provider's ****** with the request to review and adjust the claim that was sent to a provider for my blood work. I faxed my bill and the request. A couple of days later I was called and rudely told, like I was a teenager, that it was my deductible and I must pay. My insurance company explained that the doctor's ****** submitted the claim with diagnostic codes being primary and preventative being secondary, that's why I was billed. The ****** manager, **, rudely told me everything was submitted correctly. I called back a couple of days later and a rep by the name I. told me that I must bring everything to the ******, otherwise nothing would be reviewed and talked to me in a diminishing tone. I called **************** number, C., told me rep I. should not had done that because everything was in my online account. I was asked to file a complaint on March 1, 2024 and was told by C. from customer service that she would sent my claim for review. It's March 22, 2024, and I got another bill. The doctor's ****** didn't do a squat and customer service told me to go pound dirt. Not a good business when it comes to ****** personnel or customer service but wonderful doctors. Adjust the claim. I went to get my annual blood work and not get diagnosed.

  Business response

  04/01/2024

  Please see the attached response.

   

  Thank you,

  ***************************

• Initial Complaint

  12/07/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I had a cesaran on April 21,2021. I was fully insured and my child was covered under my Insurance. My sons health was great after birth and we were both released two days later. 4 months after my sons birth I received a bill for him for over $5,500. There was no listing of the services done. When I tried to get a break down of what the bill covered, no one could ever give them to me. Then I was sent to collections and the I only description I was told was complications after birth. I spoke to many people at baycare, always going higher up and everyone told me the bill was not valid and they would handle it. Here I am 2.5 years later and I still have no breakdown of what the bill is for. No one will help me and its about to go on my credit.

  Business response

  12/08/2023

  A thorough review of the patient's account has been completed.  ********************* was billed under the policy provided by the patient's mother multiple times.  Each claim submission resulted in the insurance company's response stating that the policy did not have coverage for newborns.  The patient was provided with a network discount and the balance due is correct.  Statements for the balance due were sent to the patient's mother/guarantor on 10/26/21, 12/23/21, 2/6/22, 4/29/22, 5/20/22. and 7/4/22.  Collection Letters were sent to the patient's mother (guarantor) on 4/7/22 and 9/2/22.  Itemized bills listing all services being billed to the insurance were provided to patient's mother/guarantor on 4/26/21 and 1/5/22.  Every effort was made to resolve but a payment was never received from the patient's mother (guarantor) resulting in the account being referred to a collection agency.  Guarantor was advised to initiate a 3 way call between her, her insurance and BayCare, however, that call was never received by BayCare.

  Sincerely,

  BayCare Central Business Office

• Initial Complaint

  05/09/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Fraud at its finest. I went for an annual routine visit which is covered 100% by insurance, just to receive a bill. The coding department added a fraudulent office visit line item stating that we discussed things outside of the normal routine visit which is completely inaccurate and fraudulent. The notes in my patient portal reflect that, and have literally been copied and pasted the same notes for the last 3 years (3 routine visits). I have been trying to get this resolved for months but my emails are going unanswered, people who are supposed to follow up with me are not, and they are just avoiding fixing my issue because they know they messed up.They are preying on innocent people and capitalizing at the expensive of their patients. This is what scumbag healthcare institutions do.I need my bill corrected. They are sending me messages telling me my bill is past due but cannot assist to fix my issue. FRAUD AND THEFT at its finest.

  Business response

  05/10/2023

  Good morning,

  Please see the attached response letter and let me know if I can be of any further assistance.

  Thank you.

  Customer response

  05/10/2023

   
  Complaint: 20036530
  
  I am rejecting this response because:

  I received the information of the audit stating that things were discussed outside of my annual visit and that is exactly what I am disputing. That they were NOT. So yes, mistakes do happen. This mistake is on the coding team and Baycare. I want a detailed description of the last 2 physicals with all notes in the chart and how they have been coded (how this last annual was coded versed last years visit). I want a detailed explanation of WHAT was discussed that prompted this bill (what was outside of this physical). I am still waiting for a follow up from the clinical manager. No one has reached out to me. I want very clear specifics, that no one is providing to me. This is because it is INCORRECT. 

  
  Sincerely,
  
  ***********************************

  Business response

  05/12/2023

  Good afternoon,

  Please see the attached response and let me know if you have any questions.

  Thank you,

  ***************************

  Customer response

  05/15/2023

   
  Complaint: 20036530
  
  I am rejecting this response because:

   

  I have submitted the quality of care form on April 27th and no one has reviewed anything or helped me with a single thing. I was promised follow *** with people and nothing has been done. No one is giving any information because they know it is fraud. I have attached proof.
  
  Sincerely,
  
  ***********************************

  Business response

  05/24/2023

  Please see the attached response.

  Thanks.

• Initial Complaint

  03/02/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  After not being to the doctor in many years - I decided to get a physical and make sure nothing is horribly wrong. 100% preventative care visit.Had my first visit on Nov 4th. All that was done was scheduling blood work, colonoscopy and an EKG. Blood work was completed Nov 11th.Had a follow up Jan 5th to discuss blood work results.The office is making up false claims that this follow up for my bloodwork isn't preventative care and is instead an office visit. I'm being charged money out of pocket that should 100% be under my insurance as preventative care.

  Business response

  03/13/2023

  Good Morning,

  We are currently reviewing the billing and coding for the *** (11/4/22 and 1/5/23) in question. We will provide a response once this is complete. Thank you for bringing this concern to our attention.

  Thank you,

  ******************

  Customer response

  03/24/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *************************

• Initial Complaint

  11/18/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I received a letter from MBA Law to collect a debt for my daughter's medical bill that I was unaware I owed. I called MBA Law to pay, but they would not take the payment stating the file was inactive. I just received the letter from them this week. I tried to call Baycare at the phone number on their billing webpage at **********, and it just rings busy. I am very upset that this could affect my daughter's credit rating. She is on my insurance and was only 19 years old when the service took place.

  Business response

  12/01/2022

  We have reviewed this account and see that there are 2 charges that have been sent to collections.  Our records do show that several statements were emailed to the patient prior to the account being sent to collections. We are investigating our options to help resolve this favorably and will follow up again soon. We appreciate that this issue was brought to our attention.

• Initial Complaint

  10/18/2021

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  I took my son to the doctor on 7/29/2021 and paid a copay of $40.00. Well, I received an email saying I have a past due balance of $40.00. I called customer service numerous of times and was told to email my bank statement. I emailed my bank statement on 10/12/2021 showing the $40.00 charge deducted from my bank account. I have not heard from Baycare. If I have to pay this charge, I will be disputing the 7/29/2021 charge of $40.00 that was deducted from my account, and my family will not be going to another Baycare again.

  Business response

  11/17/2021

  Business Response /* (1000, 6, 2021/10/21) */ Contact Name and Title: Dan O. Contact Phone: ********** Contact Email: ********************@baycare.org Thank you for the opportunity to clarify the situation with this customer. We reviewed and investigated, and found that the payment made was for a different service than the disputed charge. We communicated this to our customer, and she indicated that she was satisfied with the resolution. Please let us know if we can be of additional assistance.

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