Complaints

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• Initial Complaint

  Date:08/03/2022

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have been trying to straighten out my invoice with Nazareth since Sept 2021. I was private pay for a portion of my stay at Nazareth. Total stay was 7/8/21 to 9/26/21. I had a break in coverage until my weight bearing status changed, so I was private pay from 8/16/21-8/23/21 (8 days). Was put back on coverage from 8/24/21 until I hit my 100 days on 9/22/21. Then I had 9/23/21-9/26/21 (4 days) on private pay before I finally made it home. Now they are saying my insurance is telling them that I was covered from 7/8-9/15, even though the documentation insurance sent me, papers they've had me sign and I possess, all show the opposite. It had been difficult to straighten out all concerns I had. The issues I have had are on the provided spreadsheet recapping the invoices (enclosure 1): 1) I had signed a "Private Pay Transfer Agreement" stating that private pay started on 8/16/21 (enclosure 3) at the room rate of $333 circled by the social worker. I also have a "Private Pay Transfer Agreement" for 9/23/21 (enclosure 4) - no charges were circled but since the first room charge was $333 and the social worker informed me it would still be $333, I had no reason to assume the amount would be different. My husband witnessed this conversation. The first notice (dated 9/1/21) I received from Nazareth was: Room rate 8/16/21-8/31/21 16 days @ $347 per day - $5552.00 Medical Charges (no details) for 8/30/31 (10 days??) - $140.45 PreBill room charge 9/1/21 - 9/30/21 @ $347 per day - $10,410.00 Total $16,102.45 Several things wrong with this invoice: incorrect room rate, I had coverage again on 8/24/21, so only should have been billed 8/16-8/23 and invoice date is 9/1/21 so they should have had time to adjust the invoice. Medical charges were on a date I was covered by insurance. Not to mention prebilling for the entire month of Sept. 2) Invoice date 10/1/21: Got most of the charges deducted from previous invoice except the medical charges. I was informed by Nazareth that the insurance was saying my private pay day changed to just 8/31/21, so they billed me for ** & ** for that day. The ** department was very careful to provide services only when covered by insurance; 8/31/21 I was covered by insurance. Only billed me for 8/31/21 @ $347 which should have been 8/16-8/23 @ $333. I am an honest person and will pay what I deem as valid charges, so I informed them that I should have been billed for 8 days in August when they only billed me for one day at the wrong rate. Had room charges 9/23-9/26 @ $347 instead of $333. Also had a credit in medical charges for 9/23/21 (8 days??) for $109.35. Unknown how they arrived at this amount. 3) Invoice dated 11/1/21 was a finance charge of $13.00. 4) Invoice date 12/1/21. The 8/31/21 charges were reversed for the ** charges and room rate corrected for 9/23-9/26. I thought we were headed in the right direction and ****** had informed me that this would be the final invoice, which was lower than I expected it to be and I informed ****** the same. So, I paid the $1723.10 on 12/20/2021 by credit card with a phone call. So, I think I'm done even though I wasn't paying as much as I thought I should. Wrong! 5) Invoice date 1/4/22. Bill room 9/16/21 - 9/22/21 (days I was covered by insurance) at the rate of $347 not $333. I believe this is when they were saying that my coverage was from 7/8 - 9/15 with no breaks. I contacted insurance and they confirm that I was private pay was 8/16-8/23 and 9/23-9/26, twice!! (Chat transcripts (enclosures 8 & 9). Which of course is going to mix up ******* charges because now I wasn't "covered" 9/16/21 (which shows up on the 7/1/22 invoice). The charge for 9/23/-9/26 was already billed back on 10/1/21 invoice and corrected amount on 12/1/21. And medical charges for 9/19/21 (29 days??) in the amount of $65.88. I would later get a "*** Invoice date 7/1 - 9/30 (enclosure 10) when the only info was for 9/1 - 9/26. Also converted the *** invoice to calendar form (enclosure 11). On this statement provided, the charges for 9/19/21 were only $33.26, not to mention that 9/19 was covered by insurance in my view. 6) Invoice 2/1/22. 8/31/21 room charge adjusted from $347 to $333 when it should have been removed. Room charges make a lot of changes and not correct dates, but still being billed for 12 days @ $333, so finally have room changes straightened out. At this point, I believe I still owe $2,285.90 for the remaining room charges and we have a difference on medical expenses of $96.98. I have a spreadsheet of the medical charges on invoices (enclosure 2) showing medical charges leaving a balance of $96.98. I don't know how any of the figures were determined. On March 18th, ****** informed me it was for items not covered by insurance and provided the printout for Sept. 7) Invoice 3/1/21. Balance due still $2,382.88. I still believe that I don't owe for medical supplies, so I believe the balance to be $2285.90. I wrote a check for the $2285.90 on 3/22/22 and put in the mail. 8) Invoice 4/1/22. Check received and balance is $96.98. I'm still working on the medical charges, so nothing happens here. 9) Invoice 5/1/22. Balance is still $96.98. 10) Invoice 6/1/22. Up pops **/** charges of $831.28 are added for 9/16-9-22. My understanding is that I was still covered on those dates. Again **/** was very mindful of when I was covered and when I was not. Called and was informed by ****** that insurance is telling them my coverage was 7/8-9/15 and that is why they were added. ****** sends me a copy of "Notice of ******** Non-Coverage" (enclosed) dated 8/13/21 and "Private Pay Transfer Agreement" dated 8/16/21. 11) Invoice 7/1/22. No changes except finance charge of $5.00. Balance due is now $933.26. I am enclosing a check for $36.10. This is the medical charges on the *** Invoice for 9/23 ($31.01) that ****** sent me and $5.00 for the finance charge. I have asked for medical charges and **/** for my entire stay and am now being told that they can't provide them; even though medical charges for Sept. were previously supplied. So now, since I can't prove when the medical charges and **/** were incurred when I was not covered by insurance, I am assuming all others occurred when I was covered. I'm afraid they may "adjust" the charges on their benefit and I wouldn't be able to prove it. They are telling me to contact ******. ****** could only give me invoice numbers and monthly amounts. I had two chats with ****** and they confirm my understanding of coverage (enclosures 8 & 9). I am enclosing asking them to provide a letter from ****** stating the coverage was changed to 7/8-9/15 because I have all this documentation to the contrary. I also have a letter from ****** stating that I will hit my 100 days of coverage in two weeks from the date on letter (9/8/22) which would be 9/22/21 (enclosure 6). I also have an email that was sent to Nazareth that stated 100 days would be hit on 9/22/21 (enclosure 7). I believe that any days they bill me for **/** should be balanced out by days I didn't receive any *******. I have also included a recap of emails and the attachments involved in those emails (enclosures 12, 13 & 14). I am troubled, with all the issues I have been presented with, that there are so many others that are not aware of the circumstances and are being overcharged for their services. Patients, family members or estates just paying what was billed, not ensuring they were billed correctly.

  Business Response

  Date: 08/18/2022

  August 17, 2022

  Dispute Resolution Department

   

  RE: Complaint ID ********

  Dear Sir or Madam:

  We regret to hear that ***** ***** had this experience with us. We have reviewed her account in detail and have contacted her directly to resolve the issue with her.

  After a thorough review, we are crediting her account for the ******* and ********* supplies that were billed in error due to the complexity of dealing with ******** rules and regulations. We have apologized to her for the error and the length of time it took to resolve the situation. We are also using her feedback to improve our processes for the future.

  Thank you for the opportunity to respond to her concerns. Please contact me if you have any questions.

  Sincerely,

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

  Executive Director