Complaints

The 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:05/23/2023

  Type:Product Issues
  Status:

  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.

  On January 6, 2023 I went in for a unilateral breast ultrasound and was charged 2 line items for the procedure ($220 twice for an amount of $440). I noticed after the procedure that I was charged for the ultrasound twice and called the billing department. I was on hold for 45 minutes and then told this would be submitted to my insurance and refund submitted. A month passes and I get a BILL for $18, when I was expecting a refund check of $220. I call bililng again, wait for another 45 minutes, am assured it will be expedited this time. Fast forward five months later, I have spoken to billing 5 times, emailed back and forth with the billing supervisor and finally got something in the mail that looked like a check yesteday. It was another BILL. I am at my **** end and just want my money back that I am owed. I will never go here again.

  Customer Answer

  Date: 08/02/2023

  ***BBB Has Received Additional Info From Consumer***
  

   

  I have heard from the company but they have not given me a refund to date!  They are still researching.  Unbelievable
  

  Business Response

  Date: 08/14/2023

  This is to confirm we have fully responded and reviewed all aspects of Ms. ********* complaint.
  
  Please be advised it is our policy to collect the patients estimated cost share at the time of service.  The patients benefits are confirmed via an EDI **************** Interchange) process. The information is requested at the time of scheduling and/or at the time of service through a 270 real-time connection to their insurance. Based on their coverage a 271 response is received providing the patients eligibility and out of pocket cost share including Co-payment,Co-Insurance, and/or Deductible.
  
  Patients are notified of their estimated cost share at the time of scheduling services (if scheduled by the patient), if the insurance returns the 271 in a timely fashion during the scheduling process.
  
  After services are complete and the radiology report is finalized,services are coded (***/ICD10) and submitted to the insurance carrier. The explanation of benefits EOB is the source of truth that provides the patient and provider of how the services adjudicated. 
  
  After thorough review of Ms. ********* account, it was found that the incorrect radiology "schedule code" and report template was selected at the time of service resulting in the submission and coding of a bilateral breast ultrasound. It was confirmed with imaging center that patient only had left breast US on date of service in question.

   

  When a template is selected at time of service, it pre-populates the *** and Unit(s) to determine estimated time of service cost to the patient.
  
  Attached is a copy of the patients estimated time of service cost receipt showing 2 units for Breast Ultrasound,which in turn affected the total amount collected from the patient.
  
  In conjunction with the pre-population issue, our coding engine also did not pick up that only one breast US was performed due to 2 units being submitted. This resulted in bilateral ultrasound being billed and processed by her insurance.
  
  Patient contacted our billing office on July 12th 2023 requesting we review the coding of her services. The coding was updated the same day to reflect only one breast ultrasound performed and a refund request was submitted to our *********************** Our refund turnaround is ***** business days once requested.
  
  Attached you will find EOBs from the patients insurance showing the patient responsibility amount owed. Patient paid $459.42 at time of service. Original amount owed after insurance processing was $478.06 due to bilateral breast ultrasounds billed. The correct total patient responsibility owed after removing incorrect breast ultrasound is $352.87.
  
  Patient was refunded on 7/28/2023 in the amount $125.19 that she overpaid. No additional refund is owed to the patient at this time.
  
  We sincerely apologize for any miscommunications in regards to your account status and the delay in getting this resolved in a timely manner.
  
  We are committed to creating a seamless process that promptly escalates patient inquiries through the BBB to the appropriate management or executive levels within our company, tracking such an inquiry through completion.
  This account has been forwarded to members of leadership to provide feedback on avoiding this issue in the future.
  
  We greatly appreciate how you worked with us on this complaint and again apologize for the delay in getting this resolved.
  

   

  Kind Regards,

   

  *******************, RCC

  Quality Assurance Manager

  Customer Answer

  Date: 08/14/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and finally received the refund owed.

  HOWEVER, it was WAY EARLIER that I filed a complaint with them, not July 12.  This BBB complaint itself was filed on 5/23 and that was after multiple attempts to resolve on my own.
  

  thank you for your help.  You can close this 

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