ComplaintsforUmass Memorial Medical Center

• Initial Complaint

  06/12/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I received bills from Umass Memorial Health, Guarantor ID *******. The bills are for dates of service Jan. 12 - March 20th. I have consistently made payments. I paid $200 on Feb. 9th, $200 on March 21st, $100 on April 29th and $100. I received a statement on May 18th and set up a payment plan on the UMass Patient Portal for them to take a payment from my card starting May 28th. I checked my card on June 6th and found that they did not take a payment. I called on June 6th and spoke to ******. She confirmed UMass had canceled my payment plan and sent me to collections. I was not notified that my payment plan had been canceled or that I was sent to collections. Also, collections have not contacted me asking for payment. I set up a new payment plan while on the phone on June 6th, which ****** confirmed, and she assured me that my account would be removed from collections. UMass took the payment from my card on June 9th but did not remove me from collections.I would like my account removed from collections immediately and written confirmation of this from UMass.

  Business response

  06/18/2024

  Upon reviewing your account, we found that you had been making regular monthly payments towards your outstanding balances. However, as these balances were not paid in full and you were not on a formal payment plan,after 120 days, your accounts were sent to our collection vendor for further follow-up. This is a standard procedure we follow to ensure timely collection of outstanding balances.
  
  Unfortunately, when you spoke to our **************** representative on 6/5/24, you were misinformed that you had a payment plan and that it had been canceled.  
  
  Our policy at UMass Memorial Health is that our collection vendors do not report debt to credit bureaus, so your good credit standing has not been impacted.
  
  Additionally, we will remove your accounts from collection and add them to your current payment plan. We will mail itemized bills for all open accounts with balances for your review. 
  
  We understand the confusion and frustration you may have experienced and sincerely apologize for any inconvenience. Once you receive your itemized bills, if you have further concerns or questions, please feel free to reach out to me directly.
  
  Thank you.
  ***************************
  Manager **************** Department
  ********************************************* Health
  ****************************************************************************
  ************

  Customer response

  06/20/2024

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

• Initial Complaint

  02/23/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  -12/7/22 I had a vein ablation and phlebotomy surgical procedure to my right leg by Dr. D****** Jones - UMass Vascular Clinic. Leading up to the 12/7/22 surgery I was never verbally informed about a potential DVT complication. - Had 4 additional appointments post-op( 12/15/22, 12/28/22, 1/6/23, 1/9/23) aware of a DVT complication, all follow-up appts were with NPs (Nurse Practitioners). During 12/28/22 appt told by NP some patients get excited so that's how DVT can occur, imaging was not clear, so had to go back on 1/6/23 redo all over again. Put on expensive blood thinner, Eliquis - $170/mo. I requested Billing to waive/refund all charges due to issues with imaging, which I was told they did. However, I never received my copay $45 refunded. -My work time was greatly impacted having to use up to 2 vacation days to account for missing work for postop appointments. -I never got the same response from each of the NPs on how DVT happened. -During my 1/6/23 appointment with a NP, I mentioned that my frustration that Dr. Jones never called or set up any follow-up appointments w/me and never verbally explained before 12/7 of a potential of DVT. NP notified Dr.Jones. Dr. Jones called, said when doing the ablation procedure there can be a blind spot, so this DVT can occur. I asked why he didn’t verbally mention DVT prior to 12/7, he said I perform so many of these procedures I may have missed telling you that. I should’ve recorded the call as he documented the call differently. I followed up commenting on the UMass portal about the call - at no time leading up to 12/7 was DVT mentioned verbally to me. -I feel I did not get proper verbal explanation of DVT before 12/7/22, didn’t receive proper care/explanations, treated unprofessionally on 12/28/22, appointments continued with NPs instead of Dr.Jones, excessive time missed from work, expensive med prescribed. I feel I should be refunded the $45 they were supposed to for 12/28/22 and waive the additional copays billed of $90.

  Business response

  02/23/2023

  Good afternoon, we have placed your account on hold and are sending your complaint for review. As soon as we have a response, we will reach out to you.  Would you prefer the response is communicated through the BBB portal or we can reach out to you through your myChart patient portal. Please let us know your preference.  Thank-you.

  Customer response

  03/15/2023

  
  Complaint: ********
  
  I am rejecting this response because Patient Advocacy Department has not addressed the concerns I had in detail. Please address them. I had to end up going to a new surgeon for better care.
  
  Sincerely,
  
  ********* *****

  Business response

  03/23/2023

  
  Good afternoon. Because the complaint was regarding the care you had received, the complaint was reviewed by our Patient Advocacy Department. They determined that the care was appropriate, and they have advised us, as a result of that review, that it did not warrant a waiver of copays. Outside of that review, we do not have a policy allowing us to waive patient balances. You always have the right to request and access your medical records if you wish to do that. You can request your records through your myChart portal. If you need assistance paying your bill or have any additional billing-related questions, we will gladly assist you in any way we can. If you need further clarification regarding the decision made by our Patient Advocates, please feel free to reach out to them directly. The contact information is below. Thank-you.

      Office of Patient Advocacy
       55 Lake Ave. North
       Worcester MA 01655
  
  Patients can call:  774-442-3701

  Customer response

  03/24/2023

  
  Complaint: ********
  
  I am rejecting this response because: The Patient Advocacy Department has not addressed the concerns I have had in detail, please see my prior correspondence. I have called a couple of times in the past and only received a canned preformatted letter in the mail in the end.

  The Patient Advocate must document in writing to this BBB complaint. 
  
  Sincerely,
  
  ********* *****

• Initial Complaint

  11/22/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  November 21, 2022 I went to UMASS Memorial Medical Center, University Campus. My discharge paper gave me instructions for follow up. one of the instructions was to make an appointment with UNV Gastroenterology. I received their address and phone number. When I called this morning to make an appointment, I was told I could make an appointment without a referral and needed to call my primary care physician. When I called my primary care physician, they said they could not give me a referral since I have a PPO insurance. I called UNV Gastroenterology and was told PPO doesn’t matter I needed a referral. Frustrated a I asked to speak with a supervisor. I was transferred to a supervisor and after being on hold for 15 minutes, I realized I was not on hold but ignore. I then called the ER number, ***-***-****, but that number is constantly busy and cannot get through. I then call UMASS customer service to find out who was running this circus and got nowhere.

  Business response

  12/01/2022

  Thank you for letting us know about this patient's concerns. We have connected with the patient and resolved the issue.

   

  ****** ****, LICSW

  Manager, Office of Patient Advocacy

  UMass Memorial Medical Center

  Customer response

  12/01/2022

   
  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,
  
  ****** ******

• Initial Complaint

  08/03/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My son broke his ankle on 17 June. He was referred to follow up with a specialist. Although the specialist (who is excellent) has an office outside the hospital proper, because it is ON the "campus," the billing office at UMass Medical bills as if my son were an outpatient and receiving care IN the hospital, and it bills the provider as the Medical center. So, what should be a $40 copay proves to be a $550 **** with coinsurance etc. We were charged almost $6300 for my son to walk into a room, have an x-ray, have a cast removed, and see the doctor for follow up. For people who do not have insurance, this would be devastating financially. (See the three separate claims our insurance received, totalling $6256, for one follow up visit.)It is both dishonest and disingenuous of the Medical Center to treat a follow ** in an office--even if it is on campus--as if it were "in hospital." We were charged over $4100 in "surgery" charges alone--misleading nomenclature at best, symptomatic of their deceptive coding policies. While I appreciate the care the doctor provides very much, U Mass should not be sending people to follow up with a specialist without advising them that they will be subject to in-hospital rates should they do so (especially young people who have never navigated the medical system). I fail to see how this coding structure of assigning hospital rates to an office visit (just because it is NEAR the hospital or on the same "campus" ) is not fraud at worst, predatory practice at best. The administration of the hospital obviously has no compunction about employing such a misleading and dishonest structure, but ideally they would modify our charges to reflect the location of services provided more accurately. In general, I hope the BBB will challenge them on this practice, as it will particularly harm those least able to recover financially from such policies.

  Business response

  08/08/2022

  Good Morning, we are in receipt of this complaint and will begin our review.  We will respond once the review is complete. Thank-you

  Business response

  08/11/2022

                  We have reviewed all accounts and dates of service for ******. Because ****** is no longer a minor, we cannot discuss the coding for specific services without his authorization. He can email me at ************************************************* or the **************** manager at ****************************************************** to provide approval.

   

  I want to address your concern regarding ****** receiving both a hospital **** and a physician **** for one service date. When a patient is seen at a hospital outpatient site, you may receive two bills one from the Medical ****** and one from the doctor *********************** Medical Group or other providers).

  The Medical ****** hospital **** includes charges that cover the costs of running the site and tests that you may need. You may need to pay copayments, co-insurance, or deductibles set by your health plan for hospital charges. The doctor's **** covers the charges for your doctor's ***************

   

  This information is on our UMass Memorial Health website at the link below:

  https://*****************/umass-memorial-medical-center/patients-visitors/patient-resources/patient-financial-counseling/hospital-outpatient-site-billing-notice

  There is also a list of our hospital outpatient sites. 

   

  Based on additional review, it appears that your insurance company assigned copayments correctly; however, it seemed that your insurance assigned a co-insurance balance in many instances. We contacted your insurance and spoke to a representative named ***, reference # LVI39003291. *** advised that one of ******" claims had already been sent back for review. We requested that all claims with an outstanding balance be sent back for review. *** advised us to contact them back in 14 days to determine the outcome.

   

  We have moved ******' balances back to ********** until we can confirm the review results. We will be happy to communicate the outcome to you or ****** and assist with any other questions you may have. If there is specific coding you wish us to review, we can also do that for you once we receive authorization from ****** to share any medical information.

• Initial Complaint

  01/31/2022

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  I am being charged 360$ for a doctor's note. I had made a visit to the ER on April 16th 2020 due to having breathing issues, coughing and soar throat.(note this was in the middle of covid pandemic issues.) I was seen by doctor tested for covid and had to wait several hour in the waiting room. Not in a room. Tests ce back negative. I requested results and a doctor's note indicating I can return to work. Unaware to be I was not provided the note with my discharge papers. I realized when I tried to return to work. Required a doctor's note stating I could return. I returned to ER on April 20th 2020. Spoke with Receptionist and Customer Services desk. I was informed I could not get the note. They directed me to Patient Records on the other side of the building. I went to Records only to find they where closed and working from home due to the pandemic. Called and spoke with Records and was told to return to ER. Spoke to Receptionist and they said "Only option is to run you through system and you have to wait for a note." I asked "will I be charged." I was told by the Receptionist on duty "No, we will have it set up in a way to just get you in and out as quick as possible." I reluctantly agreed. 1 hr later I was asked a few questions of my current symptoms. Given a doctors note and left. Few months later I get a call from collections saying I was charged. Hurting my credit. Spoke with Billing they said they will put ot in to review. Few days later got a call from collections again. They never pulled it. Then a few minute later got a call from Umass informing me it was pulled from collec6and will be taken care of. Jan 27th 2022. Got a call from collections for same issue. Messaged Umass billing Informing me that charges will stay and issue is my insurance. I'm being charged for no real medical service. A few questions and a doctor's note. Staff not only did not have yhe correct means to provide a simple doctor's note. I was lead astray by its own employees.

  Business response

  02/16/2022

  Business Response /* (1000, 5, 2022/01/31) */ Good evening, we have reviewed Mr. N**'s account for date of service 4/20/21. Here is what took place: - We billed a claim to his insurance for $362.00 on 5/3/21. - His insurance, Tufts responded that the service was not covered -Mr. N** received 4 billing statements monthly starting in May and ending in August. -we had not received any communication from him and his account was sent to one of our collection vendors for further follow up -on September 28th we received a call from Mr. N**'s significant other to say that she contacted Tufts and Tufts stated we coded the visit incorrectly -we placed the account on hold at that time and sent his account for a clinical review of the coding. the result of that review was to change his primary diagnosis. -we changed the primary diagnosis and resubmitted a claim to his insurance -His insurance responded again and denied the claim stating the visit is not a covered service. _one of our representatives contacted Mr. N** and left a voicemail regarding the insurance response. -Patient messaged us through his patient portal on 1/28/22 disputing the balance is his responsibility. We provided the most recent response we received from his insurance company. - as of today we have removed Mr. N**'s account from our collection vendor. We do not report to credit bureaus so this has had no impact on his credit standing. We have also placed the account on hold. We will be reaching out to his insurance company to see if any additional action can be taken. Additionally, we did an eligibility check and identified that Mr. N** has Partial health Safety Net as a secondary insurance. We will be submitting a claim to the Health Safety Net on his behalf. At this time, he is not responsible for any balance while we conduct a further review. If the patient wishes to speak to someone from our office, he can speak to the Customer Service Manager. Her name is Michelle L****. Her email is ********************************. Her phone number is ***.***.****.

*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. ↩