ComplaintsforHeart Center of Nevada

• Initial Complaint

  05/09/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I had an ECHOCARDIOGRAM appointment today, 08May2023 at the clinic of ********************************, Cardiologist located at ***********************************************************************************************************. I was on the table for the procedure but while it was performed halfway by *** the Technologist we overheard from the central speaker that it had to stop because my AARP ******** Advantage by ********** ceased to served since September 2022 per ***** the Office Manager. I informed her that I am covered by 3 medical insurances so I should still be covered besides I was there last Dec 2022 for Doctor's visit from my Angioplasty which was performed by the Doctor last October 8, 2022. UMR, my primary insurance confirmed that the HEART CENTER OF NEVADA is Active likewise the medical provider. *** spoke to ***** but she added that the ****************** refused to allow the procedure, what an odd call. I do not have a non payment issue considering I have multiple insurances. I tried to contact the head office for GRIEVANCE complain but no response at this time. I hope you can follow up because if they did this to me they may be more patients who are experiencing the same mistreatment. Looking forward for your communication to them and keep me posted.

  Business response

  05/24/2023

  Good afternoon,

  On May 8, 2023, ****************** had and appointment at 8:15 am for an Echocardiogram. ****************** while checking-in provided all of his insurance information to my front desk person *******. On this day we learned that he has ***** care which we are not in-network while ******* began to verify his insurance to confirm the status and indeed it was active, that's when my Echo technician ****** called him in to do the test. As soon as ******* found out that it was *****, she let me know and I intercom ****** my technician to see if he had started the ultrasound and he said he was about to start. I asked him to not proceed and to have the patient come to the front desk so we could explain the situation. I explained to the patient that his new insurance ***** Care became effective on January 1, 2022 and we had seen him on October 25, 2022 and December 20, 2022 and he never mentioned or showed us his ***** Care card. He kept insisting to not use his secondary insurance to only use his primary but I let him know that we are not able to do this because we are now aware that he has ***** Care and we are not In-network. I apologized to ****************** and advised him to follow up with his primary care doctor to refer him to a Cardiologist that is in-network with ***** Care.

  Tania 

  Office Manager 

  Heart Center of Nevada

   

  Customer response

  05/31/2023

   
  Complaint: 20034405
  
  I am rejecting this response because:
  
  Sincerely,
  
  ***********************************

  Customer response

  06/01/2023

  First of all, ***** the manager at the Cardiologist ***************************** has been lying for the following reason;

  1) I was in the middle of the Echocardiogram procedure when she called on the PA system directing ***, the Technician  to stop  not before the procedure has started.

  2) I have 3 different ***************** if she claimed that my secondary insurance/Optum Care stop serving or canceled there are other 2 that can take care of the above procedure.

  She even warned me that I may end up paying if they will reject it however I called ***/my primary insurance and they said they are active in the list of providers so there should be no problem

  paying them. My Military Tricare will also pay had they continue the procedure. Her and the *** representative were discussing as to why they do not provide the service. Her reason was that 

  OPTUM rejects it and no matter whether I have the Primary or ******************* the ****** won't allow it. I was shocked , that was an odd excuse as to why a ****** has the say on that specially

  I have no billing issue..

  3) Further more I they were paid on my Heart Angioplasty procedure last October 8, *********************** now. Also if they do not want my business on that last visit May 8, 2023 they could

  have notified me before wasting my time, effort and challenging my right. I am a Medical Technologist / US Military Corpsman's and i am pretty familiar of the process. They should not treat me 

  as if I was born yesterday. 

  All my response to her alibi were given as what I filed my complaint , If you need further explanation that I missed to point out let me know but please read my initial complain.

  Business response

  06/14/2023

  Good Afternoon,

  As I had mentioned before in the previous letter, I asked my technician if he had started the test and per *** the technician, he said he was about to start. There is no imaging to say it was half way done. I had apologized to him and tried to explain to him that we cannot pick and choose insurance. ************************ asked me to not use ***** care to only use UMR. By law we cannot pick and choose which insurance to use and which one not to use, that is insurance fraud. We did not know he had ***** care until he provided it on May 8, 2023. When we verified it, we noticed it was effective since January 1, 2022. I just don't understand why he didn't provide the ***** care insurance card on his first visit. I had explained to him many times that we are not contracted with this plan. He mentions that he had a procedure done in the hospital but this was done as an out-patient setting.  At the end, all I was trying to avoid/prevent for patient to get a bill.

  *****

  Customer response

  06/15/2023

   
  Complaint: 20034405
  
  I am rejecting this response because: a} It's incorrect that she says She called to inquire to *** if he already started the Angiogram. I re confirmined for the 3rd time that it was in the middle in procedure that she called to stop. Of course

  there is no images that can be created because *** shut off the machine.

  b) She was not apologetic but proud thinking she is the main honcho on that office she can command/order  irregardless if it is unfair to patient.

  c) The law she mentioned is the policy on the usage and Claims of the 3 medical insurance which I submitted all the time. It state that the first { ***} should be used in the order  then the ************* Advantage second and the third would be the Tricare. She used instead the 2nd.( AARP) I did not pick which medical insurance to use and I complained as to why she is using that. She was informed by the *** Customer Servise about such Policy and they are active in the list of providers. I ask why you did that and got a paused and she answered that "let me ask the ******" whoa!  I was surprised as to why the ****** has to say on my ******* care. She even challenged and threaten me if we go ahead I'll be forced to cover 

  the charges of service for which I counter challenged her to go ahead. she ended up saying No I can do that. the Question is she really fully educated on the Procedure and Policy on the Usage and Claims because she now resort to lying and I will not stop responding her. b) what do you thing I can get out of this but all I need is Justice as I do not want her to be doing the same to all patient. I am Frustrated as well due to the fact that I belong to the ******* Profession as a General  ******* Technologist with Quest and a Corpsman in the US Navy. We never treated patient the same way she did. I  hope the **************** in *********** and the Cardiologist ********************************* would know what she did so all other location can go on Training about ****************** This is a Bad to the Business.

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

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