ComplaintsforFreeman Health System

• Initial Complaint

  04/25/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On 7/7/2023 we took my son, *************************, to Freeman ************* ********* to be treated for ear pain. After a quick consultation, he was was diagnosed with an ear infection and prescribed ear drops. While we were there, the staff checked our health insurance with ********** Blue Shield and told us that the appointment would cost $92, which is the same as we've paid in previous visits to this urgent care facility. We paid that amount in person on the day of service. A little over a month later, we received a bill from Freeman stating that we owed an additional $222.04, bringing our total to $314.04. I immediately called and spoke with someone in the billing department to find out why we were being charged an amount that was so much different than what was quoted when we were there. The person I spoke with agreed that it was strange and said she would submit it for additional review. Since then, I've never received any explanation for the discrepancy, and continue to receive bills for the visit every month. My Explanation of Benefits from my insurance provider lists the line item for the visit as "Medical Emergency Room" instead of urgent care, which leads me to believe that the visit was mistakenly coded incorrectly. I have called, left voicemails, and sent email messages to Freeman asking for an update or explanation, but have not received one. I request that they either: (1) correct the billing mistake and charge the original amount we were quoted; or (2) provide a detailed written explanation of the reason for the change to the billing amount. The billing account number is ************.

  Business response

  05/01/2024

  May 1, 2024
  
  
  Dispute *********************
  Better Business Bureau
  Complaint No.: 21624665     
  Complaint Filed: 4/25/24        
  
  
  Dear Sir/Madam,
  
  Freeman Health System is in response to the above-mentioned complaint 21624665.  Please know that Freeman strives to meet our patientsneeds by providing the best care possible to our community.
  
  Payment and benefits are determined by a patients health insurance. This patients benefits do not include a copay for urgent care services. Insurance has applied the stated out of pocket amount of $314.04 to patients annual deductible. The amount paid at the time of the visit was a deposit amount collected towards the patients out-of-pocket expense. Due to insurance benefits, we were unable to determine what insurance would deem as patient out of pocket at time of visit.
  
  We regret that communication has not been satisfactory regarding the patients *********** visit on 7/7/23 and we are sympathetic that the patient did not understand their benefits prior to care. Freeman *********** locations do fall under EMTALA communication of patient responsibility prior to medical screen and stabilization is not permitted.
  
  Freeman is unable to reduce benefits applied by health insurance. Freeman does apologize for any confusion regarding the amount collected at time of service. Due to Freemans contractual obligation with patients insurance, we feel that this inquiry is resolved.
  
  
  
  Sincerely,
  
  ***********************, RN- Patient Safety Representative
  Patient Relations
  Freeman Health System
  ************

  Customer response

  05/01/2024

  Complaint: 21624665
  
  I am rejecting this response because:

  Hi, thank you for your prompt response. I'm not satisfied with your response because you did not address my questions about why this visit was billed at a higher rate than previous visits (we have visited this urgent care location multiple times in the past and have always been billed less than $100) and why the line item for the service is listed as "medical emergency room" rather than urgent care. I'm also requesting that you provide me with the *** code that was used and the reason for using it.  

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

  Business response

  05/03/2024

  Regarding Complaint 21624665

  In response to the question regarding the code used for billing, 0456 *********** was used, and I have attached a copy.  In addition, please also note that patient used different insurance on previous visits. I have also attached the Explanation of Benefits that patient should have received from his insurance company which shows how the claim was processed, leaving $314.04 to his deductible. Freeman Health System continues to encourage ************** to contact his insurance provider with questions regarding coverage.

   

   

   

  Customer response

  05/06/2024

  Complaint: 21624665
  
  I am rejecting this response because:
  
  Hi, thank you again for your response and for providing additional information. My insurance was different on this visit than on previous visits, but in all cases coverage was a similar plan through ********** Blue Shield. Can you please offer an explanation as to why the amount that was billed increased by so much? Is $338 now the standard price for all visits to your urgent care? 
  

  Also, I don't understand why we were told at the time of the visit that $92 was our copay amount if that was not actually correct. In the past, we've always been told an accurate copay at the time of service. Could you please explain why we were quoted one price then billed something that was more than 3 times higher? 
  
  Sincerely,
  
  *********************

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