ComplaintsforDuke Health

• Initial Complaint

  02/01/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had an eye surgery scheduled on 8/28/23. A few days before surgery I received a call from Duke asking to pay $1,060 for patient responsibility. I told them I had two insurance with no deductible and I was also approved for 90% financial assistance. The person told me that I had to pay that regardless or my surgery would be cancelled. So, I had no choice, but to pay thinking I would get reimbursed after the claims were processed. I had another surgery scheduled on 9/18/23, for which I was asked to pay the same amount, which I had to pay to get the surgery done on time. After all the bills were processed by insurance, I was only found responsible for $295 for each surgery. On top of that, I was also approved for 90% discount, which the billing department had verified.I contacted the **************** through MyChart on 11/13/23, and they advised that the amount I owed was after 90% discount, for each surgery. I brought to their attention the EOBs of the insurance showing that I was only responsible of $295 after insurance payments and adjustments. I asked how could 10% of $295 be $1060. Then they changed their response and said insurance did not cover everything, although my insurance did cover. I asked them if insurance indeed did not cover $1060, then 10% of that amount would only be $106. Each time I wrote, they changed their reason for overcharging. Finally, yesterday I received response saying that prepayments are not refunded, meaning if I had not paid in advance, I would not be responsible, but because I paid in advance (as I was forced to), I could not be reimbursed despite my account being approved for 90% discount. I find ****** billing customer service both irresponsible and unethical, giving patients the run around. I sincerely hope that Duke Billing will live up to ****** high name by doing the right thing and refund the two prepayments I made in the amount of $1,060 each ($2,120 total).

  Business response

  02/01/2024

  To Whom It May ******************* Duke Health Patient Billing **************************** is in receipt of your correspondence dated 02/01/2024.  Our patients concerns are very important to us and will be addressed in a timely manner.
  
  We will be working directly with the consumer for a resolution to their inquiry. You will receive confirmation of this resolution within 7 10 business days.
  
  Thank you for bringing our customers concerns to our attention and allowing us the opportunity to respond.
  
  Sincerely,
  
  
  
  *********************
  Senior Account *************************************** and Support
  Duke ******************

  Customer response

  02/05/2024

   
  Complaint: 21230270
  
  I am rejecting this response because: the business did not address the issue raised in the complaint. 
  
  Sincerely,
  
  ***************************

  Business response

  02/06/2024

  We regret to here you are not satisfied with the response.  We have confirmed you were made aware this was an elective service and signed the financial agreement.  It was outlined that ***************** are not covered under the **** financial assistance program.  We thank you for taking the time for sharing your feedback.

• Initial Complaint

  12/07/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  12/3- 6:20pm went to **********************. Was diagnosed with community acquired pneumonia.-******************** saw me and issued a nebulizer and prescribed me with 5 different medications. I had a terrible cough, lungs hurt, lots of mucus coming out green, fatigue and no voice (my fianc was there with me the whole time) and had to have someone speak for me. -work note has me excused from work till Monday 12/11. 12/6-went to urgent care south to have them get ************ to fill out FMLA paperwork to cover my absences. They stated his home office was in ********** so they sent over the paperwork to the ********** office and told me to call up there the next day. 12/7- called office for *************************** and let them know I needed paperwork filled out. They said they do not do FMLA paperwork since I was only seen for 1 day. I told her I was put out of work due to pneumonia. Why be able to diagnose if you cannot cover the patient for work purposes?? I told her I have a work note however my job requires paperwork to be filled out due to absence. The lady said she would look into it and call me back. -associate called me back and said we cannot post date any paperwork. I told her that's not what I wanted. I was seen by ********************* and just need the paperwork filled out to cover me so I do not lose my job because I was so sick.

  Business response

  12/07/2023

  To Whom It May ********************** let this letter serve as confirmation that the patient has been in touch with the clinic and the form is in process of being completed.  Should you or the patient have any additional questions, please feel free to contact me directly at ************.
  
  Sincerely,
  
  
  
  *********************
  Senior Account Representative

  Customer response

  12/07/2023

   
  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

  05/26/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Guarantor #******* I received a bill regarding an Emergency Visit at ************************ Nov 30, 2020. This bill had already been resolved and paid.It is concerning that your hospital is attempting to bill me for services rendered three years ago without any prior notification or explanation for the delay. This unexpected bill has caused me significant distress and inconvenience, as this matter was resolved long ago.Since that visit, I have not received any communication or further bills regarding the aforementioned medical service until the recent bill I received. There has been no indication of outstanding payments or any attempts to address this matter over the past three years.

  Business response

  05/30/2023

  May 30, 2023
  
  Better Business Bureau
  ************************************
  Suite 130
  *******,**  27612
  
  RE: Case Number: 20109092
  
  
  To Whom It May ******************* Duke Medicine Patient Billing **************************** is in receipt of your correspondence dated 05/26/2023 regarding the above Case Number.  Our patients concerns are very important to ** and will be addressed in a timely manner.
  
  We will be working directly with the consumer for a resolution to their inquiry.  You will receive confirmation of this resolution within 7 10 business days.
  
  Thank you for bringing our customers concerns to our attention and allowing ** the opportunity to respond.
  
  Sincerely,
  
  
  
  *****************************
  Reimbursement Specialist
  PRMO **************** and Support
  Duke ******************
  

• Initial Complaint

  03/02/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  On 11/15/2022 I took my 9yr old son to ************* at the request of his pediatrician to r/o appendicitis. After 6+ hours of no communication by the ** Drs., my son was diagnosed with acute appendicitis via ******* was told by a medical member that he needed emergency surgery & would be admitted to start antibiotics & be prepped for surgery. There was little to no communication btwn myself & any Drs. & he wasnt put into a room until 3am. It was not until the next day after 11:30am that I was told they "werent convinced" it was appendicitis & wanted to do a CT to get a better look. All while giving him morphine & abx. Around 3pm on 11/16 that he doesnt have appendicitis & was misdiagnosed in the ** but that he needs to stay for observation & have GI Dr. take over his case the next morning which ended up him having a SMOG & have several BMs before being discharged.As a parent - we trusted Duke to treat our children & provide accurate information to us. This did NOT happen in this ********* should not be held liable for the bills that were incurred due to their negligence. It was not of our doing but of the misdiagnoses of *************. His Medical records show 35 times that he was diagnosed with acute appendicitis & as a parent I trusted they knew what they were saying, & they put us through much stress & unneccesary medical treatment b/c of their negligence! He was discharged with no further appendicitis issues but I started receiving bills for Surgeon's fees & the Dr. who misdiagnosed him to begin with & b/c he was admitted my insurance is claiming he didnt warrant admission since he didnt have surgery therefore, they are not paying the claims. Stating "You could have gotten the care you needed without being admitted inpatient in the hospital." I have tried to take this up with ********** both to no avail and it is WRONG! All I have asked is for Duke to drop the bills that were incurred due to their negligence. I will pay for the diagnostics and initial exam.

  Business response

  03/02/2023

  The **************************** is in receipt of a billing inquiry from you.  The inquiry has been forwarded to Duke Health *************** for review.  Please allow 10 to 14 days for the review process.  
  
  Thank you for choosing Duke Health for your health care needs.
  
  Sincerely,
  
  
  
  *********************
  Senior Account *************************************** and Support
  Duke ******************

  Customer response

  03/06/2023

   
  Complaint: 19527362
  
  I am rejecting this response because:  I have already contacted the ********************* with no resolution!
  
  Sincerely,
  
  ***************************

  Business response

  03/08/2023

  Please see the attached. 

  Customer response

  03/08/2023

   
  Complaint: 19527362
  
  I am rejecting this response because:  The link provided in this generic letter sent from **** is not valid.  If **** provides a proper link to an Authorization form I will fill it out allowing authorization to discuss my concerns with the BBB.  Me calling ***** has proven not to resolve this issue in any way so far.
  
  Sincerely,
  
  ***************************

  Business response

  03/08/2023

  Please see the attached Authorization Form. 

  Customer response

  03/08/2023

   
  Complaint: 19527362
  
  I am rejecting this response because: Providing this form is not my acceptance of **** refusing to compromise on bills incurred due to their negligence at this visit.  **** should now have the Auth form needed to discuss this event further through BBB to come to an agreed upon resolution.  All I am asking is for the bills incurred after him being admitted without cause be removed and I will pay for the diagnostics incurred (CT, ************ U/S,) as well as the ** Exam visit.  My son should have never been admitted with acute appendicitis and emergency surgery without the "required" CT scan that should have been performed while in the ** (before admission).  IMO the ** was so busy that they decided my son had insurance and the easiest thing to do is admit him and put him to the side until we have more time to figure it out while we deal with all these other patients with simple issues and most likely don't have insurance.  My observation sitting in the hall up against the wall with my son (b/c there was no available seats in lobby) I had 3 families on either side of me with children who needed an interpreter on speaker phone for the staff to communicate with the parents to discuss medical treatments for their child.  They were completely overwhelmed but that should not result in me having unnecessary medical bills just b/c our family has medical insurance you can send claims to!
  
  Sincerely,
  
  ***************************

• Initial Complaint

  02/06/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  The dispute is for service provided by Duke Health on Nov 1, 2022. Patient is myself. A surgery was provided by Duke Nov 1,2022, ***************************, MD, Account #************. $52,788.28 Billed, $48,893.93 Covered, $1,200.00 paid, $2,694.35 Balance. I received this bill a few days after surgery. So far, this is fine, no contest here. Several weeks after I received yet another bill by ****, for same date, Nov 1, 2022. Provider, Provider: ********************************, PA.Account #************. $6,283.20 Billed, ******** Covered, $0.0 Paid, and $2,404.15 Balance. I do not recognize this provider nor services. This is what I dispute. I wrote to Duke Health, and on Jan 24th they responded:"I have reviewed both claims submitted for encounter date of service 11/01/2022 and they both list Orthopaedic Surgeon, **********************************, MD. I am unable to locate the provider, *****************************, that you are referencing. Is the information you received from Duke Health? If you would prefer to discuss your account by phone you may reach customer service at ************** or **************. Please let us know if we can be of further assistance and enjoy your day. Thank you, Duke Health Customer Service"I called on 2/2/2023 BCBS, and they informed me that they were billed $1,047.20 by above provider ********************, and it was paid in full. I called Duke Health on 2/3/2023 and talked to *** and asked him to remove the charge of $2,404.15 for provider ********************, that I do not recognize and nor does Duke. This he refused and asked if I want to schedule a payment instead.

  Business response

  02/06/2023

  February 6, 2023
  
  Better Business Bureau
  ************************************
  Suite 130
  *******, **  27612
  
  RE: Case Number: 19330508
  
  To Whom It May ******************* Duke Medicine Patient Billing **************************** is in receipt of your correspondence dated 02/03/2023 regarding the above Case Number.  Our patients concerns are very important to us and will be addressed in a timely manner.
  
  We will be working directly with the consumer for a resolution to their inquiry. You will receive confirmation of this resolution within 7 10 business days.
  
  Thank you for bringing our customers concerns to our attention and allowing us the opportunity to respond.
  
  Sincerely,
  
  
  
  *****************************
  Reimbursement Specialist
  PRMO **************** and Support
  Duke ******************

• Initial Complaint

  10/14/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  This was incorrectly submitted to ***** under old ***** plan, causing the claim to be denied by *****. ***** has since re-processed this claim and states I may owe $10.54 and NOT $1246.00. Duke has me in collections even though I called them to explain ***** was re-processing this claim just 2 weeks ago. This billing error is for my child* ***** ******** Account ************** Date of Service May 12, 2022. This needs to be fixed so my child doesn't have collections under their name, they are a minor. *****'s website says this: Total amount breakdown for 7 services Amount billed $1,246.00 Plan discount $358.67 Your plan paid $876.79 Total amount you may owe $10.54

  Business response

  10/17/2022

  RE: Case Number ********
  
  To Whom It May Concern:
  
  The Duke Medicine Patient Billing Executive Inquiry Department is in receipt of your correspondence dated regarding the above Case Number.  Our patient’s concerns are very important to us and will be addressed in a timely manner.
  
  We will be working directly with the consumer for a resolution to their inquiry.  You will receive confirmation of this resolution within 7 – 10 business days.
  
  Thank you for bringing our customer’s concerns to our attention and allowing us the opportunity to respond.
  
  Sincerely,
  
  
  
  ***** *****
  Senior Account Representative
  PRMO Customer Service and Support
  Duke Health 

• Initial Complaint

  08/02/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Upon date of a family member's surgery in May 2022, I made a pre-surgery payment of $2,000 that would go towards my out of pocket deductible. After surgery other third party claims were processed by insurance before the Duke Professional services were processed, and therefore my out of pocket to Duke was less than they $2000 paid. Duke owes my a refund of $642.55 but will not refund me due to the fact that they did NOT get pre-approval for the services and therefore the Cigna is not paying the claim. There is no financial responsibility to the patient as a result. Duke has filed 2 appeals since June trying to get the claim approved after the fact. Regardless of whether the appeal is approved or denied, my out of pocket has been met and Duke owes me $642.55 regardless. Duke Billing Supervisors have been no help at all, as I'm constantly getting the 'run around' and telephone calls get mysteriously dropped with no call back from Duke.

  Business response

  08/02/2022

  RE: Case Number ********
  
  To Whom It May Concern:
  
  The Duke Medicine Patient Billing Executive Inquiry Department is in receipt of your correspondence dated regarding the above Case Number.  Our patient’s concerns are very important to us and will be addressed in a timely manner.
  
  We will be working directly with the consumer for a resolution to their inquiry.  You will receive confirmation of this resolution within 7 – 10 business days.
  
  Thank you for bringing our customer’s concerns to our attention and allowing us the opportunity to respond.
  
  Sincerely,

• Initial Complaint

  07/26/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Description of Complaint: I was diagnosed with breast cancer in 2019. I paid Duke in full for all the charges. I was in no state to "check" the billing. I've recently started checking all of Duke's billing against CHAMPVA, my insurance settlement statements. I am finding that Duke is balance billing me on some of my visits. The charges for 2019, 2020 and 2021 are not on my patient chart. I have requested several times for printouts to be snail mailed to me. Some were ignored, some were answered with I will send them and they have been sent. Neither of which I have received. Some messages were sent and would not allow me to reply. It was blocked. Recently, I received an email that said they uploaded my records. I have search and search where I was told and I don't see anything. I'm just trying to get the printouts for 2019, 2020, and 2021 so that I can check my insurance against what I was told I had to pay. I am a dependant to a 100% permanent and total disabled veteran. CHAMPVA is the only insurance I have. Thank you, ***** ******

  Business response

  07/27/2022

  July 27, 2022
  
  Better Business Bureau
  5540 Munford Road
  Suite 130
  Raleigh, NC  27612
  
  RE: Case Number ********
  
  To Whom It May Concern:
  
  The Duke Medicine Patient Billing Executive Inquiry Department is in receipt of your correspondence dated regarding the above Case Number.  Our patient’s concerns are very important to us and will be addressed in a timely manner.
  
  We will be working directly with the consumer for a resolution to their inquiry.  You will receive confirmation of this resolution within 7 – 10 business days.
  
  Thank you for bringing our customer’s concerns to our attention and allowing us the opportunity to respond.
  
  Sincerely,
  
  
  
  ***** *****
  Senior Account Representative
  PRMO Customer Service and Support
  Duke Medicine

  Customer response

  07/27/2022

  
  Complaint: ********
  
  I am rejecting this response because:
  They have already told me they would send me a printout of my visits for 2019, 2020, and 2021. Their message means nothing. They don’t follow through. 
  Sincerely,
  
  ***** ******

  Business response

  08/02/2022

  RE: Better Business Bureau Complaint Case #: ********
  
  To Whom It May Concern:
  
  This letter serves as confirmation that we have been in contact with the customer and have provided the requested documents.
  
  Should you or the patient have any additional questions, please feel free to contact me.
  
  Sincerely,

  ***** **

  Customer response

  08/02/2022

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* 
  Although I did not receive what I asked for via snail mail, one of the woman I spoke with uploaded my details so that I can check my billing against my insurance for balance billing. 
  Sincerely,
  
  ***** ******

• Initial Complaint

  07/25/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I went to Duke Primary care on 6/23/2022 for a new patient physical. My account number is #************. I was perfectly healthy and went in for some preventative exams. During my visit, my doctor ordered preventative exams such as pap smears, HIV screening, etc. However, all these items were billed as diagnostic instead of preventative, thus requiring me to pay the deductible (over $900 for some preventative exams!) instead of all covered by my insurance. Duke said since it's a "new patient visit" everything HAS to be billed as diagnostic. Nothing is covered even though the doctor said all tests are preventative and all the CPT codes are for preventative exams. No one informed me of this before the appointment and this came off as surprising billing for me.

  Business response

  07/25/2022

  July 25, 2022
  
  Better Business Bureau
  5540 Munford Road
  Suite 130
  Raleigh, NC  27612
  
  RE: Case Number: ********
  
  To Whom It May Concern:
  
  The Duke Medicine Patient Billing Executive Inquiry Department is in receipt of your correspondence dated 07/25/2022 regarding the above Case Number.  Our patient’s concerns are very important to us and will be addressed in a timely manner.
  
  We will be working directly with the consumer for a resolution to their inquiry.  You will receive confirmation of this resolution within 7 – 10 business days.
  
  Thank you for bringing our customer’s concerns to our attention and allowing us the opportunity to respond.
  
  Sincerely,
  
  
  
  ******* *******
  Senior Account Representative
  PRMO Customer Service and Support
  Duke Medicine

• Initial Complaint

  07/13/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  I was in Duke Hospital Sept. 2021 for a stroke/aneurysm. I have had to have follow up tests and procedures into 2022. I completed the financial assistance paperwork and was approved. My insurance has paid 1000’s of dollars to them but even with insurance and financial assistance, I have a balance. I agreed to pay $25.00 a month and provided them with my debit card information on autopay. Well, they went in and increased the payment to over $50.00 a month. Never contacted me just did it. I have told them I can only afford $25.00 but they refuse to change it back. Apparently, they have a new policy where you are only granted a certain amount of time to pay off balances. They have it so I can’t change it back to $25.00 ( it reverts back to the over $50.00 per month) and I can’t remove my card information. I can’t afford this! I live alone on only my salary and have no one else bringing in money. With this and everything else going up 25%-30% , I am really not making it paycheck to paycheck. I really want my payment to be $25.00 a month which is what I agreed to pay. Duke seems to get your card information and then take whatever they want without you having any say. It is not right.

  Business response

  07/13/2022

  
  July 13, 2022
  
  Better Business Bureau
  5540 Munford Road
  Suite 130
  Raleigh, NC  27612
  
  RE: Case Number: ********
  
  To Whom It May Concern:
  
  The Duke Medicine Patient Billing Executive Inquiry Department is in receipt of your correspondence dated 07/13/2022 regarding the above Case Number.  Our patient’s concerns are very important to us and will be addressed in a timely manner.
  
  We will be working directly with the consumer for a resolution to their inquiry.  You will receive confirmation of this resolution within 7 – 10 business days.
  
  Thank you for bringing our customer’s concerns to our attention and allowing us the opportunity to respond.
  
  Sincerely,
  
  
  
  ******* *******
  Senior Account Representative
  PRMO Customer Service and Support
  Duke Medicine
  

  Customer response

  07/15/2022

  
  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. They have already reached out to and we have agreed on a payment arrangement. Thank you so much for the assistance. 
  
  Sincerely,
  
  ***** ******

*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. ↩