ComplaintsforExpress Care Urgent Care Centers

• Initial Complaint

  01/05/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My 10 year old daughter was required to obtain a negative COVID 19 test in order to return to school. I scheduled an appointment for her with Express Care Urgent Care in Gambrills, MD for December 21st at 9:12am. While checking in, the front desk asked me for a credit card and said if it was only for a $1 hold and I had to provide it if I wanted her to have the appointment. I confirmed that the appointment was for just a COVID19 test and we would not be charged. She said "yes, it would be covered by insurance." We were seen promptly and they performed a quick q-tip nose swab (not a typical watery-eyed deep nose brain swab). We got our results back in probably 5-7 minutes when a "Dr" came in and gave us a sheet of paper with her negative results. On 1/5/22 I received an email stating that my insurance company would not be covering the bill and I am responsible for $161. My credit card will be charged in 7 days. I called Cigna (insurance company) and they said the bill they received only had a code on it for an urgent care visit, nothing for a COVID 19 test. I was put on hold while Sabrina (insurance rep) called Express Care and spoke with Yolanda in the billing department. Yolanda said they only bill for urgent care and not COVID 19 testing. Sabrina said this should not be happening and she would try to help by doing an adjustment, but it's not guaranteed. Express Care is double dipping. They are getting paid by the insurance company and by their customers. THIS IS UNACCEPTABLE!!! Especially in times likes these and when COVID 19 tests are covered for people.

  

  Business response

  01/13/2022

  Business Response /* (1000, 5, 2022/01/06) */ Thank you for your feedback concerning your experience with ExpressCare. We are committed to providing exceptional care and excellent customer service. We regret to hear that you were unsatisfied with your experience. In reference to your complaint, all patients who present to ExpressCare for COVID testing are also evaluated by our clinical provider. ExpressCare does not simply render tests nor act as a testing site. A medical evaluation including collection of vital signs and a physical exam will accompany all COVID-19 tests administered. In addition, ExpressCare provides counseling regarding isolation, quarantine, etc. depending on the disposition of the patient and their need for a test. ExpressCare bills all encounters for COVID tests to the patient's health insurance. The health insurance is ultimately responsible for determining how the claim is processed in accordance with the member's benefits. ExpressCare bills COVID-19 visits with insurance approved diagnosis codes and modifiers indicating that the visit is COVID-related. ExpressCare is required to bill insurance companies in accordance with our contract. We do not request reimbursement from the insurance company and our patient's. ExpressCare only invoices patients for the amount deemed to be "Member Responsibility" by the insurance company. In the case of this particular carrier, ExpressCare has a global urgent care contract with Cigna. Therefore, we are obligated to bill our contracted fee for all services rendered, including COVID-19 testing. For this visit, ExpressCare billed our contracted code with a COVID-19 diagnosis and a CS modifier requesting the insurance company waive the "cost-sharing" for the visit. Cigna does NOT accept or cover the CPT code for COVID testing as we are contracted to bill a global code ONLY. Despite our coding which clearly indicate that the encounter was COVID-19 related, the insurance carrier processed the claim and forwarded the entire allowed amount of $161 to the patient's deductible instead of waiving the cost-share. As a courtesy, ExpressCare advised the Cigna representative of our contractual obligations and requested they reprocess the claim. As of today (1/6/22), it appears Cigna has reprocessed the patient's claim to pay in full leaving no member responsibility. While the claim is being reprocessed by the payer, the balance has been set back to an insurance balance pending an updated EOB from Cigna. The patient's card on file will NOT be charged and there is no patient responsibility due at this time. Should the insurance carrier decline to reprocess the claim, ExpressCare will attempt to re-file requesting payment in full. We sincerely hope this resolution is to the patient's satisfaction. Should additional information be needed, please feel free to contact our Billing Department at 410-420-6970 ext. 5. Thank you for choosing ExpressCare.

• Initial Complaint

  12/09/2021

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I went to Expresscare of Forest Hill, Md, on January 9, 2021 for medical service. I have ******** and *************************** medical insurance. I assumed that they would bill my insurance. On or about October 1, I received a statement that I owed $342.81. I contacted them by telephone and spoke to "Meeka". I asked her to rebill my insurance company. She spoke to her supervisor and said that it was too long ago. I contacted United Healthcare and they told me that the contract allows rebilling up to one year. Since I received the first notice of nonpayment in October, that was the first time I knew that my insurance did not pay. Since my insurance is willing to pay this bill if Expresscare will rebill, I need your help.

  

  Business response

  12/20/2021

  Business Response /* (1000, 5, 2021/12/10) */ Thank you for taking the time to express your concerns. We regret that you were unsatisfied with your experience as it is our goal to not only provide excellent care but exceptional customer service as well. After careful review of the account, it appears that on the date of service in question, the patient did not provide the appropriate insurance information. In an effort to obtain the Advantage plan information, the patient was sent a bill requesting he verify his insurance. When he contacted ExpressCare, he provided an insurance that traditionally carries a 90 day timely filing limit. At this time, it was determined that the insurance was not provided timely and ExpressCare could not re-file the claim. However, after additional consideration, ExpressCare has opted to update the patient's insurance information and re-file the claim with the appropriate carrier. The patient can disregard any billing statement he has received to date. Once his insurance has processed and adjudicated his claim, he will receive and updated statement if there is any outstanding member liability due. We sincerely hope this resolution is to the patient's satisfaction. Should additional information be required, we encourage the patient to reach out to our Billing Department at 410-420-6970 ext. 5.

• Initial Complaint

  12/06/2021

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I scheduled an appointment with Owings Mills ExpressCare for 12:48pm, and arrived 10 minutes before my appointment time. The MA lady told me to sign in, go back to my car and wait for a text before I could come back in to be seen. I told her I had an appointment she said "we don't do appointments, it's just a reserved spot." That did not make sense but due to the line, I left as she had directed. After waiting for an hour and half, I called and asked how long more. The MA lady told me "it's a first come, first serve, and we don't do appointments." I told her their website said nothing of such and the language was fully in support of scheduling an appointment. Besides why would that option exist if the there are no plans to honor it. She replied "it's cooperate, it's their instructions for us to see patients on a first come first serve." I inquired how long more for me but was told there were 5 other people ahead and "give and take up to 4hours, if you have anything to do you can quickly go and come back." This is in addition to the over hour and half that I have waited. I felt lied to, and disappointed. My foot still hurts sitting in the car.

  

  Business response

  12/20/2021

  Business Response /* (1000, 7, 2021/12/13) */ Thank you for taking the time to express your concerns in regard to your experience. Firstly, I would like to offer my sincerest apologies for the lack of information provided when you brought up your concerns initially with our front desk team. We strive to always provide excellent care and customer service to our patients, so we regret to hear that we were not up to standard. ExpressPass was created to allow patients the opportunity to reserve their places in line ahead of time - which can reduce wait times. Unfortunately, we are unable to guarantee an appointment time with this service. Due to the large demand of COVID-19 testing, clinics may sometimes run behind schedule and can be even further delayed if emergency situations arise. We appreciate your feedback and will absolutely work on clearer communication as we never want you to feel misled, confused, and disappointed. We hope you will allow us the opportunity to serve you again in the future. Thank you for choosing ExpressCare Urgent Care Centers.

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