ComplaintsforPresbyterian Healthcare Services

• Initial Complaint

  10/30/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On October 19,2022, I saw my primary care physician, Dr. ************ for my annual medicare well check up. Pres. Healthcare schedulers made a mistake and scheduled me one day (24 hours) before I was eligible for the no cost well check up through medicare. Unfortunately during this time period my mother was given less than eight weeks to live, and my father (who was also terminally ill) and I were her primary caregivers. I did not have the luxury of the time to reschedule nor was that option explained to me. Instead in order to be seen, I was required to sign a form stating I wanted to be seen as Dr. ************ wanted to cover up a mistake made by their scheduling department. I made arrangements to have someone watch my mother while I was at the doctor. Dr. ************* nurse said we need to train the schedulers. I received an invoice of $92.61, and I appealed to the call center, and filed a written appeal with Presbyteriian. The appeal was denied, and when I called the call center the individual said you want to "appeal an appeal." I attempted to get in touch with upper management, and that information is not provided by Presbyterian. On 08/14/2023 I sent a letter to **** *******, President (CEO) with the aforementioned details, and I never received a reply. I did not make a mistake in scheduling the wrong date for my appointment, yet I am being forced to pay $92.61. I am on a fixed income, and my mother died on 12/17/2023, my father died on 04/21/2024. I did not have time to be away from them, and Pres. staff were well aware of my dilemma. I cannot get anyone to listen to me at Pres. because they are standing behind a protocol to cover their clerk's mistake with no consideration for my signing their document under extreme duress I need for Pres. to remove my $92.61 amount due. Pres. needs to train their schedulers to be more diligent, and for staff to be more empathetic when a patient is struggling with extreme circumstances.

  Business response

  11/08/2023

  Hello,

  We reached out to the patient by telephone to listen to and confirm their concerns. We also sent them a letter addressing their concerns. 

  Sincerely,

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

  Presbyterian HealthCare Service

   

• Initial Complaint

  03/07/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Office visit took place on Sep. 15 2022. In my appointment on June 16, 2022; my lab test results showed that I had results that put me in the diabetic range. On the Sep. 15 visit, the diabetic diagnosis from previous visit automatically triggered new tests specific to the condition. During the visit, a blood test was done, an eye exam, and an inspection of my feet. At the time of these new additional tests, I was not informed that any part of the services would not or might not be connected by my Presbyterian provided health insurance. Sometime the Sep. 15 office visit, I noticed a balance due showing in my account. I immediately called customer service and was told that the charges had not processed through the insurance payment process and that once that happened that there would be no payment amount due. During the interim, I recorded statements by mail stating that I owed the original amount of $148.07. I called Presbyterian today, 03/07/2023 to discuss the matter and was told that my account was now in collections. I let the customer service representative know the chain of events and that the response I was given to call the collection agency was and is unacceptable. She filled a grievance on my behalf and I told her that I would be contacted the BBB.

  Business response

  03/16/2023

  Dear BBB,

  We have contacted the patient verbally and sent them a letter addressing their concern they reported to your office. 

  Sincerely,

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

  Presbyterian HealthCare Services

   

   

• Initial Complaint

  09/06/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I am having difficulty getting Presbyterian Healthcare Services to bill my insurance for the attached bill. Sadly, this won't be the first time Presbyterian neglected to bill my insurance. I have requested multiple times through written correspondence that they please bill my health insurance, yet instead they have continued to ignore my written requests to bill the following insurance: ******* PO Box ***** ******, ** *****-**** Send electronic claims through Emdeon: payer ID is *****. Please request that Presbyterian bill *******. Thank you, ******* *********  PS My member number is my SS number, which they already have.

  Business response

  09/23/2022

  Hello, 

  I contacted the patient and addressed their concerns and sent them a letter with the outcome of their review. 

  Sincerely, 

  /s/ Sasha R on behalf of Jana M Coordinator 

• Initial Complaint

  09/05/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On 4 March 2022 I went to the Pres Now Urgent / Emergency care clinic at 4515 Coors Blvd. NW 87120 for treatment for vomiting and dehydration, presumably due to eating spoiled salad greens. I had received treatment for a similar condition in 2021, receiving IV fluids and an anti-nausea medication, and was charged the $350.00 emergency visit fee. I have also received care at this location for an animal bite. In the animal bite occasion, I was charged the $350.00 emergency visit fee, and the PA said he'd like to do x-rays of my hand, and this would be at additional cost, and asked if I consented to this, which I did. In the 4 March case, the staff took a blood sample and gave me IV fluids, anti-nausea medication, pain medication, and an acid-blocker. At the end of my visit, the doctor came to my room and discussed what she thought my condition was and gave me instructions for home / after care, including getting prescription medications at a local pharmacy. At no time was the need for any test(s) not covered under the emergency fee ($350.00) discussed. This was not a life-threatening condition; there was no need for extraordinary diagnostics or treatment which could not be discussed with me or performed without my consent due to urgency. At the beginning of April I received a bill for $3,184.00 minus a $955.20 self-pay discount for a total of $1,878.00. Presbyterian's stated policy is to discuss healthcare options with patients so the patient can make informed healthcare decisions; this was not done in this case. It is my position that because Presbyterian did not follow their policy or previous practice by not seeking my consent for the unnecessary additional tests, Presbyterian should absorb the cost of these tests.

  Business response

  11/01/2022

  Hello,

  We reached out to the patient on 4/15/2022 verbally and in writing. We addressed the concerns and mailed 2 more letters. 1 on 4/29/2022 and another one 7/14/2022. Today, the letters were mailed again.

   

  Sincerely,

   

   

  Presbyterian HealthCare Services

   Jana M. Patient Relations, Coordinator

   

   

   

• Initial Complaint

  08/20/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I filed a grievance in March of 2022 for services rendered Urgent Care but was charged for ER. I paid at the time of service. I sent a letter to the person that handles grievances. I received a letter stating that the wrong billing code was used and therefore validating my grievance and return of money paid. I have spoken monthly about what is owed to me and get every excuse possible! It started with a $400 return and as of last month was a $300 return. They will not pay me my money! I would have been sent to collections if I didn’t pay them money owed! I have a letter from individual stating the billing code error. I just want my money owed to me that they agree they owe me but refuse to pay me! Letter to me dated 3-24-22 is just verification that my grievance had been received. The letter dated 3-30-22 states the bill coding error. Every time I call the phone says “this call may be recorded.” My file should have ever phone call made along with every excuse they have given.

  Business response

  09/01/2022

  Hello, 

  I contacted the patient and addressed their concerns and sent them a letter with the outcome of their review. 

  Sincerely, 

  /s/ Sasha R. on behalf of Jana M

• Initial Complaint

  08/18/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I ******** ****** filed a complaint on behalf of my wife ******** ****** who had a telemedicine appointment on 5/23/2022 with Dr. Martinez, pharmacist with the GI Department. Nobody called. Patient relations sent us a letter dated 7/15/2022 stating the doctor did call but the call went straight to voicemail. I stated that nobody called us. I offered our T-Mobile call logs as proof. I also requested Presbyterian's call log for 5/23. The appointment was at 08:30. PtRelations has not responded to my email request. I just assumed the doctor did not know how to place a three-way call (my wife needs a Mandarin interpreter), but he insists he called so it is obvious that he misdialed our number or forgot to dial the (505) area code first. I am filing this complaint since PtRelations has not responded to my email. I find that troubling. I had to reschedule my wife's appointment which took about two months. This is not acceptable care and PtRelations still has not acknowledge the screwup. The T-Mobile logs are independent of my statement and clearly show no calls received from Presbyterian on 5/23/2022. I'd love to see Presbyterian's call log for 5/23/2022. Our phone number is verified at every appointment. It's been over three months now. Presbyterian needs to take responsibility for this. I have attached copies of PtRelations response letter and my email response which has gone unanswered.

  Business response

  10/03/2022

  The grievance has been responded to. The POA has been contacted and notified in writing by mail.

   

  Sincerely,

  Presbyterian Patient Relations 

  Jana M.

   

  Customer response

  10/03/2022

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

  In the Presbyterian Patient Relations response letter dated 7/15/2022:  They got my name wrong (never acknowledged that error nor apologized).  The main issue is that Presbyterian continues to ignore the fact that T-Mobile's call log for the day of my wife's appointment show that Presbyterian never called all day **************.  I also attached my wife's call log because I used her phone ************** to call the Presbyterian GI Department at 0832 (note the logs are CDT not MDT) to find out what was going on.  I was told that the doctor was running late but would call us.  He never did.  Everything else in the 7/15/2022 response letter is just noise.  Patient Relations is not about customer service nor care.  Their job is obviously to avoid any admission wrongdoing/liability to avoid lawsuits.  To imply in the 7/15/2022 response letter that I or my phone is the problem is not acceptable.  I've was on 100% telework for 2020-2021 and now am teleworking 60% of the week so I obviously need a reliable phone.  I would also point out that we have used several telemed calls with my wife's oncologist with no issue.  We have also done a televideo call with her liver transplant specialist in Denver Colorado with no issue.  Our *********** phone number is verified every time I call to make appointments for my wife as well as at check-in.  The screwup was by Presbyterian and there simply is no denying it.  Presbyterian needs to be accountable, take responsibility so that this error is not repeated again in the future.
  
  Regards,
  
  ******* *****

  
  

  Business response

  10/17/2022

  Dear ***,

  We will be mailing another letter to the patient today.

  Thank you

   

  Jana M.

  Presbyterian Patient Relations

  Customer response

  10/17/2022

  Complaint: ********
  
  I am rejecting this response because:  I received a copy of Patient Relations response letter to the *** last Friday afternoon.  The letter states it acknowledges and is responding to my concerns, but it doesn’t.  None of their letters have.  Patient Relations continues to ignore my statements about the T-Mobile call log that proves no calls from anyone on 5/23/2022 occurred.  That is a fact.  There is only my call to Presbyterian to speak with the doctor 1249 CDT.  That was not allowed so all I could do was reschedule my wife's appointment with no explanation as to why the doctor never called us.  To tell *** or ***** otherwise is a lie.  Presbyterian does not want to acknowledge the doctor screwed up my wife’s appointment.  This is not acceptable.
  
  I brought the call log to S**** R’s attention back in August yet she still does not acknowledge that.  I talked to her on the phone about this and emailed it to her on 8/19/2022 per her request.  She still does not acknowledge the fact that nobody called us as she claims.  She has never mentioned the call log in any of her so called response letters to address my concerns, yet it is stated in my complaint to *** and I think previously to *****.  I also asked her if she had checked Presbyterian’s call log for 5/23/2022 to see who the doctor actually tried calling.  She stated that she had not.  I find that ironic since her job title states that she is a Research Specialist.
  
  S**** R states the doctor attempted to call us.  Maybe he attempted to call somebody but it clearly was not us per the T-Mobile call log as I have been stating.  Note that the call logs are recorded in CDT not MDT.  Also worth noting is ********* call log that shows me calling the GI Department ***** ******** at **** on 5/23/2022 to find out why we had not been called for the 0830 appointment on our number on record with Presbyterian.  The receptionist told me that the doctor was running late, but he would call us.  Nobody ever call as I have always stated and that is supported by the T-Mobile call log.  The error was on the part of the doctor not us.  Presbyterian needs to take responsibility and acknowledge the error was the doctor's not ours.  Otherwise no corrective action will ever be taken to prevent this from happening to other patients in the future.
  
  Regards,
  
  ******* *****

  
  

• Initial Complaint

  07/07/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On January 5th, 2021 I used a credit card to pay $2,723 for my spinal procedure at Presbyterian Kaseman Hospital Pain and Spine institute ***** ************ *** ** ******. Two days later I applied for medicaid and was accepted as well as got the insurance to be BACKDATED (meaning the medicaid is going to cover the entirety of my procedure). I informed the front desk at Kaseman that I would require a reimbursement because I should be covered for that procedure and should not have paid out of pocket. The lady at the front desk informed me I should take the problem to their billing department and provided me with a phone number. I call the number and they tell me they aren't responsible for the refund and provide me with a number for Presbyterian Billing Department instead. I then call presbyterian only for them to tell me they have no record of my spinal procedure and they do not understand why I was sent to them and could not help me. They then had me contact the medicaid department. The medicaid department also says nope I can't help you all we do is provide the insurance and whoever you paid initially needs to refund you. I have called SEVERAL different departments to figure out how to get my money back! It has been 18 months of this not being resolved and I'm still making payments on this credit card. The amount of times I've been circled around only for people to tell me they can't help me is ridiculous!! What I need to resolve this issue is a complete and total refund of the $2,723 plus CARD SECURITY and INTEREST, as well as, a written apology!! I am charged an extra 30$ per month for card security as well as about $7.00 per month in interest rates for the past 18 months!! The entire refund should be a total of $3,389. I will accept nothing less as this company has done nothing but run me in circles because they are avoiding financial responsibility and taking advantage of their patients!! Please help me!

  Business response

  07/19/2022

  Hello,

  The patient was contacted by telephone and advised that the services were not rendered by Kaseman Presbyterian Hospital. Advised the patient to contact NM Surgery Center Orthopaedics to report her concerns to them or her insurance carrier.

   Sincerely, 

  Jana M. 

  Presbyterian Patient Relations Department

   

  Customer response

  07/20/2022

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Regards,
  
  ******* ****

• Initial Complaint

  11/14/2021

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  Unwanted soliciting for two deceased persons. **** * ******* has been deceased for almost a year and ******* ******* for about 19 years. I would appreciate not receiving junk mail that contributes to the destruction of the environment unnecessary, and plus I have to question the validity of your data.

  Business response

  11/24/2021

  Dear BBB,

  I have forwarded the concerns to the Presbyterian Health Plan to address. They replied with the following:
  Information has been flagged as a complaint and added to our prospect Do Not Mail file as of 11/22/2021.

   

  Thank you

  Jana M.

• Initial Complaint

  10/03/2021

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  Contesting $81 bill from Presbyterian Health Services. Please see attached letter and supporting documentation for more details. Files have been redacted to remove PII and financial information not related to complaint. Please contact me if additional details are needed.

  Business response

  10/12/2021

  Hello BBB,

  We have reached out to the patient to communicate this has been taken care of. However, we were unsuccessful in reaching her, but we did leave a message that her concerns have been resolved.

   

  Thank you

  Jana M., Presbyterian Patient Relations department

  Customer response

  10/13/2021

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I received a voicemail from Travis at Presbyterian on October 12, 2021 at 12:06pm stating that they have decided to adjust the balance of $81 as a courtesy to me. I find a satisfactory response to complaint ID ********.

  Thank you for intervening on this dispute.
  
  
  ******* *****

*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. ↩