ComplaintsforSSM Health St. Louis

• Initial Complaint

  06/26/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On 4/21/23 I had a visit with my ******* Care Physician and SSM keeps trying to bill me as if she is a specialist. I have called and messaged them through My Chart on 6/2/23, 6/14/23, and 6/21/23 and it has not been resolved. They sent me a bill for this date of service before it was even processed with my insurance and my insurance company told me not to pay it. When a second bill was sent I sent them a check in the amount of $30.00, which is what my co-pay is for seeing my primary care physician and included the Explanation of Benefits from my insurance company along with the remittance form. I was told by the insurance company that SSM would have received an Explanation of Payment. I also called and messaged them again through My Chart. Now someone decided to re-submit all the claims again to **** on 6/2/23. In the meantime I had an urgent care visit on 5/27/23 and because they re-submitted all the previous claims it was applied to the wrong bill. I have called again to try and have the payment put where it belongs but I don't know how long that will take to correct their many mistakes.

  SSM Health - Medical Group
  PO Box 955978
  St. Louis *********

  Customer response

  07/05/2023

  I had to call again and finally got to someone who knew what they were doing.  Because they decided to re-submit all of my claims to **** Insurance she could not apply my co-pay to that visit yet but she took the $30.00 payment off of the ** visit in May and it is now there as a credit balance (anyway that is what she tells me). I was told by **** Insurance that if I received by Explanation of Benefits then they would have received their Explanation of Payment and there would have been no reason for them to re-submit the claims.  I can't really see the credit when I look in My Chart but I did take her name and hopefully if I have any further issues I will ask to speak with her.  SSM really needs to improve their billing system, it is too frustrating for patients.  Thank you for your help on this matter.

• Initial Complaint

  06/15/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  On April 6, 2023 I had a Wellness visit with my doctor, Dr. ******** *******. The visit is covered 100% by my insurance. When I was asked by the doctor how I was, I told him by elbow had been hurting and had a small knot on it. He said he didn't know what it was but if it bothered me more he would order an x-ray. I received a bill for my visit stating that because I asked about my elbow it was considered a regular appointment in addition to my wellness visit and was charged a $74.50 copay. I don't believe I should have been charged an appointment fee because no one told me that if I responded other than OK to the doctor I was going to be charged. He provided no extra care to me or provided treatment, he didn't even know what it was. I spoke with SSM and they reviewed the case and sent me a letter stating that this was normal business practice for them. I don't believe that charging patients for services they did not receive or not providing accurate information about what constitutes a Wellness visit is normal business practice either. I will pay the amount as I don't want my account turned over to collections, but I want a refund for my copay. I will not be returning to SSM.

  Business response

  06/26/2023

  This correspondence serves and SSM Health's response to Complaint # ********

  Documentation in the medical record states the patient presented for Routine annual preventive exam.  Additionally, significant evaluation and management of acute / chronic conditions were addressed and managed during this visit. The patient had a complete physical exam and discusses and reviewed 4 acute/chronic conditions during the office visit. The patient may go to any SSM Health facility to request a copy of their medical record. The patient also has an active My Chart account and may review the After Visit Summary (AVS) for this date of service which lists the issues that were addressed at the visit. 

  The billed charges are correct for the services provided and the account balance and patient responsibility remains unchanged. No refund will be issued to the consumer. 

  Thank you foe allowing us the opportunity to respond to this complaint. 

  ***** * SSM Health - Patient Financial Services

  Customer response

  07/14/2023

  I did not get any notice stating that SSM had replied to my compliant.  I just checked today to see if there was a response and found that my complaint is closed.  I never had a chance to respond to their comments.  I do have 4 acute diagnosis as she mentioned, but he does not treat me for those, i see other doctors for those diagnosis.  He doesn't prescribe any of my medications or order any blood work.  I don't know how in good faith they can claim that he spent time during our appointment discussing these items other than reading off what diagnosis i have.

• Initial Complaint

  06/13/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  On 3/20/23 ************* (now SSM) contacted me to say that they would no longer honor my payment plan and that I had to choose 1 of 3 options to take care of the balance. I chose to have them send the balance to ************** On April 10 I contacted ************* as I had not received my packet from Commerce. They said the request was sent out late by their office and that I should receive it in about a week. I received the information from ************* several days later. On April 24, I received a billing statement from *************. I contacted ****** by phone and she said that it takes some time for the balance to get transferred to Commerce. 4/26 I spoke with Commerce and confirmed that they had the full balance and that I was to pay them and not *************. I received another statement 5/22 from ************* again showing past due. I messaged them with a copy of my Commerce Statement. 5/26 I received a final notice via **** mail. I contacted billing by phone and spoke with ***** and she said billing couldn't do anything about it and it would have to be escalated to customer service. I have attached proof of my balance with Commerce. I do not owe any payments to *************. I want this resolved immediately and not sent to collections. I have done everything they have asked of me.

  Customer response

  06/14/2023

  ************* Monroe **. I cannot give you the doctor's name as this was a payment plan for several years worth of services. Someone from the billing **** did call me last week to tell me that they were placing my account on hold for now as I provided proof that my balance was now with ************** ************* apparently hasn't sent the balance that they purchased to *************.

  Business response

  08/31/2023

  This correspondence serves as SSM Health's response to Complaint # ******** 

  ************** states she set up a line of credit with ************* for the full balance owed to SSM Health ************* and continued to receive billing statements. Per review of her account, a payment was received from ************* and posted to her account on 6/21/23, leaving a $0 balance. 

  SSM Health acknowledges a issue with posting payments from ************* in a timely manner. At no time was the account  in a collection status and there was no negative impact to the patients credit. 
  

  We apologize for the inconvenience this caused our patient. 

  ************** SSM Health ***************** Services

  Customer response

  09/01/2023

  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

  06/05/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I was put into collections without ever receiving a bill. I tried calling to find out what it was for and they would not help me and would only refer me to the collection agency. I'm sending notice to the collection agency that this isn't my debt since SSM Health billing office could not give me any information about a possible bill. They said they mailed multiple bills, I confirmed my address with them at corporate, and it matches the address at the medical clinic that I gave. I've never received any bills and I want them to withdraw my collections and send me an itemized bill to prove that I do owe money.

  Business response

  06/08/2023

  SSM Health Care bills patients based upon insurance payments and your contractual agreement with your insurance carrier. Your insurance carrier should have sent you an Explanation of Benefits (EOB) for this date of service that explains your out-of-pocket expenses.  
   
  Patient received statements on the following dates. 
   
  •3-23-23 First statement submitted by My Chart paperless billing. (Epic does not show the statement was viewed in MyChart, but an email was sent to email address on file ) 
  •4-20-23 Second statement submitted by My Chart paperless billing (Epic does not show the statement was viewed in MyChart, but an email was sent to email address on file ) 
  •5-18-23 Third statement submitted by My Chart paperless billing (Epic does not show the statement was viewed by MyChart, but an email was sent to email address on file )
  
  I have disabled the paperless billing option for the patient and mailed a paper statement per patient request. 
  
  We apologize for the inconvenience that this might have caused you. We appreciate the opportunity to address your concern. 
  
  
  Sincerely,
   
  
  

• Initial Complaint

  05/19/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have, unfortunately, tried to have mental health services through SSM. One provider, Dr. *********** ********, spent the entire hour, during the initial visit, fat shaming me. He said, "You do not need medication, you need to exercise." Then he said "I do not think you need medication, as most of the antidepressants will make you FATTER." He asked "How much do you weigh? Tell the truth or I will check your chart." I went to this person for help; instead, I left the appointment feeling worse. I have PTSD as a domestic violence survivor. So, I chose an alternate provider, as I knew Dr. ******** was not a fit. I found ***** ****, a Nurse Practitioner in the mental health department. She's not a doctor. She proceeded to ask me strange questions like "Do you work at the Pentagon?". I am no geography whiz, but I am sure the Pentagon is not located in Madison, WI. So, 3 days later, I read her notes. In the notes, she publishes my mental health history to my medical file. She stated that she received verbal consent to do so. I did not and would not provide consent to share my mental health history, nor my current mental health with everyone in the world. She also stated that I was schizophrenic; which is not true. Also, I am not delusional. She put that down because I shared with her that I was in the Navy. I even showed her my military ID. All this stuff are lies. I trusted these people only to have them put me through more trauma than I was already experiencing. I called patient relations several times, only to have no one return my calls. I have read reviews about SSM mental health services. It seems it's a thing that many other patients have experienced, providing them the wrong diagnosis. She also said in her notes that nothing I said had been VERIFIED. I did not realize I had to share receipts when I seek out mental health services. I should have never been treated so poorly; had my personal information shared for all to see.

• Initial Complaint

  03/20/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  They say I had a pr function test on Nov 10th 2022 and a evaluation of bronchospasm on Nov 10th 2022 and a pr co2/membrane diffuse capacity on Nov 10th 2022 the Dr that ordered those tests was ******* ****** from ******** ******** ******* *****  she is a ear nose and throat doctor ssm health is billing me and I never been in there facility I been calling everytime I get a bill and they would tell me that they are working on it

  Business response

  03/28/2023

  The correspondence serves as SSM Health's response to BBB Complaint # ********

  The consumer states he was never seen by a provider at SSM Health and is disputing the validity of the bill. 

  The consumer was seen at **** *** ****** 11/10/2022 and the provider did order Pulmonary testing. The tests require interpretation and were sent to SSM Health provider Dr. ***** *******. The charge from SSM Health is for the interpretation of the tests. This was confirmed with **** ** as a valid test and charge. The consumer may call SSM Health Customer Service to discuss the billing. He is encouraged to call the ordering physician to discuss the results of the study. 

  Thank you for allowing us the opportunity to respond to this complaint. 

  ***** ** SSM Health - Patient Financial Services 

  Customer response

  03/29/2023

  Complaint: ********
  
  I am rejecting this response because: the test went to ******* ****** the ear nose and throat doctor and plus I have Medicare and medicaid and if you want to bill me for something I didn't know about send the bill through my insurance 
  
  
  
  Sincerely,
  
  **** *****

  Customer response

  03/29/2023

  I would like this case to be closed. My insurance has handled the issue and rebilled it so I no longer owe any money.

• Initial Complaint

  02/28/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  In 2021 I was seen by my primary care doctor to get a second opinion on a diagnosis. My primary care doctor referred me to Doctor ******* ******. When I called Dr ******* office to book an appt they told me I needed an MRI first. When I went to tell my primary Dr (** ******) that I needed an MRI, he ordered an MRI based off the other offices requirement however when I called Dr ******* ******* office back they made me aware that they could not see me for my condition, **** ******** ***** *****. The MRI that was supposed to be used to get a second opinion by a specialist was never evaluated by the specialist that ordered it. Now I am being charged $700 for a procedure that should have never been ordered.

  Business response

  03/01/2023

  This correspondence serves as SSM Health's response to BBB Complaint # ********

  The Complainant states he is being billed for an MRI that was ordered by his ****** **** ******/PCP in error . 

  SSM Health completed the MRI as ordered by the patients Primary Care Provider (PCP). The PCP ordered the MRI at the patients request, not at the request of another provider. The patient states" my PCP ordered an MRI based off the other offices (specialist) requirement". That statement is inaccurate. The PCP ordered the MRI at the patients request because the patient states he was told that would be a requirement prior to scheduling an appointment with a specialist/neurologist. The ** of the medical practice reviewed the patients complaint and chart and  stated there is no documentation from the neurology office/neurologist requesting an MRI, and the imaging was appropriate for the symptoms. 

  
  The billed charges are correct for the services provided and the test was completed according to the orders in the medical record. The balance is applied to the patients deductible per his benefits and the balance remains his responsibility.

   

  Thank you for allowing us the opportunity to respond to this complaint. 

   

  ***** ** *** ****** ******* ********* ********** 

   

   

  Customer response

  03/01/2023

  Complaint: ********
  
  I am rejecting this response because:
  
     I was sent by my Primary care doctor to get a 2nd opinion from a neurologist on a condition that has been already known and evaluated by my primary care doctor, two orthopedic specialist and another neurologist.  This condition has been well documented and tested before.  All of this was known by my primary care doctor.  After I voiced dissatisfaction that there wasn’t an answer to fix my condition, my primary care doctor suggested for me to get a second opinion and told me to call Doctor ******* ******.  (All of this should be well documented and if it’s not that’s an even bigger problem. )  However, Dr ******* ******, the doctor who my primary care doctor referred me to doesn’t even see patients for my condition! I should have never been sent there at all.  And when I called to make the appointment Doctor ******* office, they told me to get an MRI.  I then told my primary care doctor and he ordered the MRI to get a second opinion from Dr ******* ******.  And when I called Dr ******* office I found out that his office doesn’t see people for my condition. 
  

  All of this was known by my primary care doctor’s office immediately after I was informed that Dr ****** doesn’t see people for my condition. Every part of this should be well documented as I’ve communicated everything with my doctors office and they suggested for me to go to Dr ******* ******. I did not get a second opinion from anyone and the MRI that was ordered by my primary care doctor for a specialist that doesn’t see people with my condition.  I would never have got an MRI done if my doctor was trying to evaluate my condition after he already did, two other orthopedic specialist and a neurologist.  I also, would never of thought to see another neurologist without his referral.  It was a lost cause to me then & now.  And to say that my ******* would have ordered an MRI just so he could reevaluate something that he and three other specialist confirmed is ridiculous. 

  
  ******** *****

• Initial Complaint

  02/27/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  SSM billing has made several errors in regards to my billing. I spoke to ***** ********** for almost a month back and fourth to get this correct. They had not billed several of my appointments. My balance was 2010.41 after getting these rebilled correctly it brought my total to 782.41. I sent several emails per ***** to his supervisor ***** who never responded until I sent a third email. Then *****'s manager called me and said she would look into it. Again never heard back from her either until I emailed ***** asking for his manager to follow up with me. She was very hostile and refused to do anything to make it right. She refused to pull them out of collections even though I did not sign allowing that and they are violating HIPAA by giving a third party my hospitalization dates and information that again I never signed for, I asked for proof of signature and it was an electronic signature which I confirmed via messages that it was not my signature nor did I electronically sign anything. ***** was so kind and said he was zero out my bills if he could because he saw the mess that he was trying to fix. I am not asking for a zero balance but the past month has been a nightmare because employees did not do their job. I had to do it for them. I also never received a bill ever! Not in my email or via mail. I also sent proof I spoke with a ******* and I was approved for financial assistance in 2019, SSM can not find it but I have our email correspondence. SSM doesn't seem to care and sill refuses to correct this situation.

  Business response

  03/03/2023

  This correspondence serves as SSM Health's response to Complaint No. ******** dated 2/27/23.
  
  The consumer states several dates of service were not correctly billed to her insurance, SSM health violated her HIPAA rights by giving a third party (bad debt agency) hospitalization dates and billing information, and she did not sign any authorization permitting the sharing of information.
  
  Three date of service have been billed to the complainants insurance and are in good standing. Five dates of service are seen in bad debt. The placement with collections is appropriate per SSM Health's billing policy. Signed Consent to Treat is on file. The electronic signatures are associated with Video Visits where the patient would not have been present to sign in person.
  
  Beginning 9/1/209 monthly statements were sent through MyChart to the patients email provided in the BBB complaint. SSM can see the date sent ,the email address and if the statement has been viewed in MyChart. The first statement viewed in MyChart was on 7/22/2022. She received monthly notifications and chose to not view them in My Chart. Patients have to accept an activation code and sign up for My Chart, so they are aware of the choice to receive electronic notifications.
  
  SSM Health has corrected all accounts that can be corrected and retuned the accounts that were sent to collection without being billed to insurance first. The remainder of the accounts are in collections and will remain there.
  
  Thank you for allowing us the opportunity to respond to this complaint.
  
  ***** ** SSM Health Patient Financial Experience

• Initial Complaint

  02/16/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  2/16/23 This is a Summary of Our Horrible Experience with SSM Billing. Customer service request regarding: Billing. Account number: ************. Account type: Physician Billing. We have been on a Payment Plan for a Physicians Bill Everything was fine with our Payment Plan until: 12/29/22-Paid $50 w/ our online bill pay check. 1/5/23 Check Cleared but was Not Applied to our Account 1/18 Spoke to Customer Service/**** and he said we'd get a call from Supervisor. No Call . *Received My Chart email said it was found to have been applied to an account in Oklahoma. 1/20 Customer Service/***** said it was in Review w/ Management and we'd get called. No Call. 1/23 Was told by Customer Service/***** that she was going to a Supervisor. No Call received 1/25 Customer Service/***** said we need to fax front and back of check. We did that. 1/25 Customer Serice/**** confirmed they received the check copy and would inter-office to Missing Payments Dept. 1/31 Customer Service/***** said there was nothing she could do-Manager would call back in 2 hours. No Call. 2/13 Makingthe next payment(last payment still not applied)but don't want to be behind. Made Payment through SSM IVR @7:06 am/Confirmation #******. Was not applied to our account. (Maybe check the Oklahoma Account our first payment went to) 2/14 Customer Service /**** ,once again, said nothing he can do and will get Call Back from Manager. No Call 2/15 Customer Service/***** made the effort to really try to understand. Neither Payment credited to our account. Could not find IVR with Conf.# ******. Said she was going to a Manager and she would call us. I believe the Customer Service reps can't do anything...and are told to say that. Thay are a buffer for those who can. It's been 6 weeks and we have had two Late Notices, but we made the payments! **** *******  Showing 1 of 1

  Business response

  03/01/2023

  This correspondence serves as SSM Health's response to Complaint # ********

  The complainants account has been placed in a "Contested" status while we work to resolve the payment posting issues. One payment has been identified and posted to the correct account. A second payment has been located and is in the process of being received and posted to the correct account. It is expected this will be completed March 3-8. This information has been communicated to the complainant via email communication. Once this is completely resolved and the payments posted, we will communicate this information and remove the "Contested" status from the account. 

  Thank you for allowing the opportunity to respond to this complaint. 

  ***** ** SSM Health Patient Financial Experience 

  Customer response

  03/08/2023

  Complaint: ********
  
  I am rejecting this response because:

  Today is the last day SSM said the missing Oklahoma Payment , from December last year, would be posted. 

  On 2/22 SSM said.

  
  We do show we are waiting for the refund from Oklahoma, which will be sent today and posted between March 3-8th to your account. We are working with Management regarding the phone payment issue posting. Again, we do apologize for this inconvenience you have had with these two payments. We will reach out to you as as we have a resolution.
  
  Patient Financial Experience
  SSM Health Medical Group
  ************ *****************

  As of 6:30pm on 3/8 the missing payment from December of 2022 has Not Been Posted to the account. This has been going on for 3 months!

   
  
  Sincerely,
  
  **** *******

  Business response

  03/22/2023

  SSM Health continues to work to a resolution for the consumer. According the documentation in the account, as of 3/2/23 a status of CONTESTED  has been placed on the account to indicate patient dissatisfaction and the need for follow up. The missing payment of $50 is now expected to be printed and the check expedited overnight on the 29^th of March. Until that happens a $50 customer service adjustment was posted to the account and will only be reversed when the payment is received and posted.

   

  SSM Health does not deny there is an issue with patient payments posting correctly and in a timely manner. Leadership is aware of the issue and working toward an improved process.  We are committed to resolving our patients concern and will continue to follow the account until resolved.

   

  Sincerely,

  ____________________

   

  ***** *****

• Initial Complaint

  02/01/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  We continually receive a bill in the mail for an appointment that took place in July 2022 in the amount of $100. I have spoken with someone at SSM Health 3 times and have mailed copies 3 times of the check in which they cashed, emailed a copy 4 times. I have even faxed them copies so many times I cannot count! Each and EVERY time I'm assured that this is taken care of on their end and it's their mistake and yet they continue to harass us and continue to send past due notices in the mail. I can't call anymore. I can't email anymore. I can't mail anymore as it does NOTHING. They are lazy on their end and will not take care of it. I expect them to stop sending this bill that was paid for and cashed by them back in August. I also expect a written apology in the mail to both myself as well as to the owner of the company.

  Business response

  02/13/2023

  This correspondence serves as SSM Health's response to Complaint # 18963269

   

  A review was completed and it was discovered the payment for date of service 7/20/22 was cashed on 7/21/22 but not posted until 2/13/23. We apologize for the inconvenience this has caused. The account balance is now $0.00. Thank you for allowing us the opportunity to respond to this concern

   

  Sincerely, 

   

  ************** Senior Patient ************************** Experience  SSM Health

  Customer response

  02/13/2023

  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,
  
  ******************** & Propane *********************

*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. ↩