Complaints

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:01/31/2025

  Type:Service or Repair 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.

  I had an ******************* due to a burn. It did not go well. The surgeon kept assuring me everything looked fine for 6 weeks of follow-up. When it started to smell i told him i wanted a second opinion so he sent me to wound care. They immediately sent me to the *** When admitting me they asked if i wanted anything for the pain. I asked for some ********* because wound care had put it on and it did bring relief. He said no, the surgeon might want to see it. A little while later he did bring in a needle and said i got you some diladin, lowest dose. It really dig bring relief i didn't know was possible. 5 hours later, admitted in the hospital, I asked the nurse how long that stuff last because i was starting to feel it. She said about 4 hours. I will see what i can do. Over to MRi. Ouch! I asked a few more times from the nurses for just some ********* topical or some *******. ****** was brand new, and the **** nurse had stepped in a few times at Rachel's!!OTC! request. I kept getting the answer "I'll ask". Then after ****** didn't return for a while i rang the desk., "I'll tell the next shift's nurse". I walk up and see the head nurse. "I'll ask". I finally went back and got dressed. After walking out to go buy some OTC pain reliever i sat in the ** to be readmitted. 6 people went before me that came in after me. 2-1/2 hours later, I finally went home.8 am go back to *** The doctor openly took full responsibility saying he wrote in my chart ******** upon request. I pointed out he wasn't at fault at all. The nurses didn't lack empathy. I never took my socks off in front of the nurses. Not one of them looked at my chart and saw the extent of my injury nor the note about my pain management. As the head nurse was chasing after me while i was leaving for pain meds, she was asking me to sign a form that i was leaving against doctor's orders. The way I see it she disobeyed his orders before I did causing me to leave.She didn't even offer me an *******.

  Business Response

  Date: 02/03/2025

  Hello,

  Our *************************** is currently investigating this complaint. As I receive further information, I will update the BBB. 

  If the patient would like to dispute items in his medical record, he will need to complete the form attached and return to our ************************** Once the form is received, the Provider(s) will review and determine if we can accommodate the request. 

  Thank you,

  Customer Answer

  Date: 02/03/2025

   
  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.

  I am working with the patient advocate to get my files. ********** has recommended an excellent surgeon but he uses the Hendersonville hospital. I know it it completely unreasonable but  have real anxieties now about waking up from surgery in the orthopedic ****. I am an engineer. I should be able to figure out how to navigate through your system but i can't figure out a safety backup if i can't walk to get even an *******. It is not just ************** UNC either. I really never thought another human beings was capable of that. I live alone up in the mountains. I take care of myself. All my cooking cleaning. I rarely see people. I can't believe what the world has become.

  I am a 55 year old man and i was pleading with a nurse for an *******.

  I really feel both those nurses owe me an apology. I don't care which they use. 

  I am sorry for directly disobeying doctors orders.

  Or

  I am sorry for not looking at your chart at all and being dismissive as the only source for your pain management. "I'll ask" is not an acceptable response after 1-1/2 hours and the third time asking especially since i had directions in your chart that i never referenced.

  
  

• Initial Complaint

  Date:06/26/2024

  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 went in for my annual physical that is meant to be 100% preventative in nature for Health Insurance Purposes. My doctor ordered preventative blood screening tests that are part of the annual physical. The billing department used a medical diagnosis code, Z1159, which my insurance and Pardee agreed was "encounter for a viral disease". I called multiple times to get this resolved because I was clearly there for only an annual physical which is supported by my Doctor visit notes and I never said I believe I encountered a viral disease so please order this test. My insurance got on a three way call with them to explain that the preventative diagnosis code should be been used, but they refused. I believe it is fraudulent to say I was there for "encounter for a viral disease" when I was only there for an annual physical. The end result is my visit should have and would have been 100% covered by my health insurance, but instead they say I owe $180.70. My insurance did everything right on their end and processed the claim correctly based on the billing codes used, but the problem is with Pardee Health by using a non preventative billing code when it should have been preventative. They claim my insurance did not accept the Z0000 code but the three way phone call I had with them disproved that when my insurance representative clearly said yes we do accept that billing code and it would be preventative. I will attach the Visit notes and summary from my doctor that support that I was only there for an annual physical and never once mentioned I thought I might have encountered a viral disease. My wish is for them to refund/waive the $180.70 that I owe because they did not submit it to my insurance correctly despite me calling more than 3 times to get a fair resolution. The first sentence of my visit notes is "Pleasant 36 year old male presents for routine physical..." yet somehow they code and bill it as "encounter for viral disease".

  Business Response

  Date: 06/28/2024

  Hello,

  I called BCBS of TN and spoke to ********, She stated we are In-Network and they pay 100% of the allowed amount on ************ services as long as the *** codes and Diagnoses billed reflect preventative services...
  
  She informed me that:
  *****- the allowed went to the deductible, they processed it against Dx code Z11.59 (( classified as outpt facility lab)
  80061- the allowed went to the deductible, they processed it against Dx code Z11.59 ( ( classified as outpt facility lab) 
  86803- BCBSTN paid the allowed amount and they processed it against Dx code Z11.59 ( classified as a wellness lab)
  
  I told the rep that it seems that they are not looking at the other Dxs listed on the claim... If they did, they would see they might support the first 2 labs (***** and 80061) 
  ******** is sending this back for review to see if they can use the other Dxs to process those lab codes.
  It will take 7-14 business days for a response. ******** stated that she would call me back once they complete their review. 
  Call Reference#************
  
  I added the "Dispute balance" account activity to this DOS.. So the patient will not go to collections or receive additional statements until it is removed.

  If we do not receive payment from BCBS, we will happily apply a one-time courtesy adjustment. 
  
  Thank you, 
  
  *********************** |  Patient Account Analyst Supervisor
  p ************** |  f **************

   

  Customer Answer

  Date: 06/28/2024

  I accept the response and resolution suggestions, but wish to keep the complaint open until truly resolved and not just suggested. The idea was for   BCBST to reprocess the claim with different diagnosis codes or Pardee applying a one time courtesy credit to make my amount due from $180.70 to $0.00. Since I was unable to make any progress calling myself 3+ times,  I prefer to keep the complaint open until it is truly resolved and my account balance is zero. This should be 7-14 days to see if it can be reprocessed and then if not, Pardee should apply the account credit to zero dollars due. Please keep complaint open until resolved because I would not be able to get into contact with the representative who promised to apply the one time courtesy credit. Thanks. 

   

  Thanks, 

   

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

  
  

• Initial Complaint

  Date:06/18/2024

  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.

  On April 16, 2024, I received a new patient annual physical with bloodwork and a shingles vaccine from Dr. ************************** While I am satisfied with the services he provided, my issue lies with the Pardee BlueMD's billing practices. For this single date of service, I received three separate bills from three separate providers; Pardee BlueMD for $593, Pardee Hospital for $407.40, and ******************************** Services for $71. I am uninsured, but pay $671 in monthly membership gift payments to Christian ************************** Ministries' health cost sharing program. As part of that program, just as insurance companies such as BCBS do, I agree to negotiate a self-pay rate with my providers. Pardee Hospital provided me with a 40% discount, but Pardee BlueMD and ******************************** Services are refusing to negotiate and are requiring me to pay full price. Currently, the total for all bills combined is $1071.40. Pardee BlueMD does offer a sliding pay scale for which I do not qualify; however, they adamantly refused to discuss the option of a self-pay discount. I am asking Pardee BlueMD, since they are Pardee affiliated, to please offer me the same negotiating courtesy as they would BCBS and provide the same 40% self-pay discount to my bill as Pardee Hospital provided.

  Business Response

  Date: 06/19/2024

  Hello,

  Pardee Blue MD is a Federally Qualified Health Center and is not able to provide patient discounts to anyone with an income above 200% of the Federal Poverty Level.  This is a federal requirement of Federally Qualified Health Centers. 

  We offered the Sliding Fee Scale application to ******************, but he declined and stated in his complaint that he would not qualify. 

  ****************** signed an Declination to apply for the Sliding Fee Discount and in that document it states that no other adjustments would apply. He signed the document on 4/16/24.

  Thank you,

   

  Customer Answer

  Date: 06/21/2024

   
  I am rejecting this response because: the Declination to Apply for the Sliding Fee Discount document mentioned in Pardee Blue MD's response is not located in MyUNCChart nor was it provided to me at my appointment so I am unable to view it to verify its validity. Also, while I did receive a reminder on April 11 for my April 16 appointment, Pardee Blue MD did not provide me with a Good Faith ******** (GFE) or information about its sliding fee discount policies. According to the Department of Health and ***** Services, under the No Surprises Act, FQHCs are obligated to issue a GFE to uninsured and self-pay patients several days before the appointment. To say that I was surprised to receive three separate bills from three separate businesses from this single new patient visit with Pardee Blue MD is an understatement, especially given the amounts due. Had I received a GFE and information about the sliding fee discount policies, I would have had the opportunity to ask relevant billing questions prior to my appointment. Since this information was not provided to me prior to receiving my bills, I am now once again asking Pardee Blue MD to please afford me the same negotiating courtesy as they provide commercial insurance companies. Specifically, to honor the same 40% discount that Pardee Hospital graciously provided. A 40% self-pay discount would be a $237.20 reduction to my $593 bill, resulting in a $355.80 balance due. Thank you in advance for your re-consideration.   
  
  

  Business Response

  Date: 06/28/2024

  Hello,

  Just wanted to provide an update. My team unfortunately does not have the authority to apply discounts to Pardee Blue MD accounts, therefore, our request for an adjustment was sent to our UNC Physician's Billing Team on Tuesday June 25th. I did explain to UNC I needed an answer by today, but I have not received the final word. May I have until Monday to respond with a definite answer to Mr. ******** request?

  Thank you,

   

   

  Business Response

  Date: 07/03/2024

  I apologize for the delay. ********************** physician account ********** has been adjusted to zero. He still has a hospital account balance of $407.40. 

  Thank you,

   

  Customer Answer

  Date: 07/03/2024

   
  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.