ComplaintsforAtrium Health Wake Forest Baptist

• Initial Complaint

  07/18/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I keep getting a bill I have paid already. Spoke with Service persons twice and first was given a number that did not work. Second time I was on hold for 37 minutes with no connection. Attached is a copy of the paid check and the deposit information showing it going into their account.Attached is also other communication and data that should be needed in this complaint.I hate to do this, but I should not be punished for something they did and refuse to understand it was paid.

  

  Business response

  07/19/2024

  Thank you for your inquiry. Atrium Health Wake Forest Baptist (AHWFB) has reviewed **************** concern and provided our findings below. Our apologies the patient was not able to reach us by phone timely. Patient(s) can also reach out via e-mail to *************************************************.

  The attached payment of ***** on check #**** dated 3.14.24 was made as the patient indicated. However that payment was related to a lab bill and is listed as paid by the 3rd part vendor *****, which has received his payment. The patient is currently receiving a bill for the date of service 2.9.24 which had to process with insurance and his initial statement date was  on 3.18.2024 in the amount of ***** which is still outstanding. As a courtesy to ************** his account has been rest to allow him time to send in the payment which is due.

  Regards,

  Customer Service

   

  Customer response

  07/19/2024

   I am rejecting this response because:

  CK# **** did pay the $26.22, The check related to the complaint is ck# **** for $32.55.

  Copy attached
  
  

  
  

  

  Business response

  07/24/2024

  Thank you for your inquiry regarding ************** account, *********. Attached you will find examples of statement tops for both Atrium Health Wake Forest Baptist ***************** also known as Xifin/account number ******** which is not the same business as the patient's account at ********************** (Guarantor account #**********.

  This reviewer has contacted the ********************** on behalf of the patient, as it appears both payments the patient has inquired about (***** and *****) were mailed to the the ********************** which has a different contact number *************) and mailing address for payments (PO Box  of ******). A request on behalf of the patient has been made to have the ***** payment transferred to Atrium Health Wake Forest Baptist from the Diagnostic Lab. ************** account here has been placed on a temporary hold for 30 days to allow the transfer to be completed.

    It is our desire to provide optimum patient satisfaction to our patients. Atrium Health Wake Forest Baptist is committed in providing quality patient care in a caring and compassionate manner and value our commitment to quality customer service. Again, we appreciate you taking the time to share with us your concerns and allowing us the opportunity to review your request.  Please let us know if we may be of further service to you. Please contact our billing office at ************ or toll-free at ************.
  
  
  Sincerely,
  Atrium Health
  Wake Forest Baptist

• Initial Complaint

  04/01/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My caregiver was hospitalized in December. I knew my primary doctor had scheduled an appointment with Dr. ******** ******* but thought I would reschedule it when they called to confirm the appointment. They never confirmed the appointment, but billed me $287.00 as a no show. I have never knowingly missed any appointment, let alone a doctors appointment. Wake Health has been very aggressive about pursuing the charges, including calling me at home during the Easter weekend.

  

  Business response

  04/02/2024

  Please see attached response and statement. As a one time courtesy this patient's account has been rest to allow him time to make payment or set up a payment plan on the (2) dates of service he was seen and is being billed for currently.

  Thank you,

  Customer Service

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

   

  Customer response

  04/03/2024

   I am rejecting this response because:
  
  I do not owe this fee, as I have explained to every one of WakeHealths representatives who called. Dr. ******** office never contacted me to confirm the appointment. Most medical practices in this area charge a $25 fee at most in cases of this sort, not $287.  This is exorbitant, particularly since they made the mistake! No way will I accept this settlement! Thank you.

• Initial Complaint

  02/19/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I broke my ankle on 3-27-2023 and went to Atrium Health Wake Forest main campus Emergency Room. 'The **ray confirmed a trimalleolar fracture (tibia, fibula and ankle). I had surgery by ************* on 4-5-2023. Before the surgery a Wake Forest employee advised they did not have time to pre-authorize my surgery with my primary insurance (UHC) because it's effective date was 4-1-2023. The employee advised they would need to bill my secondary insurance (BC/BS of Michigan) for the surgery. My husband ****** agreed as we had no idea what this would mean and I was in severe ********/BS paid the bills (less my out of pocket portion $6000.00 approx. that I paid myself)to Wake Forest Hospital. In October of 2023 BC/BS became aware of my primary insurance and took back every single payment they made to all providers. BC/BS did this because they were billed as primary instead of secondary. Until this happened I had no clue about this industry standard. I contacted both UHC, BC/BS and Wake Forest more times than I can count as I am receiving invoices from ***** ***** radiology...everyone. I have two insurances which I pay a great deal for each month. I should not have ANY bills due after April 5, 2023 as I met my deductible and out of pocket responsibility. The surgery was over $62,000.00. Wake Forest submitted the surgery bill to UHC and UHC has paid their portion. However, as of 2-16-2024 they still have not re-submitted the bill to BC/BS, which is causing my deductible and out of pocket not to be reflected on the EOBs. I talked to BC/BS on 2-16-2024 and all they need is the invoice to be resubmitted by Wake Forest. BC/BS said my only alternative is to print the EOBs from UHC showing they have made payment to Wake Forest and fax them to BC/BS so they can process them! I do not have a fax and Wake Forest knowingly processed the invoicing incorrectly, I paid them what I owed, how is it legal for them to hold off so long on this? I am afraid my credit will be ruined as I pay my bills on time and have an excellent rating. **** at Wake Forest has promised it is being processed but every time I check it has not. Also, Wake Forest is currently showing a $5,000.00 CREDIT on my account which they refuse to refund until BC/BS has been billed? They are holding my money AND not re-submitting the claim! I asked why, obviously after BC/BS is resubmitted my bills will be lower not higher? ANY help you can provide would be appreciated. I have muscular dystrophy and the anxiety and stress this has caused of the last year is taking a toll on my health.

  

  Business response

  02/23/2024

  2.23.24
  Better Business Bureau
  *******************************************************************************************; 27101
  Attn: ***********************
  
  Re:       ID ********      *****************************
  
  Dear ************,
  
  Thank you for your correspondence dated February 19, 2023,regarding the above-referenced file.Atrium Health Wake Forest Baptist (*****) has reviewed the concern for ********************** with our findings below:
  
  Our goal at ***** is to provide quality patient care in a caring and compassionate manner, and we regret ********************** feels that her experience with us was anything less than excellent. We hope this information is reassuring that her concerns were taken seriously and addressed with the utmost care and sensitivity.
  At the time of the patients accident on 3.27.23 her current primary insurance had not taken effect. Unfortunately,since the United Healthcare policy was not active it is not possible to get a pre-authorization from insurance prior to the procedure though this did occur as time is required by the patients insurance company to review requests for approvals. Claims did initially file to the patients ********** policy that has a ******** deductible in error which has been corrected. United Healthcare did receive a claim for the $62,677.11 mentioned by the patient. Currently $700.00 is still processing with the patients primary insurance. A claim has also been submitted to ********** as of 2.21.24 which is currently awaiting adjudication.As $2930.65 is still processing with Insurance on Invoice # *********, that amount is currently not eligible for refunding until ********** has processed the secondary claim. A request to refund has been made on behalf of the patient in the amount of $2,730.87. Please allow up to 6 weeks for the check to be received in the mail. Once ********** process the secondary claim the account balance can be revisited. ********************** will likely receive her explanation of benefits before ***** does.
  Our apologies for any distress the patient may feel due to the filing error. Several charges have been adjusted due to incorrect payer invoked on this account.
  Regards,
  Customer Service
  ********************************************* Blvd/ *************, **  27157
  Toll Free **************
  ************** /   Fax ************** *************************************************
  Atrium Health Wake Forest Baptist Health is now Atrium Health Wake Forest Baptist

  Customer response

  02/25/2024

   I am rejecting this response because:

  The primary problem I am facing is the invoice for my ankle surgery on 4-5-2022. ***** did not bill my primary insurance UHC only my secondary BCBS. This invoice MUST BE SUBMITTED IMMEDIATELY as BCBS has revoked all payments made to providers as of October 2023 when they found out I had a primary insurance. I have a stack of invoices threatening collection and I am terrified of my credit being ruined. Also I have paid ***** more than ******** out of pocket!! So a **** $2900.00 is ridiculous.
  
  

  
  

  

  Business response

  02/26/2024

  Good Morning,

  United Healthcare (UHC) has already made payment on your 4.5.23 visit, which was posted at Atrium Health Wake Forest Baptist  on 2.2.24. An explanation of benefits should have already been sent to your home by UHC. The balance of which has refiled to ********** as a secondary in February as your primary needed to file first. There are No charges here in collections. .Additionally a contact was made to the Wake Lab and there are no charges related in collections. Your credit has not been impaired. Charges prior to 4.1.23 were processed with ********** only. The 3.27.23 to 3.28.*****  visit processed to your deductible  = *******. As your secondary has a ******* the current  remaining charges are anticipated to go to your ********** deductible. Once an explanation of  benefits is received from ********** - the account will be re-evaluated.

  Regards,
  
  Customer Service
  ********************************************* Blvd/ *************, **  27157
  Toll Free **************
  ************** /   Fax ************** *************************************************
  Atrium Health
  Wake Forest Baptist Health is now Atrium Health Wake Forest Baptist

  Customer response

  02/26/2024

   I am rejecting this response because:

  As of the date this complaint was filed, BC/BS had not received the refilling. Please provide the date the surgery claim was submitted. 
  Also, I have bills with labs, radiology, Novant health not Wake Forest which are past 120 days due (October 2023) due to the delay in my APRIL 2013 surgery not being submitted to my insurances correctly. Also, I do not see a follow up to my account credit? After further checking I paid ATWFB a total of over $8,000.00! However the patient portal is now blocking me from seeing my payments or statements. This is illegal I believe?
  
  

  
  

• Initial Complaint

  01/23/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I have been trying to schedule an initial appointment, and more importantly, a Stretta procedure with Dr. *******. I was told by a nurse at the procedure line that I needed to have my referring gastroenterologist fax over a referral. My doctor did so on December 20,2023. The referral was faxed to 336-********. I called to confirm the procedure department received this on December 27,2023 ( I called 336-******** 1). A woman confirmed she received it (she said she received it and faxed it over to the procedure line herself on 12/20/23) and put me on hold while calling the GI office department at phone number, 336-********. They confirmed they also received it and a nurse would call me the next day to continue to schedule my appointment with Dr. *******. I waited a full week and never heard anything. I called the GI department and spoke to M***. She was very short and unhelpful. She said the procedure line did not make me a “chart”, therefore she couldn’t do anything for me. She told me a phone call could take weeks and that I “needed to be patient.” I told her I had been patient and waiting for 3 weeks at this point. Again, I waited for a phone call and it never came. I called the procedure line again on 1/13/24 and spoke to A******. She was very sweet and helpful. She agreed that someone from the procedure line department was supposed to make my chart as soon as they received my referral on 12/20/23 and that was the reason no one was calling me. I explained how frustrated I was and that the office was delaying patient care. She was kind enough to make my chart while I was on the phone while also sending an email to her manager and the office manager of the GI department, B***. A****** said she could no longer find my GI referral (that was confirmed received by both departments at the end of December of 2023). She said this was because no one made me a chart. I tried contacting manager B*** 1/16/24 when I spoke to T****. She said she would call me back and never did.

  

  Business response

  02/02/2024

  Dear BBB,
  
  At Atrium Health Wake Forest Baptist, we value you as our patient, your care and patient experience is of our utmost priority. It is always our desire to provide the highest quality care and satisfaction in a compassionate and professional manner. Possibly misinformation has been provided to the patient, our apologies. A Medical Record was created for this patient on 1.10.24. This patient's referral was transferred to the clinic since Dr. ******* always reviews referrals specific to the requested procedure prior to an appointment being scheduled. Dr. ******* usually sees these patients in his clinic prior to scheduling a procedure with this patient's appointment, which is currently scheduled for 2.13.24 at 2:00pm for Ms. *******. The procedure the patient is interested in is preformed approximately every 3 months.
   Again, we appreciate you taking the time to share your concerns with us as this allows us the opportunity to continually evaluate and improve our services to ensure each visit and experience is a positive one. Please let us know if we may be of further assistance to you. You may contact our billing and customer service office at 336-********.
  
  As always, thank you for choosing Atrium Health Wake Forest Baptist!
  
  Sincerely,

  Customer Service

  Atrium Health Wake Forest Baptist

  Customer response

  02/02/2024

   I am rejecting this response because:
  
  2 days after I made this complaint, wake Forrest GI called to schedule my appointment. That’s no coincidence. Then, after that was scheduled they made their response to BBB. It is evident wake Forrest atrium did not take ANY accountability for the situation I had to go endure. I have proof that my referral was sent to the procedure line on 12/20/2023 and it was confirmed the procedure line and GI office received the referral on that date when I called on 12/27/2023. I have listed in my complaint the dates and names of employees I spoke with and the misinformation I was given. Management, in addition to all employees, failed to do their job duties, thus, delaying patient care. 

• Initial Complaint

  12/27/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  12/26/2023 I went to **** ****** Family Practice for what I was told a scheduled appointment. Was told that they couldn't find my appointment. The office manager came out as was very aggressive and hateful. Saying they were a sister practice to next door. My Physician Dr. ******* has passed away and the Nurse practitioner next door doesn't like to see patients, she had rather talk on the phone . I had to beg to come into the office so she could listen to my chest she ordered a chest x-ray stat upon hearing how bad my chest congestion was.. I informed the nasty office manager that I would run out of blood pressure meds as well as other med that Dr. ******* had me on and her reply was oh well. That's considered denial of medical care. I also will be filing a complaint with the AMA.

  

  Business response

  01/11/2024

  1/11/24
  
  Better Business Bureau
  119 Brookstown Avenue, Suite 304
  Winston-Salem, NC  27101
  Attn: Melissa Neal
  
  Re:       ID 21055413      ***** *. *****
  
  Dear Ms. ****,
  
  Thank you for your correspondence dated December 27, 2023, regarding the above-referenced file. Atrium Health Wake Forest Baptist (AHWFB) has reviewed the concern for Mr. ***** with our findings below:
  
  Our goal at AHWFB is to provide quality patient care in a caring and compassionate manner, and we regret Mr. ***** feels that his experience with us was anything less than excellent. We hope this information is reassuring that his concerns were taken seriously and addressed with the utmost care and sensitivity.
  Mr. ***** arrived at our *********** ******** ******** clinic at 8:00am on 12.26,2023 without an appointment. Mr. ***** was advised the day prior this clinic would not be scheduling an appointment. Attached is a copy of a Dismissal letter sent to Mr. ***** dated November 2, 2023, which allowed additional care thru December 3, 2023. Our clinic (s) cannot fill medication for someone who is not an active patient. Mr. ***** has since completed a new patient appointment with ****** ******** ** ***********. Hopefully, this new relationship will be mutually beneficial as long as treated with mutual respect.
  Regards,
  
  Customer Service
  Medical Center Blvd\ Winston-Salem, NC  27157
  Toll Free (833) 662-7921
  (336) 716-3966 \   Fax (336) 716-1700 [email protected]
  Atrium Health
  Wake Forest Baptist Health is now Atrium Health Wake Forest Baptist
  

• Initial Complaint

  12/21/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I have continuing problems with billing at this facility. I see a mental health professional via telephone only visits. It has been like this for 2+ years. They are scheduled as "Return Clinician Phone Visits". There is no copay since they are telehealth. Upon submission to insurance they are being changed to "Office Visit" and I'm being charged a $20 copay. ****** straightened out many of these past errors; however, Atrium is back dropping off the qualifier indicating telehealth / telephone. Atrium has spoken with ****** multiple time, Atrium agrees the money isn't owed, and promises to rebill with the correct qualifier. They do not through. ****** has called at least 5 times regarding the error, I have called at least as many. I'm told this is ******'s error not theirs, they will not rebill, and if I don't pay they will take me to collections. I need help in resolving this once and for all. The dates in question are: 12.20.23, 11.22.23, 11.10.23, 10.26.23, 10.13.23, 09.29.23, 09.15.23, 09.01.23, 08.18.23, 08,04.23

  

  Business response

  01/10/2024

  1/10/24
  
  Better Business Bureau
  119 Brookstown Avenue, Suite 304
  Winston-Salem, NC  27101
  Attn: ******* ****
  
  Re:       ID ********      ******* ******
  
  Dear Ms. ****,
  
  Thank you for your correspondence dated December 21, 2023, regarding the above-referenced file. Atrium Health Wake Forest Baptist (AHWFB) has reviewed the concern for Ms. ****** with our findings below:
  
  Our goal at AHWFB is to provide quality patient care in a caring and compassionate manner, and we regret Ms. ****** feels that her experience with us was anything less than excellent.  We hope this information is reassuring that her concerns were taken seriously and addressed with the utmost care and sensitivity.
  Claims correctly billed to the patient’s ****** ******** policy, with the ninety-three modifier which processed without a co-pay for dates of service: 8/18/23, 9.29.23, 10.13.23 and 10.26.23. Two dates of service mentioned by the patient were physical therapy related, which does require a co-pay: 9.1.23 and 9.15.23. Correction processed on three dates of service mentioned by the patient on 12.28.28 for: 8.4.23, 11.10.23, 11.22.23. Insurance modifiers were on the account invoices, however, did not process onto the insurance claim. The 12.20.23 visit has not yet transferred from an insurance status and is not currently billing the patient.
  Our apologies for any distress the patient may feel due to the filing error, the account has been corrected.as of 12.28.23 with claims refiled for 8.4.23, 11.10.23, 11.22.23 and 12.20.23 all currently processing with insurance.
  Regards,
  
  Customer Service
  Medical Center Blvd\ Winston-Salem, NC  27157
  Toll Free (833) 662-7921
  (336) 716-3966 \   Fax (336) 716-1700 [email protected]
  Atrium Health
  Wake Forest Baptist Health is now Atrium Health Wake Forest Baptist
  

  

  Business response

  01/11/2024

  Good Afternoon,

  Ms. ****** is not currently being billed for the 12.20.23,11.22.23,11.10.23 or 8.4.23 related to her Telehealth visits, which are still filing to insurance and require additional time to reprocess. Unfortunately Atrium Health Wake Forest Baptist along with this patient must wait on her insurance company to reprocess these claims. Excluding the visits previously mentioned, Ms. ****** had an outstanding patient balance of 70.00 for Date of Service 12.1.23.. 20.00 has been applied to Invoice/*** ********* related to the 12.1.23 visit as accounts with outstanding balances are not eligible for refunds. .

  Regards,

  Customer Service
  Medical Center Blvd\ Winston-Salem, NC  27157
  Toll Free (833) 662-7921
  (336) 716-3966 \   Fax (336) 716-1700 [email protected]
  Atrium Health
  Wake Forest Baptist Health is now Atrium Health Wake Forest Baptist
  

  Customer response

  01/11/2024

  Better Business Bureau:
  
  Provided Atrium begins billing correctly for Dr. ******' appointments, I will accept this resolution. I'll ask that they apply payments as specified on my checks, and CORRESPONDING to their invoice. I'll accept the business' solution in reference to complaint ID ********. I do appreciate their efforts to begin straightening out this problem.

• Initial Complaint

  08/07/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On 6/13/23 I went to have ear wax removed. I have been going to this practice for close to-- if not over-- 10 years. I paid $100 upfront as my share of the visit. When I received the bill there was a $205 charge for being a "new patient." I called the billing number and spoke to a representative who said it was because I had "not seen the Dr. for 3 years and 1 month" that I was being billed as a new patient. I explained that I was an established patient and more importantly, I was NEVER told that I would be billed as a new patient when I made the appointment. Several attempts were made to change this charge to no avail. Every person I spoke to claimed they had no authority to change this code and kept passing me back to general billing. I asked for the Office Manger at Atrium Health Wake Forest Baptist **** **** *** ****** ********** - ********** -- Formerly known as ********** **** **** *** ****** **********, but was given the same answer as not my area, please call this number. The number to general billing. My desire is to have the balance of $97.47 waived as this is what I would term "surprise" billing that has been outlawed. Again, this was never explained to me at the time of my making the appointment or the actual Dr. office visit. Account Number: ********* Date of Visit: 6/13/23 Atrium Health Wake Forest Baptist **** **** *** ****** ********** - ********** Formerly known as ********** **** **** *** ****** **********

  Customer response

  08/18/2023

  I have not heard from the business in response to my complaint.

  
  

  

  Business response

  08/23/2023

  Dear BBB,

  Thank you for your inquiry regarding ******* ********’s account related to her 6.13.2023  visit . It is our desire to provide optimum patient satisfaction to our patients. Atrium Health Wake Forest Baptist is committed in providing quality patient care in a caring and compassionate manner and value our commitment to quality customer service. Ms. ******** has been seen previously at ********** ENT, however there had been a long span of time since her last visit which required her chart to be updated as it had been over 3 years since her last appointment. A new patient is one who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice within the past 3 years. The physician had the options of (2) codes 99203 and 99202 and chose the lesser code of 99202. This patient is misunderstanding the resent law that was passed:“Surprise billing” is an unexpected bill from an out of network provider or an out of network facility mainly related to unexpected accidents/illnesses related to emergency rooms, and a patient having to be seen emergently at out of network facilities. There is also a law relate to “Good Faith” estimates” when received prior to service and the bill having to be within 400.00 of the estimate. None of these (2) options qualify for this patient. The A**** Managed Care plan of the patient was filed as a courtesy with the insurance explanation of benefits processed  by her own policy the amount to bill the patient which was a total of 197.47. The patient was billed correctly however as a one time courtesy the 97.47 has been adjusted as we value the relationship with Ms. ********.
  Again, we appreciate you taking the time to share with us your concerns and allowing us the opportunity to review your request.  

  Thank you for your inquiry regarding ******* ********’s account related to her 6.13.2023  visit . It is our desire to provide optimum patient satisfaction to our patients. Atrium Health Wake Forest Baptist is committed in providing quality patient care in a caring and compassionate manner and value our commitment to quality customer service. Ms. ******** has been seen previously at ********** ENT, however there had been a long span of time since her last visit which required her chart to be updated as it had been over 3 years since her last appointment. A new patient is one who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice within the past 3 years. The physician had the options of (2) codes 99203 and 99202 and chose the lesser code of 99202. This patient is misunderstanding the resent law that was passed: Surprise billing” is an unexpected bill from an out of network provider or an out of network facility mainly related to unexpected accidents/illnesses related to emergency rooms, and a patient having to be seen emergently at out of network facilities. There is also a law relate to “Good Faith” estimates” when received prior to service and the bill having to be within 400.00 of the estimate. None of these (2) options qualify for this patient. The A**** Managed Care plan of the patient was filed as a courtesy with the insurance explanation of benefits processed  by her own policy the amount to bill the patient which was a total of 197.47. The patient was billed correctly however as a one time courtesy the 97.47 has been adjusted as we value the relationship with Ms. ********.
  Again, we appreciate you taking the time to share with us your concerns and allowing us the opportunity to review your request.  

  Thank you for your inquiry regarding ******* ********’s account related to her 6.13.2023  visit . It is our desire to provide optimum patient satisfaction to our patients. Atrium Health Wake Forest Baptist is committed in providing quality patient care in a caring and compassionate manner and value our commitment to quality customer service. Ms. ******** has been seen previously at ********** ENT, however there had been a long span of time since her last visit which required her chart to be updated as it had been over 3 years since her last appointment. A new patient is one who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice within the past 3 years. The physician had the options of (2) codes 99203 and 99202 and chose the lesser code of 99202. This patient is misunderstanding the resent law that was passed: “Surprise billing” is an unexpected bill from an out of network provider or an out of network facility mainly related to unexpected accidents/illnesses related to emergency rooms, and a patient having to be seen emergently at out of network facilities. There is also a law relate to “Good Faith” estimates” when received prior to service and the bill having to be within 400.00 of the estimate. None of these (2) options qualify for this patient. The A**** Managed Care plan of the patient was filed as a courtesy with the insurance explanation of benefits processed  by her own policy the amount to bill the patient which was a total of 197.47. The patient was billed correctly however as a one time courtesy the 97.47 has been adjusted as we value the relationship with Ms. ********.
  Again, we appreciate you taking the time to share with us your concerns and allowing us the opportunity to review your request.  

  Customer Service 

  Atrium Health
  Wake Forest Baptist Health is now
  Atrium Health Wake Forest Baptist

  Customer response

  08/23/2023

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and I accept it.  I appreciate your adjusting the $97.47 off my bill.  I also agree with your statement on "surprise billing".  After sending the compliant, I researched and found more information on that subject. I would suggest, however, that when making an appointment, it is disclosed at that time about the "3 year rule".  I think it will be very helpful in avoiding any confusion when the bill comes in from the Drs. office.  Again, thank you.

• Initial Complaint

  07/01/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I recieved services at Wake Forest Baptist Health/Atrium Health endoscopy center/digestive health, a Rheumatologist as well and a Dr ******* **** and his assistant *****. They have a copy of my insurance that was a used at the date of services (most expensive one an endoscopy) on May 25th. When I first called them they assured me my insurance was in network. I was never told otherwise and at each appt, or procedure or test all they did was ask for my copay. Which I then said I didn’t have copay as I had met my out of pocket max for the year and they said oh ok. Moving forward I was sent no bills and at my most recent appt they discussed my insurance with me again and I was not told I was out of network or owed any money!!! All of a sudden I have a $14,000 bill and more on the way saying insurance is covering nothing. !!!! Bcbs sent me the denial claims today and said I visited an out of network facility!!!!!!! How was this mistake made??? Why did they tell me they took my insurance and assured me they were in network ???? They even billed bcbs. I did not call bcbs to make sure of this bc I have been so sick and in so much pain so I was trusting them when they made a copy of my insurance card and continued to treat me.!!!!! Not once did they say I owed any money !!! I am devastated as I am on disability I can’t pay this high bill that is going to get even higher!!!!! I am just devasted. I would have never chosen to get help here if I had known they were out of network!! I have reached out to a Lawyer. And plan to file an appeal with bcbs telling them I was misinformed and thought I was covered all along. I should not be held responsible for all these charges !!!!!! I am so upset !

  

  Business response

  07/07/2023

   Blue E shows the claim that Atrium Health Wake Forest Baptist filed to Blue Cross as "Paid To Patient" and there is no access for this provider to see what was paid/denied to patient. To fully respond to this patient's concern - a copy of the full Blue Cross explanation of benefits for each date of service is required from the patient please.
  
  

• Initial Complaint

  02/28/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  This facility billed my auto insurance without my knowledge after my auto accident on Sept. 2, 2022 and when I asked them not to cash my medical payments check back on Oct. 21, 2022 and to bill my health insurance they said they would cash and hold my medical payments check of $5,000 until my health insurance paid and made the necessary adjustments. My **** was billed on Oct. 28, 2022 and my health plan paid this facility back on Jan. 9, 2023- I would only owe $1,505.00 after my insurance adjustments were made, and as of Feb. 6, 2023 at approximately 6:30 PM EST- no payment had been received. I have now left 2 voicemails with no response since my last conversation back on Feb. 6, 2023, on the status of my account and when I can expect my refund of $3,495.00 for the amount that is now considered to have been overpaid for services rendered.

  

  Business response

  03/06/2023

  Good Afternoon,

  This patient account has been reviewed per the inquiry by Ms. ***************. The patient was involved in a liability and is as the patient described  which is handled by our business partner ACI- Administrative Concepts (contact  information: 336-554-7783). The amount the patient is requesting refunded is in process of being refunded to her Med-pay carrier as the payment source, which in turn will re-issue the funds to the patient. Refunds can take up to 6 weeks for processing. Ms. ***************  can follow up with her Med-pay carrier at that time.

  Kindest regards,

  Customer Service 

  Atrium Health Wake Forest Baptist

   

  Tell us why here...

  Customer response

  03/06/2023

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and I accept it.

• Initial Complaint

  02/27/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On 11/4/2022 I had a colonoscopy performed at the Atrium/Wake Forest ********* ****** ** ******** ****. This procedure is covered 100% by my insurance company, ***** of NC. The attending physician, nurse and facility all billed the procedure as related to a colonoscopy. However, the anesthesia portion of the procedure was billed as related to an endoscopy. Therefore, my insurance denied this portion of the procedure. I talked with my insurance company to find out what the problem was with the claim and they indicated that that the CPT code used, ***** **, "was not a preventative code for the procedure." I did some research and found out that CPT code ***** is for anesthesia used related to an endoscopy. CPT code ***** is for anesthesia used related to a colonsoscopy. I have informed Atrium/Wake Forest billing of this "error", several times. The billing office said they performed a coding review and state that they billed correctly. I have also messaged the attending physician who performed the colonoscopy. He replied that the billing department had not informed him of my inquiry, and that he would talk to GI billing and the office supervisor. I have not heard back from anyone. This is either a simple coding error or fraudulent medical billing. I did not have an endoscopy performed. I had a colonoscopy performed. Attached are copies of the message threads related to the billing department and the attending physician, along with the bill from Wake. Sincerely, ****** *****

  

  Business response

  03/06/2023

  Dear BBB and Mr. *****,

  Atrium Health Wake Forest Baptist has reviewed the claim documentation in question for 11/4/2022 procedure note and Anesthesia record.  A charge correction for this claim updating the CPT code from ***** to ***** has been completed with the claim to be refiled to your **** ***** policy. The coder was following CMS guidelines for coding a screening colonoscopy that turns into a diagnostic one which is coded with CPT code ***** for most insurance(s). Managed Care and Commercial Insurances require CPT code ***** to bill. Our apologies for the error and any undue stress this may have caused the patient while this charge was in review.

  Kindest Regards,

   

  Customer Service 

  Atrium Health Wake Forest Baptist

  336-716-3966

  Customer response

  03/06/2023

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and I accept it.

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