ComplaintsforGuidewell Emergency Medicine Doctors, LLC

• Initial Complaint

  07/16/2024

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  Went to Guidwell on January 22nd 2024 for a allergic reaction. Was told my bill would X thousand dollars, and when asking for a breakdown - told me it was not possible. After being given a simple saline and some benadryl, i received my bill noticing that i was charged for x2 the amount of items (overcharged). I requested to have this reviewed, telling me - there was issues with the billing department and it would take a couple months. Fast forward to March where i went in person to talk to ****** at the office is confirmed there was an issue with the bill - and she would take matters back to corporate accounting. I call **** ***** **** ****** who confirm there are 'odd' charge codes being put and multiple different ones were being 'tried' with mistakes in them. Fast forward to July - still no answer - and everytime i go into the office no one is available to speak. I have enlisted the help of a health advocate who has been calling every week since March asking for updates - and each time its 'billing deparetment is having issues'. Its been close to 7 months with no corrective action - not a single response from anyone in billing.

  Customer response

  07/16/2024

  ***** form signed.

  Business response

  07/19/2024

  Thank you for reaching out and providing us an opportunity to review your feedback, ****. In February, Change Healthcare, the third-party vendor we use for coding and billing, experienced a cyber security breach which is continuing to cause widespread impacts to their operations. In order to protect our patients’ information, we made the decision to cease communications with Change Healthcare’s systems which did create impacts to our ability to provide patient statements and confirm past claims that had been submitted to payers. We know that accuracy and timely billing processes are important to our patients and understand your frustration with the billing interruptions we are currently experiencing with our Coding and Billing vendor.
  
  To ensure your concern is addressed, our ******** ******** has coordinated with our Director of ******* ***** to confirm your benefits and the claims filed as well as the accuracy of all charges as they applied to your deductible, and she will be reaching out to you to review. If you do not hear from her or have any further questions, please reach out to us directly at ***************************. We apologize for any inconvenience experienced and thank you for your patience and understanding.
  

• Initial Complaint

  05/28/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  see Attached document
  
  

  Customer response

  05/29/2024

  Gentlemen and Ladies:

   

  The business involved in this complaint, Guidewell Emergency Services, settled my issue regarding my spouse's treatment at their *****, ** facility this past December. Guidewell, by phone, fully refunded the co-pay that was charged for this treatment as a credit on my ****** **** in the amount of $959.00.

   

  Therefore, this complaint can now be closed.  If needed, I will contact my local Better Business Bureau in the future. Thank you very much!

   

  Sincerely,

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

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

  *****, ** *****

  ***** ***-**** - cell

  e-mail:

• Initial Complaint

  04/23/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  My daughter, who is covered under my insurance, visited Guidewell Medical Clinic for an urgent care visit on 1/29/24 in Tampa, Florida. She presented her insurance card and she was charged a total of $560 dollars in two charges ($130 and $430) the day of her visit. When I received the EOB from my insurance company, it says we were only responsible to pay $163.84. The clinic says we need to contact their billing department, gave us the number and said "Good Luck". Come to find out their billing is handled by Change Health and the phone number states that they are closed due to the obvious data breach. There needs to be a better response and a process for getting help with billing issues. How do I get my refund of nearly $400, as Change Health will likely never come back?

  Business response

  04/26/2024

  Thank you for reaching out regarding your daughter’s visit. We know that accuracy and transparency with billing processes are important to our patients and understand your frustration with the billing interruptions we are currently experiencing with our Coding and Billing vendor. While we cannot access Change Healthcare’s systems at this time, we will be initiating an internal investigation and will reach out to your daughter directly to discuss any findings and arrange a refund if indicated. If she has any further questions, please have her contact us directly at [email protected] so that we can quickly assist. Thank you for providing us an opportunity to resolve this issue.

• Initial Complaint

  04/17/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I went to Guidewell in October 2023. My first complaint is that they charged $1200 for 5 min with a doctor which seems excessive. With that said, when I was referred to Guidewell, I thought it was a walk-in clinic, but have learned since that it’s more like a replacement for going to the emergency room. Even so, I ended up in the hospital ER after and the charge for a doctor there was less expensive. But the issue now is…I’ve been unable to pay my bill because their website is down each time I go to pay my bill. I called the phone number instead to pay via phone and it’s disconnected. I’m concerned about this going on my credit report. How is anyone supposed to pay their bill??

  Business response

  04/30/2024

  Thank you for reaching out and providing this feedback, ******. In February, Change Healthcare, the third-party vendor we use for coding and billing, experienced a cyber security breach which is continuing to cause widespread impacts to their operations. In order to protect our patients’ information, we made the decision to cease communication with Change Healthcare’s systems until the threat has been fully addressed. We do not currently have an estimate on when normal billing operations will resume but can assure you our leadership team is actively monitoring the situation and looking for ways to minimize negative impacts to our patients. At this time we are unable to view balances or accept payments for past visits, but we can confirm that all billing and collections activity for current and past-due accounts has been temporarily paused. No current accounts will be reported as past due or forwarded for collections until after normal operations resume and patients have had an opportunity to make a payment on their account. We apologize for any inconvenience experienced and thank you for your patience and understanding. If you have any further questions you can reach us directly at **********.

• Initial Complaint

  03/20/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I visited their office on ******** *** in ***** ** on ********. I paid $*** upfront which is their standard to be seen. I was seen for my ailment and told I would need to pay an additional **** to which I agreed. So I paid them (with bank statements to prove it) $*** total. They only sent the first charge through my insurance, they never sent the 2nd charge which would be coded as a “procedure” charge (meaning I don’t get any credit toward paying the **** for my deductible) I realized when my health insurance statement came. I called Guidewell, was connected to someone in Jacksonville who told me their billing department is down and has been for weeks. I asked when it would be back up and he said he hoped this last week. I asked him for my invoice at least so I could manually send it to my health insurance provider for credit and he said he would “try to put the request through” that was a week ago from today and I’ve received nothing.

  Business response

  03/22/2024

  
  Thank you for your feedback, ********. In February **** ****** **********, the third-party vendor we use for all of our coding and billing, experienced a cyber security breach which caused widespread impacts to their operations. Guidewell Emergency Doctors was informed that our patient information does not appear to be included in or affected by the breach. However, in an abundance of caution and to protect our patient’s information, we made the decision to cease communication with ****** **********’s systems. There is not currently an estimate on when normal billing operations will resume, but our leadership team is actively monitoring the situation and looking for ways to minimize negative impacts to our patients.
  
  In the meantime, we have contacted your insurance carrier directly to ensure the claims for your visit have been processed and confirm any patient responsibility is accurately reflected. Based on the completed claims, your patient responsibility is $*** which was paid at the time of service. We will be issuing a refund for the additional **** that was collected during your visit. Our Facility Director will be contacting you directly to arrange the refund. If you do not hear from our office within 2 business days or have any further questions, please reach out to us at ************ or by email at [email protected].
  
  We apologize for any inconvenience experienced and thank you for your patience and understanding.

• Initial Complaint

  03/19/2024

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  The nature of this dispute is they aren't filing any insurance claims and cannot provide the patient with a detailed receipt with services rendered. I've called Guide * ** * times this week asking when they are submitting the claim, and the answer is the same: they cannot bill any insurance right now because the billing department is down. I was offered the billing department's phone number, which I called, and the number was disconnected. This is now occurred for over * weeks. I had to pay the bill because there was a deductible. Guidewell caused me to pay more than my deductible due to them not billing the insurance. The doctors were great. It's the billing department with the issues.

  Business response

  03/22/2024

  Thank you for your feedback, ******* In February **** Change Healthcare, the third-party vendor we use for all of our coding and billing, experienced a cyber security breach which caused widespread impacts to their operations. Guidewell Emergency Doctors was informed that our patient information does not appear to be included in or affected by the breach. However, in an abundance of caution and to protect our patient’s information, we made the decision to cease communication with Change Healthcare’s systems. There is not currently an estimate on when normal billing operations will resume, but our leadership team is actively monitoring the situation and looking for ways to minimize negative impacts to our patients.
  
  We understand that this billing interruption is frustrating and are committed to finding alternative solutions to continue servicing our patients. Because we require access to Change Healthcare’s systems to provide itemized receipts, we cannot offer a detailed bill for your visit. However, we were able to confirm that your most recent visit’s claims were submitted and payment was issued on November ** ***** You should be able to obtain an explanation of benefits from your insurance carrier that will include the details of your claims and any payments for your records. If you have any further questions or need assistance with obtaining the claim number for your visit, please contact us directly at *******i********************   
  
  We apologize for any inconvenience experienced and thank you for your patience and understanding.

  Customer response

  03/26/2024

  This complaint is for my son ****** ******* who was seen on March **, ****. The insurance has still not been billed.

  Customer response

  03/27/2024

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

   Complaint: ********

  I am rejecting this response because:This complaint is for my son ****** ******* who was seen on March **, ****. The insurance has still not been billed.

  Regards,

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

  Business response

  04/01/2024

  Thank you for the additional feedback, ******* We were able to review ******** records and confirmed that his visit occurred around the time that billing operations were paused, which did cause a delay in filing the claims for his recent visit. We understand that the delayed filing of claims impacts our patients and are committed to resuming billing functions as quickly as possible. While we cannot submit the claims to your insurance until billing operations resume, our Facility Director has confirmed benefits and will be reaching out to you directly to review the account and determine if any overpayment occurred so that you can be issued a refund as appropriate. If you have any further questions or do not hear from our Facility Director, please email us at *******i****************com so that we can assist.
  

  Customer response

  04/08/2024

  I was contacted by Guidewell and they are still unable to bill my insurance or print an invoice. Guidewell states this is all due to a cyberattack that occured weeks ago. 

• Initial Complaint

  05/06/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I visit guide well emergency doctors in Winter Park Florida on December 12, 2021 they have build my insurance my insurance denied the claim because they have requested more information from the Guide well .but the Guide well has not released any information. I have called Guide well with Insurance company on the phone with me. My insurance company advice guide well that we needed more information from them before payment will be made .guide well has not released any information to my Insurance company .I am still being billed my insurance have gave me a letter stating that I owe zero amount due to the fact that Guidewell not release additional information. I have called them again .now Guide well is trying to say it’s still my fault and I explain to them the letter that I receive from my insurance company stating I have a zero balance due to the fact that guide well will not release additional information to them . Now Guide well is saying it’s my fault because I have secondary insurance that’s why my insurance denied the claim .I do not have secondary insurance I have called Blue Cross and Blue Shield again they denied that . And stated that guide well is not releasing the information that they are requesting and that’s why they have not released a payment to guide well

  Business response

  05/23/2022

  Good morning Ms. ********,
  
  I understand that deciphering an Explanation of Benefits can be challenging for patients.  This letter is to inform you that we have reviewed the account and present the following facts:
  
  1. Ms. ****** was seen on 12/12/21 in our Guidewell Emergency Medical Doctors in our Winter Park location.
  2. Ms. ******’s claim was denied by Florida Blue because of what they deemed as a coordinate of benefits issue.
  3. Ms. ****** called our Customer Service line twice in an attempt to resolve this issue.  No record of having a payer representative on the line.
  4. On her second call on 5/6, she was able to provide Customer Service with the information necessary to refile the claim.  At that time she was told that the claim would be resubmitted for payment and a request was sent to our Accounts Receivable team to review and resubmit.  This appears to be the same day she filed a complaint with your office.
  5. At no time did Ms. ****** receive a billing statement requesting payment for this denied claim.
  6. Ms. ******’s claim was reviewed and resubmitted to Florida Blue for payment on 5/20.
  

  
  

  Business response

  05/24/2022

  Hello - I have instructed our billing and operating manager to administratively adjust the expenses associated with Ms. ******'s visit to a zero balance.  We hope this resolves the issue and that Ms. ****** would consider returning to us for care in the future.  We strive to provide a high level of care at a fraction of the cost and time of the emergency room.  Your health and well-being is important to us, as well as your experience at our GuideWell Emergency Doctors.

  Respectfully, 

  ***** *****, Sr. Director, GuideWell Health

   

  Customer response

  05/25/2022

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]

  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. Thank you so much for your understanding 

  Regards,

  ***** ******

   

• Initial Complaint

  03/14/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I received a COVID (PCR) test in September, 2021. Guidewell informed me that there was no charge to me and the test was covered by my insurance. Additional services were offered, but denied. I was billed for an in patient exam that wasn’t authorized nor did it take place. I contacted Guidewell twice regarding the bill, as well my insurance company. Guidewell informed me that they had made an error and would correct the billing code during the initial contact. After receiving another bill, I again contacted the billing department and was informed that the notes to change the code were on the account, but the corrections hadn’t been made yet. I was told that the corrections would be input and my account was being put in a hold status as to not generate additional bills until the matter was resolved. I received a letter, dated March 2nd, 2022 from transworld informing me that my account was in collections. This company is attempting to fraud the public and take advantage of people in an already vulnerable position due to the public health crisis.

  Business response

  03/23/2022

  Good day.  The attached is in response to the subject Reference ID.

   

  Please feel free to reach out with any questions or concerns.

• Initial Complaint

  02/23/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I visited one of the Tampa GuideWell clinics for a covid consultation. I tested positive but had no symptoms. They suggested the monoclonal treatment and assured me that my only expense would e $130 deductible. I asked what my insurance would be billed for and they assured me that insurance would cover the visit due to the urgency of the virus. They billed my insurance $3,900 , $1,200 for the actual infusion, $1,500 for a Trigger Code ??? No idea what that is. $1,200 for the actual office visit. My insurance covered $2,275, and my copay was $130. $2,405 that has been paid, is more than enough for the covid infusion I received. Their engaged in deceptive pricing practices.

  Business response

  03/25/2022

  From: **** ***** <*************************>
  Sent: Friday, March 25, 2022 9:00 AM
  To: Info <*****************>
  Subject: FW: Answer to Complain ID ********

   

  Good morning,

   

  Please see unencrypted answer as per your request.

   

  Thank you,

  **** *****

   

  From: **** *****
  Sent: Thursday, March 24, 2022 18:06
  To: *****************
   Subject: Answer to Complain ID ******** - Secure

   

  Ms. *******

   

  I understand that deciphering an Explanation of Benefits can be challenging for patients.  This letter is to inform you that we have reviewed the account and present the following facts:

   

  1. Mr. ***** was seen on 12/15/21 in our Guidewell Emergency Medical Doctors North Tampa facility for an office visit and infusion therapy.
  2. Mr. *****’ total charges for this visit = $3,900
  3. Cigna adjusted these charges by $2,275 which left a balance of $1,625 (total allowed amount)
  4. Cigna applied the entire balance ($1,625) to Mr. *****’ deductible as patient responsibility
  5. Mr. ***** paid $130 at the time of service leaving an outstanding patient balance of $1,495

   

  The coding was reviewed and found to be correct.  The charges associated with this visit are accurate and in accordance with our contract with Cigna.  There is no further action warranted on our part.

   

  Mr. ***** has an outstanding patient balance of $1,495.  Timely payment would be appreciated.  Mr. ***** can call our billing & collection customer service line at ************ to review his statement as his convenience.

  
  Please let me know if you need additional information.

   

  Respectfully,

  **** *****

  Guidewell Emergency Medical Doctors

   

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