ComplaintsforRaleigh Orthopaedic Clinic, PA

• Initial Complaint

  06/04/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I called in December 2023 to have a second opinion by a hip specialist. I explained my condition (hip dysplasia with a labral tear) and the referral/front desk coordinator said I should see ************** based on my diagnosis, and assured me that he was familiar with my condition and treats it. I asked him to please make sure someone at this practice is knowledgeable of the condition, since hip dysplasia is rare. He assured me that ************** would be able to help me, and to send my medical records to them with my imaging results so that the team could look ahead of time. I sent all my records to the provided email and sent a follow-up email. I came to my appointment on-time, and it took about an hour to be called back. Once I was called back, they immediately told me to get ready for the **Ray. I was confused, since I already had multiple X Rays and MRIs, and told them I already sent all of my imaging to the team. The nurse looked confused and sent me to my room to wait for the Doctor. I had a nurse come in multiple times to confirm who I was, they were confused I had already sent my imaging studies and were "trying to find it". Turns out the doctor never reviewed my information I waited another 30 min in the room before the doctor showed up. He had not reviewed any of my imaging, and quickly told me he doesn't know about Hip Dysplasia, and he does not even do the surgery anymore to repair the labrum. How is it ethical to send me on my way without even doing an exam or looking at my imaging studies? He was not in my room for 5 minutes. He did not do an exam, no review of my medical history, nothing. Then, they STILL charged me for the x-ray that was not performed and for an office visit. I did not get an **ray nor did I get a full office visit. I have disputed and they sent me to collections after I paid $100, which I thought was more than fair. They continue to ignore me.

  Business response

  06/04/2024

  Good afternoon, after speaking with the patient on 5/17/24 I reached out to the Physician and provided the patient complaint information. On 5/21/24 he responded to the email as indicated that he in fact did review the imaging and the health information was shared in the paperwork that she too filled out on arrival. He confirmed x-rays were reviewed. There was a clerical error that was made regarding the charge of x-rays and those charges were removed before my initial conversation with her on 5/17/2024 (of which the patient also confirmed).

  Services were rendered for her visit (it was scheduled as a second opinion). The surgeon that she saw that day is a total joint and sport medicine physician who has been practicing orthopedics for over 20 years. While he may not do this surgery much anymore himself, she was here for a 2nd opinion. He advised her that she should follow the recommendations from Duke. I have attached the office visit note from that date of service.

  As for not getting back to her, I personally was out of the office from 5/18-5/27 returned only for 2 days to be out again on 5/30 & 5/31. Personally, working on getting through items that need attention. There was an out of office reply to my emails that would have informed her of my absence. My sincere apologies for the timing of the events however, she was sent to collections prior to contacting me on 5/17/24. 

   

  Please let me know if any further information is needed.

  Thanks, 

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

  Director of Clinical Services

  Customer response

  06/04/2024

   
  Complaint: 21801148
  
  I am rejecting this response because:

  ************** did not perform any physical exam to confirm the diagnosis, nor did he indicate in any way he reviewed my images prior to the appointment.  I was incorrectly told by the scheduling department that ************** was experienced with Hip Dysplasia and labral tears, and that he would be an appropriate physican to reach out to for a second opinion.  ************** informed me that he had "heard" of a PAO but did not know anything about it.  I was misled into believing that this physician would be an adequate second opinion, which was not the case.  I have tried since February to contact the billing department, each time I was sent to voicemail. I never received a call back from ***** until 5/17, 3 months later.  I also sent $100 to pay for a portion of the bill that I felt was adequate considering the level of "care" received.  I have written a letter, I have called, and instead of speaking with me, I was sent to collections instead of professionally contacting me in a reasonable period of time.  I received no automated email from ***** that she was out of the office, as I do not have her email, and none of the billing staff responded to let me know that she was out. It appears she also had the response from ************** before she went out of office again for the second time, and still did not contact me as she said she would on voicemail.  I am appalled that a business would find it appropriate to ignore patients that they do not want to deal with.  There has been no understanding or desire to work to find a solution and reduce the bill to account for the lack of care and for being misled into believing this was an appropriate place for me to seek care.  ***** informed me that I should not expect much from their scheduling department in regards to them knowing about my condition, which is fair.  In that case, why did they specifically tell me that he was experienced in that area if they should not have said that? This business is not taking any accountability for that.  Additionally, if ************** reviewed my imaging as he said that he did, then why did he still think it was a good idea to come in, considering he was not experienced in hip dysplasia? How was he so sure of the diagnosis and able to provide a good faith second opinion that I should continue with Duke, if he knew nothing of dysplasia, and no longer did the labral repair surgery? Why was I scheduled with a total joint replacement doctor for this when clearly I should not have been? This is a money grab tactic by the clinic to see patients they are not qualified to see, and get $241 for lack of experience and a sub-par 5 minute conversation. 
  
  Sincerely,
  
  ***************************

  Business response

  06/05/2024

  Good morning, 

  As stated previously, the services were rendered and the position of not reducing the fees has not change. 

  Customer response

  06/05/2024

   
  Complaint: 21801148
  
  I am rejecting this response because:

  services were not rendered as I described and my confidential PHI was shared with BBB, an unauthorized third party. I also filed a complaint with the federal trade commission and OCR.  Have a great day! 
  
  Sincerely,
  
  ***************************

• Initial Complaint

  11/01/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  The doctor recommended a knee brace in July 2023. The insurance specialist from Raleigh Orthopedic took my insurance information and called me back and told me it will cost $773 for the brace. I agreed to purchase it for that amount.A few weeks after picking up the brace, I received a payment request for $995.When I asked for an explanation, she said I need to call my insurance company. I asked her why she gave me the price as $773 if she was not sure. She should have asked me to contact my insurance company BEFORE the purchase to get the right amount. She said she will have her manager call me.The manager never called me. Instead I received a letter from a debt collector.

  Business response

  11/01/2023

  On October 18th, ************ DME manager was contacted he reached out to our billing office and they discussed honoring the $773.53. This conversation was followed up with a message sent to ********************* CBO manager for follow up, unfortunately this was missed at that time.
  
  Patient,*************************, contacted the office on 11/1/2023 and spoke to **************** Manager and honored the $773.53 brace fee. The payment was collected at this time and the patient was pleased with the results. 

• Initial Complaint

  01/17/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had surgery on Oct 14, 2022 at Rex Hospital. This was pre approved by Medicare and my doctor and the hospital verified the insurance and good faith estimates were provided. After the surgery I received a bill for 3689 dollars from a doctor I do not know. The doctors name is ******* J. ****** with Raleigh Orthopaedic. Raleigh Orthopaedic filed a claim against an insurance provider that is not my provider .After that claim was denied Raleigh Orthopaedic demands that I pay this bill. We have asked Raleigh Orthopaedic to refile the claim with our correct information but they refuse and claim I am responsible. My insurance did pay a total of $136,000 covering all other claims for this surgery so I am at a loss why Raleigh ortho will not file a claim with my insurance provider. I will make this clear .. I have never signed any release or consent with this doctor or Raleigh Orthopaedic.

  Business response

  01/17/2023

  Good afternoon,

  Dr. ****** was the Orthopedic surgeon that assisted in the surgery. Dr. ******** was the primary surgeon while Dr. ****** was scrubbed in for the entire case as provided full assistance to Dr* *********

   

  Please let me know If you need any further information.

   

  Thank you, 

• Initial Complaint

  11/02/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Our Daughter ****** ******* had a hip surgery 4/12/2022. We have paid the copay and every bill we have received. Once we paid the last $600.00 the account was paid in full. Then we get another bill for $34.00 we have tried to contact the office numberous times to find out why and where the bill is coming from. The office stated it was from her PT but PT was paid in full at every visit. Then we were told it was money still owed for the PA. When we have talked with the billing staff contact we are hung up on or put on hold and then the call some how disconnects. We leave messages in which noone calls or when they do the call is lost. Now I have been sent to collects for $74.21 in which noone can tell me why we owe the money when it was paid in full. Not only that we never got a bill for 74.21 until 11/1/22 in which as you can see in the attachments the statement sate was 10/14/22 and was not mailed until 10/24/22 in the meantime they sent it to collections and we received that statement sate of 10/22/22 so how is it noone can explain or show where the money is due and why we were sent to collections prior to even getting the bill.

  Business response

  11/23/2022

  Due to the Physical Therapy billing cycles and the number of physical therapy visits the patient completed per week the balance owed was accurate. The Central Billing Office Manager attempted multiple times to reach out to review and discuss each claim with the patients guardian, however, was not able to reach her. Direct phone numbers were provided in the messages that were left and CBO Manager did not receive a return call. We are always happy to do what we can to improve a patients experience and would have removed the $74.00 charge. Raleigh Ortho makes every attempt to collect monies owed before sending bad debt balances to collections. The system used sends out notices if 35 days has past since last payment, while there can always be room for a technical error to occur, in this situation the debt was owed. The notice the patients mother received was the first notice the organization sends out if the 35 days has past, but there are 2 more notifications sent out after that as well. This patient was not sent to collections and there was much time to respond to and review the claims and provide the necessary information. Thank you for taking the time to review this response, we are happy to help in any way we can.

• Initial Complaint

  10/24/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I have been victimized and harassed by billing/collections generated by a fraudulent bill submitted by Raleigh Orthopaedic/Therapy Services (*** ******** **** **, **** ** *****; ***** ****** provider) for chart # ****** Date of alleged service June 2, 2022. The collections account is ****************. I contacted Ms. ****** in July 2022 upon receiving the false statement and she acknowledged that she had inadvertently entered "June 2" instead of the actual session on "June 22." She stated this error would be corrected; instead I have been subjected to months of harassing billings and unfair debt collections on behalf of the therapy clinic. (I also filed a fraud claim with my insurance **** ********** ****** on the basis that the clinic submitted a fraudulent claim for services NOT rendered on June 2 and received payment from **** ********** ******). She also admitted that someone signed me in on June 2nd and then signed me out a few seconds later. I can provide evidence that I was in my work location on that date for eight hours. In total, this admission and the "stealth sign ins" raise questions about questionable business practices and insurance fraud perpetrated by the Raleigh Orthopaedic Therapy Services.

  Business response

  11/04/2022

  In response to the claim, this was an administrative error and has been rectified. The billing office has voided the claim to the carrier. The patient is not getting billed for the June 2nd date as it was an administrative error.

   

  Thank you,

  ***** ******* Director of Clinical Services

  on behalf of

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

   

  Customer response

  11/04/2022

  
  Complaint: ********
  
  I am rejecting this response because: notwithstanding the correction of the error after six months, the emotional distress of monthly billings and two collection letters- one as recent as November 1st - has not been addressed.  Compensation of some kind is due for the emotional distress due to unfair/fraudulent billing  - how about a refund of a therapy session for which I paid.  I did not fail to note that at each therapy session I had in May - July, the therapist had at least three patients in queue for the same appointment time - while I sat  at the therapy machine, another patient was t one of the tables and a third off to the side with some exercise.  The therapist was moving from one to the other but the "trick" was apparent (stacking patients).  So my payment for what I thought was my "session" does not give me the courtesy of the full attention of my assigned therapist!  I ignored that aspect of the therapy while I continued my several sessions of therapy.  However,  this business'  affront to my security with this billing error has triggered all my bad memories about the therapy . I think I should speak up about the stacking practice, especially now when I am smarting from the "error" that caused me unwarranted emotional distress (in addition to the lack of services)
  
  Sincerely,
  
  ******* ******

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