ComplaintsforAtrium Health Wake Forest Baptist

• 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.

• Initial Complaint

  12/19/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  While taking my father in for Prostate removal surgery Friday, the doctor that performed the surgery was never there. I still cannot reach him or his offices. They did the surgery and released my father the very next day, against all protocol. My father hadn’t had a bowel movement, (which they are not supposed to release you if you haven’t had one)no one showed him how to use and clean his catheter, and not one single instruction on what to expect and how to do anything for home care. The resident whom I spoke to told us Dr. ***** wasn’t available to tell us about the surgery because he left for his weekend vacation. We have tried countless times to contact his office, no one will call us back. My dad now has an infection due to the surgery and the incompetence of Dr. *****’s staff, NOT telling my 69 year old father how to properly clean and sanitize his catheter. They gave us NO instructions and now we are back in the emergency room, spending even more money to deal with an issue that could have been avoided if they had only cared enough to teach him what they needed to do. Or even kept him a couple days longer to monitor. We will be switching all of our doctors from Atruim wake forest Baptist health to the doctors at ******. Patient care seems to be their number one priority there because it seems at wake forest they are more concerned with their holiday vacations than helping the patients that are LITERALLY dying. Wake forest Baptist is more concerned about their money than patient care. My complaint is about Dr. *****. He shouldn’t be allowed to treat patients. He doesn’t care about them and it’s very concerning. Something has to be done about this as this shouldn’t have even happened.

  Business response

  12/30/2022

  Additional information is needed please Ms. ***** is not a patient- have contacted BBB via e-mail on 12.20.22 and attempted to reach out to to Ms. **** (can not verify has an authorization for the patient at this point without knowledge of the patient)left a voicemail today.  No identifying information was provided for the patient mentioned such as name, date of birth, address. No contact has been made with ****** ***** (not a patient) - have left a voicemail.

  Customer response

  01/03/2023

   I am rejecting this response because:
  
  

  My fathers name is ***** *** *****. Birthday is *********. Thank you!

  
  

  Business response

  01/03/2023

  The patient has now been identified as his name and date of birth has been provided today. Thank you. Ms. ****** ***** can call the Patient and Family Relations Department to discuss her concerns regarding her father at 336-713-2273. Someone will be more than happy to assist. Currently The HIPPA authorization on file for this patient lists his spouse and PCP only which may require Patient Relations at some point to further discussing this matter with the patient directly however bringing this concern to our attention is greatly appreciated.

  Regards,

  Stephanie ********
  Manager, PFS-Customer Service
  Medical Center Blvd
  Winston Salem, NC 27157
  Office: ***** ******** | Fax: (336) 713-4808
  
  Atrium Health
  Wake Forest Baptist Health is now
  Atrium Health Wake Forest Baptist

• Initial Complaint

  12/01/2022

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  My refund check expired and wake forest has refused to reissue the check without sending in the original copy. I don’t have it and wake forest needs to send my money

  Business response

  12/02/2022

  Thank you for your inquiry regarding your account with Atrium Health Wake Forest Baptist. We are committed to providing quality patient care in a caring and compassionate manner and value our commitment to quality customer service as well. Atrium is sorry to hear that your original refund check expired prior to you cashing the 20.00 check issued in January of 2022. Unfortunately you call on 12/1/22 got disconnected while a representative was attempting to assist you with your request to speak with a manager. Your inquiry on 11/25/2022 was transferred by our extended business office. As of today, Atrium has requested the first step which is to have the prior check voided. Once completed, a third party company currently  processes the refunds for Atrium Health Wake Forest Baptist. Due to the pending holidays, please allow 6 to 8 weeks for the refund to be received. 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. It is our desire to provide optimum patient satisfaction to our patients.
  
  Atrium Health Wake Forest Baptist would like to extend our apologies for any undue stress this misunderstanding may have caused Mr. ******* during this review process.
  Regards,
  Stephanie H*******
  Manager, PFS-Customer Service
  Medical Center Blvd Winston Salem, NC 27157
  Office: (336) 716-3966 | Fax: (336) 713-4808

  Customer response

  12/02/2022

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

• Initial Complaint

  10/27/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I called your ophthalmologist department on Wednesday, October 26. 2022 to book an appointment with Dr. ******, who I have seen before. I had my eyes examined by my optometrist. Dr **** ****** and she requested that I bee seen my Dr. ******. I was told I could see Dr. ****** in April 2023! Six months to wait for my appointment. I think that is entirely too long to have to wait. ******* ********

  Customer response

  11/07/2022

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

  
  

  Business response

  11/11/2022

   

  November 11, 2022
  
  
  
  Dear Melissa ****
  
  Thank you for your correspondence regarding the above-referenced file. Atrium Health Wake Forest Baptist (AHWFB) has reviewed the concern for Ms. ******** and provided our findings below.
  Our goal at Wake Forest Baptist Health 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.

  Practice Manager Ms. ******** of the Ophthalmology Department of Atrium Health Wake Forest Baptist has reached out to the patient and provided her direct contact information in an attempt to accommodate the patient appointment change but has not yet made contact with Ms. ********. A message was left for the patient today to return the Office manager's call. Patient's always have the option to request to be placed on a waiting list should there be a delay in an appointment time.
  

   

  Kindest Regards,

  Stephanie ********
  Manager, PFS-Customer Service
  Medical Center Blvd Winston Salem, NC 27157
  Office: ***** ******** | Fax: (336) 713-4808

• Initial Complaint

  07/09/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I am being over billed by Atrium Health Baptist Hospital. I have made numberous calls and complaints to Atrium and **** ***. I went to Atrium for Health care on Dec 15th 2021 for a followup visit. Atrium sent in my insurance claim and *** denied it. I was on **** ***** up until Oct 31 2021. I have been back and forth with Atrium and *** over this bill since Mar 2022. It was denied due to a billing error on *** end because they said I had secondary insurance. Atrium has been sending me a bills for $502.00 when I only owe $47.00. I spoke with an agent at *** named ****** on June 9th and 16th. She said the problem was resolved in their system. But now there are 2 claims on my *** account. Today I received a collection notice from ***** ********* *** because Atrium turned me into a debt collector even though they are trying to collect $455.00 more than what I owe. So I sent in another complaint to *** and to Atrium attn Marcie today. So not only is Atrium trying to overcharge me they are also trying to ruin my credit. I have been dealing with both of these business via phone and written correspondence for 4 months and cannot get a correction made. I have also filed a complaint with medicare and I will be filing another one today. Email to Atrium today... Marcie we last spoke on March 15th 2022 about the billing error from Dec 15 2021. I never did hear back from you again. In the meantime I have spoken several times to *** and ****** ******, Office Manager at the Drs. office about this error. On June 9th and 16th I spoke with ****** in the complaint dept at *** in CA and she admitted that they denied the claim in error and she corrected it to show that I only owed $47.00. Today I get a collection letter from ***** ********* because Atrium is trying to overcharge me and *** has not removed the original claim. You need to call me so that we can discuss this. I sent another complaint letter to *** today.

  Business response

  07/11/2022

  Ms. ****,

  Thank you for Choosing Atrium Health Wake Forest Baptist for your medical needs. We apologies for your insurance frustrations. Insurance is filed as a courtesy and the insurance policy thru the explanation of benefits (EOB) is required to advise Atruim Health Wake Forest Baptist of the patient's out of pocket responsibility per the patient's policy. Unfortunately, as in your case, errors are occasionally made.  A resent payment last week from ****** ********** ******** ********* has reduced the patient original responsibility for Ms. **** to 47.00 as Ms. **** mentioned which allowed this balance to be returned from collections and bill internally once more for a standard cycle. Unfortunately, Ms. **** has not updated Atrium until now. The Insurance payment posted on 7/6/2022 and the  insurance contractual processed with a request for the charge to be returned from agency. This has caused no  no ill effects to the patient's credit. Ms. **** will receive an updated statement for the 47.00 soon.

  Kindest regard,

  Atruim Health Wake Forest Baptist

  Customer response

  07/11/2022

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

  Thank you for finally clearing this matter up after I have been trying to get this issue fixed for 4 months. I read your response back from the BBB and as far as the comment that stated that I had not updated you. That was a little bit insulting, I have printed out all of my outgoing phone records from February to June that list all of the phone calls I have made about this matter. First of all Atrium has known since March when I first contacted you, that there was a problem. Yet I never actually received any timely follow up from Atrium. Secondly I did not hear back from *** until June so I was waiting on my next bill from you to make sure that it had been updated. But, instead you chose to forward this to collections instead of trying to help me get this resolved. So thank you for finally taking care of this matter and don't ever treat people like they are stupid! My advice to you is, get rid of the "blame the victim" passive agressive attitude and simply offer a blameless apology next time and move on!

• Initial Complaint

  03/24/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I saw my mental health provider on 07.09.21 for a telehealth / phone visit. I owed $0 as a copay as per ******'s agreement with their providers. ****** advises that WFUBMC instead billed for an office visit and not telehealth. I'm now incorrectly being billed for a $25 co-pay that I don't owe. When first billed, I sent a written message via WFUMBC's portal detailing the error. In fact, I have written multiple times with the same "the claim has been resubmitted" excuse. (See attachment) I had the same issue on 05.14.21, but after months of messaging it was resolved 6 months later. I want this fixed once and for all! I want all future telehealth visits coded correctly! I don't care what you have to do. I want a streamlined channel for when this happens again (and it will). Lastly wipe my bill clean, stop billing me, and simply leave me alone.

  Business response

  03/31/2022

  A duplicate denial was issued lastly by the patient's insurance after a corrected claim was submitted on the account of Ms. ******. A corrected claim was generated by Atrium Health Wake Forest Baptist to the patient's insurance on 1/6/22 with the modifier 95 that indicates an interactive audio and video telecommunications system visit. This balance has been sent back to an insurance status for review and cease billing until an update can be received. Our apologies for the claims error(s) processing by both her insurance and Atrium Health Wake Forest Baptist.

  Kindest regard,

  Stephanie H*******
  Manager, PFS-Customer Service
  
  Medical Center Blvd
  Winston Salem, NC 27157
  Office: (336) 716-3966 | Fax: (336) 713-4808
  Email:[email protected]
  
  Atrium Health
  Wake Forest Baptist Health is now
  Atrium Health Wake Forest Baptist
  

  Customer response

  04/06/2022

   I am rejecting this response because:  

  Ms. *******,

      Thank you for your update. With all due respect, there should be no reason for any further involvement on my part. As stated on the original complaint, for me to consider this successfully resolved, 1) I wanted the $25 removed entirely from my bill; 2)  I wanted to know how I resolve this the next time it happens (and it will), and 3) I wanted to be left alone with no further discussion.

     In all, exactly none of these have occurred. From your response, WFUBMC has acknowledged they sent the original filing coded with the wrong identifier. My provider demarcated the call as telehealth as she has done 23 other times. Yet your coding department still filed it incorrectly. At ******'s request, I began notifying you in July 2021 and have been repeatedly told it was being changed and resubmitted. In actuality, WFUBMC dragged their feet for six months, all the while I was told it was occurring. In actuality it waited until your hospital finally got around to it. ****** paid the original bill based on what you billed. That was neither a problem created by myself or the insurance company. The error is all on Baptist and if you had refiled it correctly, as I requested, insurance would likely have corrected it quickly. However, 9 months later, and now you have issues. You made the error, I don't owe the copay, and I was involved at the onset. It is now your responsibility to correct this without any further involvement on my part. When the hospital files on my behalf as a 'courtesy', I think it's reasonable to have it be done correctly.  Otherwise, all of our time gets wasted

      Ms. *******, this is in no way directed specifically at you, although I'm sure it may appear as such. I greatly appreciate your help. Instead this is directed at WFUBMC's coding and  billing department. Their ongoing errors, their ineffectiveness in rapidly resolving problems, and the amount of time they waste is absolutely reprehensible. This should have been handled from the beginning when I made them aware of it, yet they made an easily correctable problem unnecessairly lengthy and tenuous. I'm out of it.

     By copy, I'm making the BBB aware that as of now, the complaint is not resolved to my satisfaction. Once the original requests are completed in total, I will happily do so. Again, thank you for your help.

  Regards, 

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

  Business response

  04/06/2022

  Ms. ******,

   

  Options to contact: Please send in any concerns thru your  My Wake Health account ; email [email protected].  ; call Customer Service directly: 336-716-3966

  The current status of Your Claim(s): Correctly filing with hopes the insurance resolution will occur quickly.  We all have to wait for the correct processing by your insurance company at this point as unfortunately your Insurance company does advise how a patient is to be billed per the explanation of benefits (EOB). The information was provided for both yourself and the BBB to have an understanding of your filing status. Please disregard your previously received billing as the 25.00 balance was returned to Insurance currently with a follow up made by Atrium Wake Forest Baptist recently. Apologies again for your continued dissatisfaction.

   

  Regards,

   

   

  Page *******

  Customer Service Specialist

  Medical Center Blvd\ Winston-Salem, NC  27157

  (336) 716-1101  \  TollFree (833) 662-7921

  (336) 716-3966  \   Fax (336) 716-1700 pa******@wakehealth.edu

   

  Atrium Health

  Wake Forest Baptist Health is now

  Atrium Health Wake Forest Baptist

• Initial Complaint

  02/28/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had visited the emergency room in Wilkesboro NC due to some severe stomach pains and the feeling of passing out/nausea. I had a TERRIBLE experience and I would like to discuss this further with someone. I have called financial services. I was told to email. I emailed on 9/22/21, 10/7/21 and 11/10/21 - no response. I wrote on a bill and mailed it back to contact me - no response. I just received another bill in the mail today that I intend to send back with another request for contact. I will seek legal action if not contacted to discuss.

  Business response

  03/01/2022

  Good Morning,

  Ms. *******'s account has been reviewed and unfortunately no emails have been located to date in her My Wake Health portal or at the Customer Service Site: PFScustomerservice      [email protected]  Should this email response not be sufficient Ms. *******  will need to provide copies please of her original email correspondence requests (and where sent) to either of these locations mentioned. There was contact on 9/22/21 with the patient and response on 9/23/21 where requested information was mailed to the patient per her request. At some point the patient moved from the time of her visit to her BBB concern necessitating an address update. A call was made to **** ***** on behalf on the patient - Spoke with Mark ref ************ on this **** ***** Plan and have been advised that patient does not have ER benefits which is considered non-covered by ***** *******'s insurance plan. As a courtesy to the patient a courtesy contractual is to be processed for the technical hospital HAR and once approved will reduce that balance to 3947.15 on that HAR . Pt also has a balance of 286.27 for Physician charges currently also. Several other balances are also at collections currently and Ms. ******* can make arrangements with PRC Consultants 800-991-5265. To date ***** ******* has never made any payments on her account so would not be eligible for a refund.
  

   

• Initial Complaint

  10/13/2021

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I gave birth February 12th 2021 at Baptist. I was charged over $3,000 for myself and $3,000 for my daughter + a nicu stay. Wake forest didn’t give me reasonable payment options, and would not work with me because at the time I “had insurance”. Now, with Medicaid - the only option was “access one” which is on their portal as interest free. Wake forest put half my bill in collections. Promised to not put the other half and send it to access one, and did not follow through with that promise. They pulled some of the amount out of collections that was wrongfully put in, but refuse to pull the other half. Access one was NOT offered, nor was a reasonable payment plan for me. They refused to provide financial aid before it was sent to collections. AccessOne is not interest free, and now I also have a collections balance lingering over me due to this business. They also have not sent the AccessOne account over to AccessOne, and it’s been months since requesting.

  Business response

  11/01/2021

  Atrium Wake Forest Baptist Health has shorten our "in-house" payment plan options recently for all patients. Unfortunately it is not possible to hold (2) accounts with the offered monthly payment of fifty dollars.  month. An in house payment plan would be 306.37 for 12 months on your current self-pay balance alone 3676.25. If you wish to set up a payment plan with Access One which offers a lower monthly payment option, Access One must be contacted to add each charge as permission is required. Ms. **** is being provided the same options our other patient's are being offered.

  Financial assistance is a program for uninsured individuals unfortunately, at this time and Ms. **** currently would not qualify as at the time services were incurred she was covered by Blue Cross Insurance.

*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. ↩