Business Profile

Orthopedic Surgeon

OrthoCarolina

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Complaints

This profile includes complaints for OrthoCarolina's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

22 total complaints in the last 3 years.
6 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. 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.

Initial Complaint
Date:04/08/2025
Type:Service or Repair 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 was seen for a knee issue. My insurance was out their network and they did not tell me. Had ex-rays and was charged for an office visit.. I then went back 2 weeks later for a re-check that is when they said my insurance was out of network. I did not receive anymore care. I should not be responsible for this visit.
Business Response
Date: 04/11/2025
It is a patient's responsibly to be know their insurance coverage. You signed a financial waiver on 1/15/2025 that you would be responsible for the medical expenses regardless of insurance coverage. Please call ***** ****** at ************ to discuss your payment arrangements.
Initial Complaint
Date:03/13/2025
Type:Billing Issues
Status:
ResolvedMore 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.
My health insurance charges a co-pay per visits to a provider, $40.00 for a Tier 1 provider and $80.00 for a Tier 2 provider. I went to see a Tier 1 nurse practitioner but was charged a Tier 2 copahy because OrthoCarolina bills under the doctor a nurse practitioner or physcian's assistant reports to. This practice by OthroCarolina is solely by choice and causes patients like me to unknowingly be charged an incorrect copay for a provider I did not see. Other providers do not do this. It is unethical and OrthoCarolina needs to change this practice. My insurance, *****************, indicates other practices charge based on the true provider or will resubmit a claim based on the real provider for such a situation but OrthoCarolina does not. The reason provided by their billing department is, "that's the way we have always done it", which is not a valid answer for an invalid practice. This request is to get OrthoCarolina to get their billing practices in line with other providers in North Carolina so that it does not penalize patients if their insurance has a provider tiered co-pay system which OrthoCarolina should abide by since they accept contracts with *****************.
Business Response
Date: 03/20/2025
Thank you for sharing your concerns with OrthoCarolina. After a thorough review of your billing concerns, the OrthoCarolina *************** decided to adjust the $40.00 copayment. The remaining account balance is $5.73 for the x-ray fee. Please let us know if you have any additional concerns.

Customer Answer
Date: 03/20/2025

I am rejecting this response because:
I accept OrthoCarolina's tactical resolution to my immediate billing complaint but they not addressing that underlying issue which caused the issue to start with. Other providers bill by the true provider to ensure insurance covers the appropriate visit co-pay. Ortho is choosing to bill by the doctor a Physician's Assistant or Nurse Practitioner reports up to. As such, a patient can be charged a higher co-pay if the billing doctor has a lower Tier rating than the PA or NP providing the actual service. Ortho knows this and is leaving the underlying problem unaddressed. There is no way this issue has not impacted any number of their patients for a 100% fixable issue. All my other providers bill by the actual provider to avoid this issue and that is what Ortho should do to. There is no rationale for choosing to do otherwise.

Business Response
Date: 03/20/2025
The OrthoCarolina ************************ is in the process of reviewing our provider insurance concerns directly with ***. ********* ********** was in the process of being approved to see *** patients at your office on 12/30/2024. The approval process may take up to 90 days to complete. The supervising physician's name, ******************* per our policy, was used on the billing statement. Dr. ******** per our records with documentation from ***, is credentialed through UHC as a premium care physician and should be a tier-one provider. OrthoCarolina is reviewing this concern directly with UHC. The provider reviews with UHC are a lengthy process and we wanted to address your concerns directly and promptly.
We extended a one-time courtesy to adjust the $40.00 copayment so you would not have to wait for our provider issue with *** to be resolved. If you have additional concerns, we will review them directly at ************.
Customer Answer
Date: 03/20/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to my complaint, and find that this resolution is satisfactory to me.

Thank you.
Initial Complaint
Date:02/15/2025
Type:Product Issues
Status:
ResolvedMore 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.
Failure to refund overpayment
Business Response
Date: 02/21/2025
The patient, ***** ******, was given a refund for the surgical deposit on 2/21/2025. The outstanding physical therapy charges from January 2025, were resubmitted to ********************** carrier. Please call the OrthoCarolina Careline at ************ if you have any additional concerns.
Customer Answer
Date: 02/21/2025

I am accepting their response, with two caveats. First, the account is still carrying a $6.89 Credit balance which should be refunded to **** x1237, and second, a charge on 12/27/2024 for $158.00 was applied to the "PrePayment Surgery" amount paid on 12/19/2024. The insurance claim was originally "Denied" and I have asked BCBS FEP to review. It should be approved shortly. When that is done, I expect OrthoCarolina to Credit $158 back onto **** x6639.
Business Response
Date: 02/24/2025
The $6.89 payment was from a previous deposit made on 11/13/24. The *** claim is pending with insurance. Once the claim has processed the refund will be sent to the patient's credit card.
Ms. ******** physical therapy charges from 1/13/2025, 1/15/2025, and 1/20/2025 are being processed with insurance.

Customer Answer
Date: 02/24/2025

I reject OrthoCarolinas explanation on the 11/13/2024 *** and the balance due of $6.89. OrthoCarolina submitted a charge of $1,199 for this service and ****************** had a plan allowance of $133.91. BCBS FEP received the claim on 11/18/2024, processed the claim on 11/20/2024 and their system paid that claim on 11/25/2024. The amount we owed was $20.08. I have provided the Explanation of Benefit.
In OrthoCarolinas Billing Summary in MyChart, it shows the payment was received and that transaction is marked "Paid Off".
OrthoCarolinas claim that The *** claim is pending with insurance is false and they have received their payment. As to their claim that the physical therapy charges are being processed by insurance, as of 3:00PM on 2/24/2025, their third submittal for the January treatments have not appeared on BCBS FEPs website.

I am sure many healthcare providers rely on patients not reading or understanding their benefits or EOBs, but that is not always the case!

Business Response
Date: 02/26/2025
The $158.00 was paid by insurance on 2/26/2025 creating the credit for the shoulder sling. The $6.89 was credited for the *** deposit. Both credits were returned to the credit cards on 2/26/2025.

Customer Answer
Date: 02/28/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to my complaint and find that this resolution is satisfactory to me.

However, I must note that the $158 credit was applied to the wrong card, not the one which originally made the pre-payment. But we did get the money back in the end.
Also, the claims for physical therapy that were previously mentioned as being twice denied by insurance for not being filed correctly were submitted a third time. Once again, they were denied for the same reason. In my opinion, I think that BBB should indicate to the world that this business has very questionable billing and bookkeeping practices.
Initial Complaint
Date:06/12/2024
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.
Dates of transactions were 3/20/24-4/12/24 and 4/24/24. Every time I went to the doctor, the receptionist stated todays visit will be $250. I would pay $250 for each visit. Which should of cleared each visit. I noticed they started debiting my debit card recently. I found out that my office visit actual price was $225 on 3/20and $194 on 4/12 and $130 on 4/24.My insurance paid for office visit on 3/20/24. They claimed my visit on 4/12 only $30 was applied to him. But I paid $250 for that specific visit as directed by the receptionist. Nothing was applied to my doctor on 4/24. So why are they telling patients each visit is $250 and not applying it to that specific doctor. Why tell the patient the bill is more than what it actually is.They do whatever they want to do with your money without telling the patient what they did with your money and still send you a bill. That should be illegal. Unorthodox customer service.They even broke my ribs while I was in the hospital and would not admit it. I had to go to urgent care for help. I shouldve sued them. They charged me for that too. Ortho Carolina is the worst and a rip off. They need to place my money specifically on the date of service I paid for. What is left over is up to me where it goes to.
Business Response
Date: 06/14/2024
The account support manager reviewed ******************** billing concerns with the patient. **************** is a self-pay patient and OrthoCarolina's policy is to collect $250.00 at every office visit. The patient is billed for the outstanding balance. If the balance is less than $250.00, the payment is applied to any outstanding charges. The charges on her account were correctly billed.
**************** should call the *************** at ************.
Initial Complaint
Date:05/20/2024
Type:Service or Repair 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 visited Orthocarolina at the ***************** location and got a cortisone shot in my foot. I was billed $200 as they filed it as an "Office Surgery." My out of pocket is $70 and the medicine itself is $7. I was then billed another $70 for an office visit. This place is a ripoff and does not truly care about patients
Business Response
Date: 06/07/2024
Thank you for sharing ***************************** concerns with me. I reviewed the charges from the patients bill from the date of service, 4/18/2024. ************ had not met her deductible and she was billed $83.33. ************ was billed for an office charge, injection, and the injection drug. The fee for the injection was for the provider to place the injection in the correct tendon location. The patient was treated for left plantar fasciitis and consented to an injection in her left heel.

If ************ has additional concerns, she may reach out to the *************** at ************. OrthoCarolina is closing the BBB review for ************.

Thank you,

*********************, CPC

Privacy Manager

************** (Phone)
Initial Complaint
Date:01/25/2024
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.
In Fall 2021 my son was seen by OrthoCarolina in ***********. At the time of service I submitted both insurance cards reflecting my son has two insurances (one primary and the other a secondary). In 2023, I was contacted stating I had to pay for the full visit of 2021 due to the fact that only one insurance was billed and that insurance company finally denied due to the factor the secondary was not billed. Never once over the course of two years was I contacted and OrthoCarolina admitted they did not contact me until 2023. I was told also by OrthoCarolina billing office that the time frame to dispute or rebill has passed and I now have to pay the bill in full. The bill is now with the collection company. My son has been seen numerous times prior to the 2021 visit and after in which both insurances were billed. Now they are declining in seeing him demanding I pay the bill in full. OrthoCarolina clearly made a mistake and want me to pay for their mistake.
Customer Answer
Date: 01/25/2024
My son name is *******************************. Guarantor number/account number: *********    Amount $460
I have spoken to many representatives in the billing office of OrthoCarolina. I even spoken to managers and everyone has told me the same thing which is even though my son has two insurances I have to pay the bill for 2021. There are numerous notes on his account with ********************** that can validate my claim.
Business Response
Date: 01/29/2024
DOS 08/06/21- The account support manager spoke with ******** explained she never presented the Tricare card (primary insurance card) at the visit. The manager explained that ******** did not present the Tricare or ******** card at her son's visit. The OrthoCarolina *************** verified eligibility. ******** paid the visit in 2021 and then recouped the funds in 2023. The account support manager suggested the charges from 8/6/2021 be changed to the self-pay rate, reducing the billing balance from $460.00 to $319.00. ******** to setup a payment plan with the new balance of $319.00.
The insurance information was corrected in the patient's account for the 1/25/2024 office visit. The Tricare and ******** insurance information were updated to the patient's account.

Customer Answer
Date: 01/31/2024

I am rejecting this response because I spoke to *********************** of OrthoCarolina on January 26, **** and my exact response to **************** is that on the date of service which is in question I personally gave the check in PSC my son's military ID card showing he has Tricare and his Healthy ************* card. The factor which she states they were not scanned in I have no control of the check in person scanning in the cards. However, I know I personally handed the PSC/Check in person both items and explained Tricare needed to be billed first then Healthy Blue. During the conversation, **************** stated on my son's visit and previous visit on different dates his insurance for Tricare and ******** has been pulled and verified which means Orthocarolina has and is aware my son has two insurances. On the phone call also with **************** I sent to her direct email another copy of my son's military ID card. Therefore, her dispute stating "******** did not present the Tricare or ******** card at her son's visit" is false. I would like the cameras in the waiting room and above check in to be pulled if that is in question from that date. And I will not set up payment arrangements due to the fact that per this phone call and previous calls with OrthoCarolina billing office representatives and managers have all stated eligibility was pulled and verified which means OrthoCarolina is aware and has always been aware he has two insurances. Even previous visits and current visits both insurances were billed and has paid. Therefore, 8/6/2021, both insurances should have and needs to be billed!

Business Response
Date: 02/02/2024
This is a final review from OrthoCarolina!
The patient's mother did not present the insurance cards at the appointment. ******** denied the charges in 2021. The charges from 2021 are not billable to the insurance carrier because they are past the timely filing deadline.
The charges from 2021 were changed to a self-pay rate to the lower the fees. A payment plan may be set up with no interest for up to 12 months. The patient is responsible for the outstanding balance.
Initial Complaint
Date:07/03/2023
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 am disputing $194 for a virtual appointment on May 18, 2020. I initially disputed this bill with Orthocarolina and was told several times they were looking into it. Shortly thereafter, I got letters and calls from a collection agency. I again disputed the charge (see my attached email). I never heard back after that email was sent.I then called earlier this year to make an appointment with a different doctor at Orthocarolina. I was told I could not make an appointment till I paid my outstanding bill...a ********** had assumed had been written off.I would like my balance to be zeroed out so that in the future I am able to go to Orthocarolina to see other doctors.
Business Response
Date: 07/05/2023
The billing supervisor reached out to ************** and reviewed the billing charges from 5/18/2020. The billing charges were paid from 5/18/2020 but the charges were not paid for date of service 4/8/2020. ************** is responsible for the office charges from 4/8/2020. She was offered the opportunity to pay her bill, but she declined.
Initial Complaint
Date:06/13/2023
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 had hand surgery back in November of 2021 with OrthoCarolina. My surgery costs reached the limit of my insurance's out of pocket maximum. However, every time I went in for physical therapy, Ortho carolina still charged me a $60 co-pay. The visits were paid in full by my insurance, so Ortho Carolina double dipped and they owe me $360.When I called the billing department, they claimed my copay was being applied to a pending charge which my insurance was disputing. I logged into my account recently and it seems that dispute was resolved, but Ortho Carolina has not reimbursed me for my co-payments.
Business Response
Date: 06/19/2023
The patient was contacted by the OrthoCarolina and advised to speak directly with *****, the Account Support Manager. Her contact number is ************.
Initial Complaint
Date:05/01/2023
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.
Orthocarolina has billed numerous times for therapy procedures which were not done on particular visits. (1st occurrence was last November). After many calls and messages via their portal as well as changes documented by the actual therapist which treated me to verify the info I have given, there are still remaining discrepancies in my bills for the attached insurance EOB's. I have sent 5 messages regarding these and they will not respond as requested. They forced me to pay an incorrect charge back in March before allowing a treatment visit. Their attitude @ the Park rd. location is demeaning to patients and give incorrect info as they do not understand the issue. Their failure to send proper paperwork to my insurance company resulted in delay in treatment as well as billing inaccuracies. They also have posted some of my payments made to wrong treatment dates despite my specific request as to which date the payment is for. I have included just the recent dates which have wrong amounts but have numerous other ***** of messages sent...
Business Response
Date: 05/05/2023
****************** billing concerns have been thoroughly investigated by the Account Support Manager of OrthoCarolina multiple times. The manager has made compromises with his physical therapy charges and submitted corrective claims to the insurance company. ****************** charges are correctly billed, and any additional questions may be directed to *****, the manager, at ************.
Customer Answer
Date: 05/08/2023

I am rejecting this response because:
I requested ***** the billing manager to call me last week, waiting for a response. Orthocarolina has still not corrected some of their inaccurate bills to my insurance company from last Feb. They continue to make errors.... Just las week, payments I made on April 26th for specific service dates were applied to some of the wrong dates without my permission. This has occurred 4 times. I messaged them via my patient portal twice about this. Waiting for response and corrections.....
Business Response
Date: 05/10/2023
The account support manager has reviewed the patient's account and the requested dates of service. The patient's balance was reviewed and corrected. The account support manager is closing the review of the patient's complaints.

Customer Answer
Date: 05/14/2023

I am rejecting this response because:

Better Business Bureau:

Orthocarolina continues to apply payment I made designated for a specific visit to the wrong date of service. I have wasted more time sending another detailed message to billing via my patient portal and left a voice mail for the account manager.
Once they take the time to insure this correction is made, I will end complaint.

Business Response
Date: 05/18/2023
Please reach out directly to ***** during business hours from 8:00 to 5:00, Monday through Friday. This case has been closed by OrthoCarolina.
Initial Complaint
Date:04/27/2023
Type:Service or Repair 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.
Im being refused medical treatment because of a dispute that I filed with the BBB and Orthcarolina 2 years ago on a Dr. ****** and his staff. I refused to pay fees because of unjustified treatment and now my doctor is sending me to them for physical therapy and ** denied due to bad debt. When talking to ***** in billing she claims I owe $107.24 and then said $35 for physical therapy and a $60 charge. Party was very rude and condescending and only amount I owe is $107.24. I received an apology from Dr. ****** on behalf of his staff but did not want to continue treatment with him and was referred to another surgeon for my knee replacement surgery in 2022. I left a message by voicemail for *********************** office manager for accounting but no response.
Business Response
Date: 04/28/2023
The account support manager of OrthoCarolina spoke with ******************** and explained she has a legacy balance of $110.00 for a June MRI during 2021. Additionally, there is a current balance of $107.24 that is due. ******************** does not want to pay the balance at this time.

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