ComplaintsforUmass Memorial Health-HealthAlliance-Clinton Hospital

• Initial Complaint

  05/13/2022

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  I visited UMass Memorial ******* Hospital - ************************************************************* on 02/09/22, I went to *********** there around 10pm and didn't leave until around 2am. The visit was fine and I left. I got a **** on 03/11/22 for ******. I paid that **** in full on 03/31/22. It pull from my account and cleared successfully. To my surprise on 04/10/22 I got another **** for ********, I noticed some of the charges were on my original ****. I also noticed that my visit was changed from an urgent care visit to an emergency room visit. I tried to contact them by phone multiple times and could never get through to anyone. On 05/10/22 I got another **** for a different amount again. This time the **** is ********. Not one of these bills was mailed to me, it was all emailed to me stating I have new billing in my chart. I log in to my chart and My original **** paid does not exist. The **** I received on 04/10/22 also does not exist. My payment of ****** is not reflected anywhere. There is no receipt nothing. On the **** from 05/10/22 there is a highlighted section that says insurance paid and then you paid and that section reflects ****. Yesterday 05/11/22 I then tried to call the number on the email and that number did not connect me to anyone so I set a message through my chart, asking for a copy of all three bills with a breakdown and a receipt attached to the original **** emailed and mailed to my physical address. I also stated that I would be complaining. The message sent successfully and stated to give them 24/48hrs. I logged in today 05/12/22 to see if there was a response and to my surprise again my message thread was deleted! I am frustrated and want answers because I will not pay this **** until I have the correct information and I don't think it should effect me by going into collections and effecting my credit score when I feel like I am being scammed. I only have my emails because they will not respond to me or provide me with paperwork. Acct # *******.

  Business response

  06/09/2022

  Good afternoon, we have reviewed Ms. ********* complaint. Here is what we found.   She was seen at the ******* Emergency Room on date of service 2/9/22-2/10/22. There were two bills generated for that date of service. The physician **** was $383.00. Her insurance United Health care was billed and they assigned her a cost share amount of $245.59. She received our 20% prompt pay discount which brought her balance to $196.47. She paid this in full as of 3/31/22.  The facility **** was also submitted to her insurance for total charges $2,816.46. United Health Care assigned her a cost share of $1,439.35. She received her first **** with a 20% prompt pay discount for $1,151.48. She did not submit payment within the first billing cycle so the prompt pay discount was removed from her account, bringing the balance back to $1,439.35.  I adjusted her account back down to $1,151.48 to honor the prompt pay discount for her.  All of the billing detail and payment detail should reflect in her myChart account. If she access her home page menu and goes to "Billing Summary" and then chooses "View balance details" she should be able to see her recent payments. If she clicks on the "communications" tab on that same page she should be able to see her statements.  Ms. ******* sent a message to us on 5/11/22 through her myChart. We responded to her on 5/16/22 explaining all of this to her.  

   

  If we can provide any additional information we would be glad to do so.  If payment is submitted in full the prompt pay discount will stay on her account. If she chooses to establish a payment agreement, the account is no longer eligible for the discount.  If she wishes to make payment arrangements, she can contact our ******** Service Supervisor *********************** at ************

  we apologize for any confusion!  

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

   

  Customer response

  06/10/2022

   
  Complaint: 17312797
  
  I am rejecting this response because: my insurance has contacted me and UMass to communicate that "this amount exceeds the patient responsibility for this health care service. Please adjust records so member will not be billed for this amount. Please remember as stated in your participation agreement, you may not **** the member for any charges above the patients responsibility." Also, I am unsure on how you can **** someone separately for the time the doctor was in  the room when the same charges are on the second **** as well. 
  
  Sincerely,
  
  ***************************

  Business response

  06/21/2022

  Good afternoon, based on Ms. *******'s rebuttal, we contacted her payor and spoke to Provider Relations Representative ****, Reference # ****. We were advised that her patient Responsibility is: $1,439.35. Deductible $1,254.41, Co-Insurance $34.94, Co-pay $150.00. This is based on the plan information and benefit at the time of service. **** advised us that Ms. ******* can call member Services if she has questions on the balance and her benefit. As we stated previously, we did honor the prompt pay discount therefore, her current outstanding balance is $1,151.48 for this account.  

  Customer response

  06/21/2022

   
  Complaint: 17312797
  
  I am rejecting this response.
  
  Sincerely,
  
  ***************************

  Business response

  06/22/2022

  Good afternoon, We would be glad to assist MS. ******* in any way that we can. If she wishes, one of my team can contact her and have a conference call with her insurance company if that would be helpful. We are billing her according to the explanation of benefits we received from her insurance company. We would not be able to change that, as it is based on her benefits under her plan. If she is disputing the patient responsibility amount, she can, as her payor suggested, reach out to them with any dispute or questions that she may have. 

  
  Please let us know if we can assist with a three-way call to her payor. We would be glad to do so. We do offer interest-free monthly payment agreements and Financial Assistance. Our Financial Counseling team can help screen her to see if she would be eligible for any financial assistance program. Their direct line is ************, and they are available M-F 8:00 am-4:30 pm. The prompt pay discount would no longer apply if she would like to establish a payment agreement. Her balance would be $1439.35. The plan can be established by contacting our office at ************ M-F 8:00 am-4:30 pm. The plans are very flexible. Our goal is to assist our patients in preventing financial burdens.

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