ComplaintsforEncompass Medical Group

• Initial Complaint

  02/17/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  My labs for my physical for 2021 have not been paid due to incorrect code. I know the codes are incorrect because my insurance told me they are incorrect. I've called Encompass numerous times about this issue. My insurance also tried to speak with them and they would not speak to my insurance. The labs were done by ***** ********** I've explained the situation to them and my account is on hold account number is *****************. I thought it would be taken care of due to this also happened in 2020 but they corrected it. They constantly tell me it will be fixed but it never is. They also never call back. Called billing ************ says I'm number 1 in que but no one answers phone I left msg no one called back this was on 2-26-2023. Called office explained situation again was told nurse would call back no one called back this was 2-17-2023. Per insurance this is an easy fix they just need to refile claim with the corrected codes. I will add my physical was done on Oct 19 2021 but my labs were done Sept 17 2021 my physical for 2020 same way labs and actual physical done on separate days. Both times incorrect codes for labs. This year 2023 my physical was done labs were done on same day which is the way I have always had my physical done my whole life. Not sure why Encompass is not calling back and why they are not correcting this error.

  Business response

  04/06/2023

  We received complaint id# ********* regarding *** ******* lab bill from ***** *********** and
  incorrect ICD-10 codes submitted. After careful review of her lab order, speaking with *****
  and review of her insurance carrier when the lab tests were ordered, I do not believe we
  submitted any incorrect diagnosis codes. According to ***** ***********, the codes in *****ion
  went to the patient’s deductible. An adjustment of $871.22 was given as a disallowance from
  the insurance carrier and the patient was billed $82.78. None of the tests in *****ion were ‘not
  covered’.
  While we believe we did not submit incorrect ICD-10 codes, we have asked ***** to client bill
  us the lab tests and Encompass will pay for those.
  As it relates to *** ******* leaving messages that were not returned, according to my notes,
  someone from our billing department left her a message on February 26, 2023 after she called
  earlier in the day. It does not appear that call was returned to us.
  I hope we have taken care of this matter in a way that satisfies *** *******.
  Sincerely,
  ***** ** *******
  

  Customer response

  04/07/2023

  [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.  Just to add this was my yearly physical covered at 100% including my labs as long as Encompass takes care of the charges that ***** claims I owe I am satisfied.

  Regards,
  ****** *******

• Initial Complaint

  01/09/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Found out a few days before a scheduled surgery that I was pregnant and had to cancel. In my paperwork it stated that there would be a $100 charge for cancelation unless you did not have medical clearance due to a health issue. They have billed me the $100. I have contacted the billing office and doctors office for 3 weeks and left multiple messages to see what they need and where I send it to prove the pregnancy and have the charge removed. They will not respond or speak to me. The billing department keeps telling me that I need to speak to the doctors office but the doctors office will not return my calls. I've asked to speak with supervisors at the billing office to see if they can speak to the doctors office and they are also not returning calls. This is terrible business. At least have the decency to speak to someone about the situation. They are going to turn it over to collections if I don't pay but aren't willing to even respond to my calls and questions regarding the charge. It's plain wrong and unethical.

  Business response

  01/25/2023

  This letter is in response to complaint #******** submitted by ***** ********. I had a chance
  to speak to *** ******** as well as review her billing records. *** ******** cancelled an
  appointment for surgery two days prior to the surgery date after finding out she was pregnant.
  *** ******** had signed paperwork stating she would pay the $100 cancellation fee if she
  canceled for any reason other than medical. *** ******** reviewed the phone call attempts
  she made to Encompass Medical Group without resolution to her complaint.
  After speaking to *** ******** and reviewing the medical situation, her balance has been
  adjusted to $0 and there will be no cancellation charges required. I am attaching a copy of the
  receipt of the adjustment indicating she has a $0 balance. I believe this resolves the complaint
  completely.
  Thank you for allowing us to resolve this issue promptly. If you have any further questions
  about the complaint, please reach out as I would be happy to help.

• Initial Complaint

  03/30/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I had lab work done (***) the medical assistant (****** for Dr. **********) that called with the results fraudulently identified herself as a nurse, in which she is a registered medical assistant NOT a nurse. She stated my lab work all came back normal with one exception of low Vitamin D levels. I specifically asked about a few specific things ( as I am a new patient with Encompass- with major health issues and have a team of doctors outside of this office), in which she stated everything WAS FINE. After a visit for an Echocardiogram test with their Independence location; it was brought to my attention that my lab work was REALLY NOT OKAY. There were several results that were of major concern. I called to make a complaint about ****** in which I was met with threats and hostile conversation. I was then denied my medical results of my Echocardiogram and here we are two plus weeks later I am still being denied my results. The office manager nor has anyone else bothered to contact me. Nor will they return any calls from myself or my care team.

  Business response

  04/18/2022

  This letter is in response to the above-referenced complaint, made by Ms. ****** ******. I had an opportunity 
  to review the complaint filed against Dr. ****** office and have also personally spoken with the patient to 
  review the complaint in its entirety. Ms. ****** confirmed she now has all the test results that were ordered by 
  Dr. ****. 
  Ms. ****** stated during our phone conversation for clarification purposes that ****** was not the one who 
  identified herself as a nurse, the receptionist who took the phone call told Ms. ****** that “Dr. **** only has 
  one nurse, ******, who can return phone calls to his patients”. Ms. ****** also let me know that she discovered 
  the lab result discrepancy when retrieving her results from the patient portal, and not a staff member at the 
  Independence location. 
  Lastly, Ms. ****** has asked for all her medical records, which were provided to her so she can find a new 
  physician. The complaint has been resolved and all appropriate results and medical records are in Ms. ******’s 
  possession. 
  If you have questions or concerns, please do not hesitate to contact me.

*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. ↩