ComplaintsforNebraska Pulmonary Specialties, LLC

• Initial Complaint

  02/13/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Trying to charge me almost 500$ after waiting 4 months for an appointment for an at home sleep test and they didn’t even prescribe medication or give me a cpap device. Apparently my sleep test appointment never got sent out so I was waiting because of their ineptitude. I shouldn’t owe them anything.

  

  Business response

  02/13/2024

  This individual does not have an outstanding balance in our office; there is no charge that was not approved or covered by insurance (other than what appears to be his copays, which are his contractual obligation with his insurance company).
  

  Initially after seeing the patient, we awaited insurance authorization before scheduling the sleep study (this took a couple of months, which is outside of the normal timeframe). The sleep center, it appears, had a back-up in available HSTs so it caused a slight delay as well.  Once the insurance authorization occurred in November and an HST became available, the individual had the study. It takes a typical time of 6-8 weeks after the study to be scored and then interpreted. From that interpretation, there was no indication that the individual needed CPAP or any medication, and based on that, insurance will not approve CPAP treatment as a result.
  

  We recognize that the timeframe to obtain the insurance authorization was outside the normal limits, and will address any possible workflow issues that we can to shorten this for other patients ongoing. The patient has not received a statement from our office since October 2023, and has no current outstanding balance with us. NPS is not trying to collect any amount of money from this patient, as of today. His bill may be from ***** Medical Center, the facility where he had the HST performed. That is a separate entity entirely from our organization and not within our scope to inquire or resolve. I am happy to speak with the patient, should he wish to call and inquire about this. I do not see any documented communication from him about any bills received. 

  Customer response

  02/22/2024

  Complaint: ********
  
  I am rejecting this response because:

  I had an at home sleep test completed by picking up the test from NPS and dropped it off after completed at the same place. There was no mention of other entities doing any other diagnostics or being involved in any way. I did not have any other tests done or visit any other facilities, nor did I actually stay overnight at the facility. The only place I visited was ******** ********* Specialties. My complaint will be satisfied when ******** ********* handles the issue with ***** ******* ******.

  
  Sincerely,
  
  ******* ******

  

  Business response

  02/22/2024

  ******** ********* Specialties does not issue Home Sleep Tests from the Lincoln office. ******** ********* Specialties is an independent practice located in Suite *** *** *** ONLY at the Medical office building connected to ***** ******* ****** East (we lease space from ***** ******* ****** only). The patient picked up his sleep test from ***** ******* ******'s Sleep Center, which is located in the same building as our practice, but on the *** ****** ***** ***. We recognize this may be confusing, but their name is on the door & entry sign, that is where he picked up & dropped off the equipment (please see attached photos of the front of each suite door). NPS has no HST equipment on site in Lincoln. This remains a ***** ******* ****** billing issue for the patient to resolve with them. ******** ********* Specialties has no bearing, control or access to any of ***** ******* ******'s billing procedures or patient accounts. 

• Initial Complaint

  06/23/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I went to NPS for a sleep study under Dr. ***** for sleep apnea treatment. The doctor ordered an at home test and if positive we would discuss treatment like a CPAP. I already know I have sleep apnea, but the doctor wanted this. After the at home test on March 23, 2023, I received a call from NPS telling me they received my test results and would be contacted in the next two weeks about next steps. After one month, I was never contacted, so I called their office. Nobody answered the phone I left a message. A few days later they called back, but I was unable to answer the phone. I called them back, but again nobody answered the phone, so I left a message. I called three more times that week. The following week, May 2, 2023 I was called asking why I didn't show up for an appointment at 3:00 PM. I was never notified of such an appointment, was not aware, nor would have been able to have showed up for an appointment at that time. Over the next couple weeks I called them 12 times to figure out what's going on. Nobody answered the phones, and I left a message most of the times, but I never received a call back nor a letter from them. Eventually, I received a bill for $252 (as well as some $1200 to my insurance company), so I had to drive there and pay it in person, which I paid on June 15, 2023. I paid this bill despite the fact that I never received test results, instructions on next steps, or any other assistance or treatment which was the whole purpose of me going there. I paid and received nothing. Additionally, they failed to disclose that I would be billed for the testing device from a different company, ****** Health. I never received a bill from them or was notified. I only learned of this yesterday, June 20, when a collection agency called me about a $260 bill for a home sleep test. When I went back to NPS, they said they were not responsible - even though they were the company I went to - not ****** - and they never told me! I want a refund for both bills

  

  Business response

  06/29/2023

  Hello, 

  Thank you for providing the opportunity to respond.  In order to confirm the patient has sleep apnea, as required by insurance for any further treatment of such diagnosis, a sleep study must be done. Patient confirmed in phone call with the CMA that he had never had a sleep study done before (attachment “C ******** - Communication Documentation"), otherwise, we would have used those results to further treatment.  The patient did confirm his willingness to move forward with treatment during his 2-28-23 visit with Dr. ***** ***** (visit note not included, as it contains more than the minimum necessary to disclose for this situation.  Should it be needed, please contact me directly as we may need a HIPAA release from the patient).
  

  HST (Home Sleep Test) was done through ***** Medical Center on 3/23/23.  NPS received the results on 4/6/23 and called the patient on 4/12/23 to follow up and deliver results.  Patient does not have VM (Voicemail) set up on phone and there was much back and forth between clinical staff and the patient, in attempts to reach him.  (See attachment “C ******** - Communication Documentation”).
  Since we could not reach him via phone, an appointment letter was sent to him to schedule a follow up visit for 5/2/23.  The letter was sent, and then text messages were sent to confirm his appointment (See attachment “C ******** - Communication Documentation"). 
  

  Patient did resolve his balance with NPS but did not understand that the fee for the actual device, the technical fee, would come from *****.  NPS only provides the interpretation to the study, we do not charge or manage the charges for the device itself.  See attachment “6-15-23 bill concern”. 
  Included is the patient statement (attachment named “6-7-23 Statement for ********, ***********”).  Patient paid $238.74 for the New Patient visit with Dr. *****, and $13.95 for the sleep study interpretation.
  

  Also included is “C ******** – RingCentral Phone records detail”. 

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