ComplaintsforPhysicians' Clinic of Iowa, PC

• Initial Complaint

  05/03/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On February 2nd, 2022, our daughter's primary care physician noticed that one of out daughter's ear tubes had not fallen out. They are supposed to fall out after a few years. She recommended we go to Physician's Clinic of Iowa's (******** department to see if they could remove it. On February 2nd, ************************** team at PCI recommended our daughter have surgery to have it removed. They said someone with their billing team would follow up to discuss costs. They sent us a letter advising of the procedure but did not follow up, so we called them the week of March 21st. The billing representative said we would need to pay $1137 prior to the surgery for it to go forth, and when we asked for a payment plan, she asked, "Is this a 'waiting for payday' thing?" in a tone that suggested we should be ashamed to be living paycheck to paycheck and not to have $1137 at immediate disposal. She did not say there were any other costs involved in the surgery--just the $1137. I said I needed to talk it over with my wife, and did so. My wife called them back later that week and spoke to the same billing representative. My wife asked to confirm that they do not offer payment plans, and the billing person repeated the snide comment about needing a payday. We paid the $1137--the doctor's ****** did not send us a **** summarizing costs and insurance payments. On April 1st, we had the surgery done at ************** Iowa, which is next to PCI and at which PCI physicians have visiting privileges. PCI recommended we have it done there. ************** did not advise of any other payments due. Then, on April 28th, we received a **** from ************** Iowa for over $1300. I called PCI to ask about the $1300, and to tell me when they had told us we would be receiving multiple bills for the procedure, and that we might have made a different decision about an elective surgery had we known it would cost more than $2000. The billing team was not sure they advised us there would be another ****.

  Business response

  05/11/2022

  
  Re:   Customer Complaint # *******************
  Chain of events:
  2/21/22               Patient was seen by rendering provider at that time provider made surgery referral
  2/24/22               Request was sent to the Financial Counselor to create the estimate for surgery that was scheduled for 4/1/22
  3/16/22               Preservice estimate created and mailed to patients parents (see attached)
  3/21/22               Complainant called office inquired if there was an option for a payment plan for the prepayment that was due.  He was advised at that time that preservice payments are due in full and if it was a matter of needing to wait until his payday to make the payment that would be fine.   Complainant requested the Financial Counselor reach out to him on Friday of the same week. 
  3/23/2022           Complainants wife called office and paid in full the prepayment of $1,137.00 and a receipt was mailed.
  4/1/2022             Procedure was performed at ***************
  4/5/2022             Billed to insurance
  4/14/2022           Insurance paid assessing $997.50 toward the deductible of the patient.
  5/2/22                  Overage from prepayment refunded to patient in the amount of $139.50.
  
  Response
  It is the policy of Physicians Clinic of Iowa PC to collect in full any anticipated out of pocket cost related to PCI providers portion of the elective procedures.  Per the cover letter this payment is due 10 days prior to services being rendered to the patient. Our follow up on payment happens 10 days prior to procedure with phone attempts to secure payment.  On the same cover letter in paragraph four it states services preformed outside of PCI as follows; If your services are not being rendered at PCI, you may wish to contact the facility to learn about their payment policies.  Here are their phone numbers for your convenience.  Facilities and phone numbers provided.  As you will also see on page three of the estimate mailing there is information indicating that fees will be assessed by the facility and anesthesiologist and the information needed to obtain pricing from those entities.
  Per the concern that the providers office did not send a **** summarizing charges of the for the procedure, that information is provided on the estimate of patient responsibility as well as the patient does receive an explanation of benefits from their insurance company explaining what they paid and what the patient responsibility amount would be.  In addition to these two methods PCI will provide an itemized accounting of the procedure should the patient request it.Since there was a credit balance after the prepayment no statement generated.
  The Financial Counselor who handled the conversations with Mr. and ******************* at no time inferred or intended for any part of the discussion to shame the parents.  It is not unusual for the financial counseling team to work with patients regarding timing of payment due which revolve around pay periods.  We work diligently with patients to arrange payment when it fits best within their budget keeping in mind that full prepayment is due prior to procedure date.   
  
  Settlement
  Regarding the desired settlement of the matter PCI makes every attempt to inform patients on billing aspects of the procedure as supported by the copy of the information sent to the Complainant.  As for the refund the patient responsibility amount has been applied to the balance and the overage has been refunded to patient.  

  Customer response

  05/11/2022

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

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