Complaints

This profile includes complaints for Kaleida Health's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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• 

  Kaleida Health

  PO Box 475 Buffalo, NY 14201-0475

• 

  Kaleida Health

  P.O. Box 4551 Buffalo, NY 14240

• 

  Kaleida Health

  726 Exchange St Ste 255 Attn Risk Management Buffalo, NY 14210-1484

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:10/08/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Back on 2/15/2024, I went to a doctor's office, located in the ******* ******* Hospital building, to see Dr. P****** I received a bill from Dr. P*****'s office for the visit and promptly paid them the $132.25 that was due. This is Dr. P*****'s office and he has no other locations. While in the appointment, Dr. P***** (or his staff) did not send me for any testing or other services in the hospital. He did not even use any instruments during the appointment. It was to see if I had a hernia and he used his hands to press a few areas and determined it was not a hernia. ******* ******* Hospital is attempting to charge me a separate $174.10 charge. The Explanation of Benefits states for "outpatient medical services". I had no services provided by ******* ******* Hospital in any way. After more than 7 phone calls and attempts to have this charge removed since I had no services provided by the hospital, Kaleida sent this amount to collections. In addition, I had surgery at Kaleida on 2/21 and had promptly paid my cost but Kaleida had incorrectly applied my payments and applied it to my disputed amount of $174.10 from 2/5. Per Anista at Kaleida on 6/11, she said she would have this adjusted to move the $174.10 payment from the 2/5 DOS to the correct 2/21 DOS. As of today, this has not be reapplied and now they refuse to move the money since it has been sent to collections. Please note I have had several other services also through Kaleida since February and all those charges were paid as soon as the bills were received. My only disputed amount is that $174.10. I have been in contact with Kaleida starting April 12, when I received the first bill. As noted above, in each of the 7 attempts made to have this corrected, they would call me back in around 30 days and they had the information incorrect and confused. I want this unwarranted charge for $174.10 from ******* ******* Hospital removed as I am not willing to pay for services that were never received.

  Business Response

  Date: 11/05/2024

  Good morning, I reviewed the patient's complaint, and this is what I found. The balance of $174.10 is from Date of Service 2/21/2024. The patient had Ambulatory Surgery on this date. The claim was billed to her **** ***** Federal plan. They paid $3895.04 and applied $392.71 to the patient liability as coinsurance. The patient made a payment of $218.61 toward this balance leaving $174.10 still outstanding. Please let me know if you need any further information.Thank you,Paula R***

  Customer Answer

  Date: 11/05/2024

  Better Business Bureau: I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.As stated in the original complaint, I had paid the money for the services from 2/21.  $647.48 was paid 4/20/24 (I paid all my charges from 2/5, 2/14 and 2/21 with the exception of this disputed charge).  They misapplied my payment for and applied it to the oldest balances first and when the payment was made I told them that the amount of $174.10 from 2/5 was in dispute and to not apply it to that charge.  They ignored my request and I have since tried on 3 separate occasions to have them correct this misapplication of the money.  The amount that is being disputed is $174.10 for DOS of 2/5 from ******* *******.  I never had services from ******* ******* on 2/5 and my payments of other amounts due should have never been applied to this amount (as this amount was already in dispute with Kaleida at the time).  I am again attaching the bill from Kaleida showing the 2/5 charges (it also shows the 2/14 and 2/21 charges that were paid in full the same month as I received the billing).  The bill shows a total on 2/5 of $306.35 after the insurance adjustments.  If you see the explanation of benefits forms I am also attaching, there are 2 for that day - 1) Dr P***** (*** Clinic) bill for $132.25 and a separate bill for ******* ******* Hospital for $174.10. When I spoke with my insurance carrier about the $174.10 charge they stated ******* ******* said it was for "outpatient medical services", however, I never had outpatient services from ******* *******.  I verified this with the physician (P*****) office.  It was a consultation visit only and no services (ie. x-rays, labs,etc) were provided so there should be no charges from the hospital since they did not provide any services. Regards, ******** *****

• Initial Complaint

  Date:08/13/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

       I had an appointment on 5-7-24 at 705 Maple Rd Williamsville, NY 14221 with Dr Barta M****. When I received a bill I was charged for an office visit $119.27. I was also charged a facility charge for Millard Fillmore Suburban Hospital $125.85 wich I have never had an appointment or visited a doctor in that hospital. My complaint is about the facility charge  wich is $125.85. I tried to resolve this problem with Kaleida Health billing office and they are not willing to help or resolve this issue. I paid $25.00 at office visit on 5-7-24.

  Business Response

  Date: 09/04/2024

  Good morning,

  I reviewed Mr. ********** complaint, and this is what I found.

  The patient was seen in our Maple West Endo Diabetes clinic on 5/7/2024. The patients charge for this visit were $592.81. The patient paid what he thought was his copay for these service on the DOS for $25.00

  With BC they split our bills and pay the professional and technical fees separately.  On the professional side billed on a 1500 form they (BC) applied $119.27 to the patient's deductible. On the technical side they (BC) applied $125.85 to the patient's deductible. Toal due is $245.12 minus $25.00 that the patient paid. Leaving the balance due of $220.12.

  Please let me know if you need any additional information.

  Thank you,

  ***** ****

   

   

  Customer Answer

  Date: 09/05/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  [To assist us in bringing this matter to a close, we would like to know your view on the matter.]
  
  Regards,
  
  ***** ********
  
  Please can you review those two statements that they billed to my insurance. They billed two claims. An office visit and the other is a hospital facility charge that I have never been to. 
  All the other years they only billed me for the office visit. I never had to pay more than $120.   Thank you 
  
  

  Business Response

  Date: 09/06/2024

  Good morning,

  Mr. ********** prior visits were covered by IHA. For the visit that's in question he has BC -Bluecard coverage. Both plans pay differently. The service took place at the Maple West Endo Diabetes Clinic. The charge that was billed to his BC was "Level 4 Est Detdet M for $592.81. BC splits their members services in a TC/PC split. He was not in the hospital, but the clinic is part of Kaleida Health. 

  I also see a note on Mr.********** account indicating that on 8.8.24 a Charity Care application was sent to him at his request.  At this time, I do not see that the application has been returned. Our CC program can assist patients from 25% to 100% if qualified.

  I hope that this information is helpful.

  Thank you,

  ***** ****

   

  Customer Answer

  Date: 09/08/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  [To assist us in bringing this matter to a close, we would like to know your view on the matter.]
  
  Regards,
  
  ***** ********
  
  Two years ago I had the same insurance blue cross with the same doctor. I was not charged a facility charge. If that is the case why was I not notified that there will be a facility charge beginning of this year. My father has the same insurance plan blue cross and goes to the same building just for cardiology and is not charged a facility charge like I was. 
  
  
  

  Business Response

  Date: 09/16/2024

  Good morning,

  This patient had 2 different insurances a year apart. The insurance for 2023 was BC and they paid the service in full. The insurance for 2024 is IHA. They applied the balance of $220.12 to the patient's deductible. Both insurances have different contracted rates with Kaleida that could cause situations like this one.

  My Customer Service team did explain the balance to the patient. They walked through the profession charges and the technical charges on his account. They also offered him our Charity Care program. An application was sent to the patient, but we did not receive it back as of today. 

  The patient can dispute this with his IHA as they paid the claim with the deductible balance.

  I hope that this helps. If you need anything further, please let me know.

  Thank you,

  *****

• Initial Complaint

  Date:09/05/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  If you want people to pay their bills you should refer them to the correct kind of DR when they visit your ER. Terrible service, condescending attitude from the nurse, and long wait times make me never want to go back. The ortho you referred me to directed me to call a podiatrist to avoid multiple DR visits and bills. Why did your hospital refer me to the wrong kind of Dr?

  Business Response

  Date: 10/10/2023

  I’m have the ER record pulled to review the notes. I will also place a hold on the patients account while under review.

• Initial Complaint

  Date:08/25/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On May 26, 2023 I went to an Urgent Care facility because I was not feeling well. My mother accompanied me. A NP took my vitals and examined me. She then insisted that I go to an ER because she could not perform tests that she deemed necessary. She suggested Millard Fillmore Suburban Hospital because it was nearby and she called the hospital to share the information she had gathered. I did go and gave my name and verified they had been contacted by the NP from Urgent Care. I then waited a very long time in the waiting room before I decided to leave without being seen or receiving treatment. The bill was $805.48! I do have insurance. I owe $75. I called Kalieda to inquire about this but they reviewed it and said that is the cost. Over $800 to take a patient’s name and perhaps look over the notes sent over from Urgent Care. I was not seen or treated at all.

  Business Response

  Date: 09/18/2023

  I had ******** ******** medical record pulled and reviewed by the HIM department today. They confirmed that the patient was Triaged and seen by a provider. The patient left AMA and the record was documented as so.

  The account was billed to her insurance and paid leaving a $75.00 copay due from the patient.

   

  Please let me know if you any additional information.

• Initial Complaint

  Date:06/30/2023

  Type:Billing Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My daughter had a visit with a provider at Kaledia. We are fully insured through ******** **** ***** with a co-pay of $10. Kaledia keeps billing an extra $116.88. ******** has sent me proof they have paid the balance and Kaledia will not take it off. They have now sent the account to collections. There is an extra $10 on there that I have previously tried to pay but Kaleida said not to until the $116.88 was resolved. So now we are getting collection notices for $126.88. Everytime my husband and I talk to Kaledia the push it back on the insurance even though we have papers from the insurance showing its adjusted and reference numbers for payment. This has been going on for nearly a year now and we can't seem to get a straight answer. The account was supposedly on hold while it was being resolved which was clearly not true due to the collection notices. The date of service was 7/1/22 for ******* **** ******* **** *************

  Business Response

  Date: 07/21/2023

  Good morning, After reviewing this account for ******* **** I found the following. ******** updated their payment on 6/28/2023 leaving a copy due from the parents of $10.00. I also looked for the credit that the mentioned and was unable to locate that. I closed the account at the collection agency. Thank you, Paula  

  Customer Answer

  Date: 07/25/2023

  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

  Date:09/17/2022

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  This complaint is in regards to erroneous billing for a fully insured, in-network routine colonoscopy performed July 2, 2021 at Millard Fillmore Hospital. I am insured by Empire Plan through my husband ******* **** born Nov 6, 1940. Dr A******** who performed the procedure is in Buffalo Medical Group, and so is my primary physician, Andrew H********** Buffalo Medical Group accepts Empire Plan. There were no complications or additional issues with the procedure. My insurance card #*********. Kaleida Health persists in not submitting the hospital part of the bill to the appropriate part of Empire Plan. The doctor's part of the bill was submitted and processed in 2021. On Aug 22, 2022 Tamara at Empire Plan helped me by settting up a 3-way conversation with Hannah at Kaleida Health. Empire Plan has 2 parts. The doctor's bill and the hospital bill are submitted to 2 different places. Tamara made sure Hannah understood the address where to submit the hospital part of the bill. Hannah said she understood and had no further questions. Conf# from Tamara: *********. I have 2 more number written down from that conversation: ************ and ****** (from Hannah). Today Sept 17, I received the same bill for $1,253.70! Nothing was done! The claim is still not processed. I have received no request for additional information from Kaleida. Since the doctor's part of the bill was processed successfully they know I was insured! The 3-way call was the 2nd attempt at resolving this bill. I have previously been "escalated" at Kaleida with absolutely nothing done. Kaleida Account# ******. Please help.

  Business Response

  Date: 09/26/2022

  Good afternoon,

   

  The account for **** ***** ********* has been billed to her BC Empire Plan. The account is on hold pending processing of this claim. Thank you, Paula R***