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    ComplaintsforLenox Hill Radiology

    Radiology
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    Complaint Details

    Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.

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    Complaint Status
    Complaint Type
    • Complaint Type:
      Billing Issues
      Status:
      Unresolved
      Lenox Hill Radiology billing department keeps sending me bills for the amount of $42.27. According to my insurance company I owed only $201.11, which I paid at the reception. I contacted Lenox Hill Radiology at least 5 times myself. ***************** called them back in February, they still cannot resolve the problem and now threatening me to send a collection agency after me. I want them to stop harassing me and apologize.

      Business response

      05/02/2024

      We have thoroughly reviewed all aspects of *** ************ complaint.

      Please be advised that it is our policy to collect an estimated cost share for procedures at the time of service.  Patient benefits are confirmed via an EDI **************** Interchange) process. The cost share information is requested at the time of scheduling and/or at the time of service through a 270 real-time connection to the insurance.  A 271 response is received from the insurance which provides patient eligibility and any out-of-pocket costs for which the patient would be responsible- including Co-payment, Co-Insurance,and/or Deductible. If the insurance returns the 271 in a timely fashion,patients are notified of their estimated cost share when contacting the site to schedule services.

      After services are complete and the radiology report is finalized, services are coded (CPT/ICD10) and submitted to the insurance carrier.  After processing the claim, the insurance issues an Explanation of Benefits (***) which is the most accurate source for providing the patient and provider with information on how the services were adjudicated. 

      Through researching the patients account, it was identified that the 271 response we received from the insurance on the date of service (2/13/23) showed a patient responsibility of $201.11 which the patient paid.Once the claim was processed by the payer, the *** we received showed that the patient responsibility was $158.84; $42.27 less than the original estimate the insurance had quoted. We subsequently generated a refund and a check was sent to the patient on 4/24/23. This check was cashed on 5/2/23.
      The insurance then submitted an adjustment on 8/28/23 which showed the original patient responsibility quoted on the 2/13/23 date of service ($201.11). This has led to the balance showing on the patients account of the previously refunded amount of $42.27. As a result, we have found no wrong doing on the part of Lenox Hill Radiology and the billing statements sent to the patient are valid.
      The ***s are attached for reference.
      We are committed to creating a seamless process that promptly escalates patient inquiries through the BBB to the appropriate management or executive levels within our company and tracking those inquiries through completion.

      We greatly appreciate your assistance and cooperation in achieving a resolution.

      Customer response

      05/05/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

      [Your Answer Here]

      Lenox Hill Radiology claimed:

       > We subsequently generated a refund and a check was sent to the patient on 4/24/23. This check was cashed on 5/2/23. 

      Please provide a copy of the cashed check with the information who cashed it.

      I have not received and I have not cashed this check. I have double-checked my checking account and I have not found any deposits in the amount of $42.27 in the last 18 months. I also checked the specified date, I have not deposited or cashed any check on 5/2/2023.

      Lenox Hill Radiology must investigate who cashed their check. It was not me.

      In order for the BBB to appropriately process your response, you MUST answer the question above.


      Sincerely,

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




       

      Business response

      06/06/2024

      Unfortunately, we cannot provide additional information than has already been provided as it would not be secure to include such transaction information on a public platform. The patient's bank should be able to locate the check with the check and transaction numbers listed in our previous response. 

      Customer response

      06/17/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

      [Your Answer Here]

      > The patient's bank should be able to locate the check with the check and transaction numbers listed in our previous response. 

      That is the problem. I checked with my bank. There is no such transaction. I had ************************************************************ a copy of my bank statement. One more time: I have not received the check and I have not deposited it.

      A copy of my bank statement was sent to *************************** on June 4th, 2024. I have attached the copies one more time.

      I DO NOT owe any money to ********************* Radiology my balance should be $0.00. Please prove that I deposited the check. Contact me personally at my cell: ************ or email a copy of the check to my personal email address: **********************.

       

      In order for the BBB to appropriately process your response, you MUST answer the question above.


      Sincerely,

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




       
    • Complaint Type:
      Service or Repair Issues
      Status:
      Answered
      I had a CT Scan completed at the ************ location on 2/19/2024. I was charged $****** for services and paid via **** debit. This is not showing up on my Cigna. I called the billing and they claim they billed Cigna on 2/22 however, whoever entered my info mustve done it wrong and it was sent to the wrong address. I am now in need of an MRI and ********************* is telling me for that I will owe them over 800 dollars. I have a 1000 dollar deductible and have paid ****** of that already but because they didnt bill correctly, ***** cannot update. They claim they will rebill to the correct address however it can take 45 business days. I cannot wait this long for this to be resolved. This needs to be expedited because their incompetence is delaying my further medical care. This has already been over 6 weeks.

      Business response

      04/19/2024

      This is to confirm that we have reviewed all aspects of *** ********** complaint.

      Please be advised that it is our policy to collect an estimated cost share for procedures at the time of service.  Patient benefits are confirmed via an EDI **************** Interchange) process. The cost share information is requested at the time of scheduling and/or at the time of service through a 270 real-time connection to the insurance.  A 271 response is received from the insurance which provides patient eligibility and any out-of-pocket costs for which the patient would be responsible- including Co-payment, Co-Insurance,and/or Deductible. If the insurance returns the 271 in a timely fashion,patients are notified of their estimated cost share when contacting the site to schedule services.

      After services are complete and the radiology report is finalized, services are coded (CPT/ICD10) and submitted to the insurance carrier.  After processing the claim, the insurance issues an Explanation of Benefits (EOB) which is the most accurate source for providing the patient and provider with information on how the services were adjudicated. 

      Upon review of the patients account for the 2/19/24 date of service, we have identified that the patient made a $433.50 payment based off of the patient responsibility information we received from her insurance (Cigna) on the 271 response. The 271 also showed a total deductible of $1,000.00.

      Around the same time that the claim was submitted to Cigna, there was a major cyberattack on Change Healthcare, the platform used by the insurance to process claims.This has caused a delay in claims processing for Cigna and many other payers and has led to this specific claim not yet being processed. Therefore, when the patient attempted to set up a new appointment, the estimate from the payer showed a deductible amount that did not reflect the previous payment made on the 2/19/24 date of service.

      We are currently working with the insurance to get the 2/19/24 date of service resolved but, in the meantime, we have placed an override on *** ********** account to include the previous payment on our end. We have also placed a note on her account advising that the previous amount quoted was incorrect and to provide ********************** with an updated patient responsibility estimate of $386.97.

      While researching this complaint, it was noticed that an authorization is required for the procedure being requested by the patient. Once that authorization is obtained, the patient is free to schedule her exam.

      We apologize to ********************** for the delay she experienced in scheduling services and any inconvenience caused by this situation.

      We are committed to creating a seamless process that promptly escalates patient inquiries through the BBB to the appropriate management or executive levels within our company and tracking those inquiries through completion.

      We greatly appreciate your assistance and cooperation in achieving a resolution

      Customer response

      04/22/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

      [Your Answer Here]

       I am currently on the phone with Cigna 4-22-24 and they are telling me that the claim still has not been sent to the proper channel therefore, Im still waiting for this to be resolved. I have never in my life dealt with such a matter. I want this to be resolved as soon as possible as again, this is effecting my ability to get my other imaging and as of right now I am still out over ****************************************** Cigna. Although I appreciate the reflection of what I owe 386 dollars however, that is not accurate at this point how that I have paid more toward my deductible. 

       

       

       

      In order for the BBB to appropriately process your response, you MUST answer the question above.


      Sincerely,

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




       

      Business response

      05/02/2024

      After speaking with **********************, I contacted Cigna at ************** on 4/30/24 and spoke with **** (reference #****) who informed me that the claim was set to process within the next ***** hours. I also confirmed with **** that the deductible amount will show as applied at that time. I relayed this information to ********************** and gave her the call details so that she can follow up if necessary. 

      Thank you for your assistance and patience in resolving this issue. 

    • Complaint Type:
      Sales and Advertising Issues
      Status:
      Resolved
      I am writing to address a persistent and concerning billing issue regarding services provided by Lenox Hill Radiology (*** Account #************. I received a breast ultrasound in November 2022 and the procedure was billed to my health insurer, Cigna, for $293.06. Cigna processed and paid the full amount based on the explanation of benefits (EOB) dated June 16, 2023. As per the **** I had no out-of-pocket responsibility for this procedure.Despite the payment being made by Cigna and no outstanding balance on my part, I have been continuously receiving invoices from *** indicating an outstanding balance of $220.00. The discrepancy arose when *** sent a duplicate claim to Cigna for the same amount, which was rightfully denied by ***** as it had already been processed and paid.I initially brought this issue to ***'s attention in early to mid-2023, and after almost two months, the matter was seemingly resolved. However, the problem resurfaced in late December 2023, and I have been receiving the same incorrect invoices each month since then. Despite numerous calls to the *** billing department and assurances from *** representatives that the issue would be resolved, I continue to receive threatening invoices stating that I owe $220.00 due immediately.In addition to my efforts, a Cigna representative, ****, spoke with *** billing on February 20, 2024, and was assured that the invoice would be corrected to reflect a zero balance. Regrettably, this has not been the case, as evidenced by the most recent invoice dated on March 23, 2024.I am deeply frustrated by the lack of resolution to this matter despite repeated attempts to address it. This ongoing billing discrepancy has caused unnecessary stress and inconvenience, and it is imperative that it be rectified promptly. Please find attached to this email copies of the EOBs mentioned, and other relevant documentation necessary to clarify the situation.

      Business response

      04/01/2024

      Dear ************* - 

       

      I sincerely apologize for the delay in resolving your grievance. I have thoroughly reviewed your account and determined the reasoning behind the multiple claim submissions and then erroneous statements billed to you.

      On 11/30/2022 Cigna processed your bilateral breast ultrasounds by paying one side and denying the other for Maximum benefits met. Upon receipt of this denial, we determined we had incorrectly billed Cigna with using LT and RT modifiers when they process bilateral services using a 50 modifier. This partial payment left an unresolved balance on your account which in turn generated statements to you.

      In an attempt to get the claim corrected so that we received the correct reimbursement amount from Cigna per our contract, we submitted an updated claim with the corrected modifier coding on 1/29/2023 Cigna denied the claim as benefit maximum reached, which translates to a duplicate submission. On 12/22/2023  Cigna retracted their payment for your services and indicated we needed to submit a void request for the original claim and resubmit a new claim. When they retracted their payment, this started the statement cycle again for the unresolved balance.

      I resubmitted a corrected claim today 4/1/2024 to try and resolve this issue. As of today, we have no payment from your insurance due to their retractment.

      I have placed a temporary statement hold on your account to avoid future statements to be sent while we wait for payment from your insurance.

      Again, I sincerely apologize for the delay in getting this issue resolved with your insurance as per my review, you are not responsible for any amount at this time. In the event that the insurance continues to deny, I will send this service for a patient courtesy adjustment. 

      Customer response

      04/01/2024

      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 and the matter has been resolved.

      Sincerely,

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



       

    • Complaint Type:
      Billing Issues
      Status:
      Answered
      I had 4 MRIs done at ********************* Radiology. I have *************** and ********* *************** paid their portion and the balance is to be billed to ********* By law you cannot balance bill the patient when they have ******** and ********* *************** is primary and ******** is secondary.The account number is ************. I have been trying to resolve this for months. Today I received six bills for ******.

      Business response

      03/21/2024

      This is to confirm that we have reviewed and responded to all aspects of **************** complaint. 

      After a thorough review of the patient's account, it has been determined that the billing statements the patient received were sent in error. We are experiencing an issue with billing the secondary insurance ********** which caused our system to automatically apply the coinsurance from the primary payer's ********** Explanation of Benefits to patient responsibility. As a result, statements were erroneously mailed to ************. We are currently working on fixing the problem, but the patient will not owe any amount regardless of outcome. I have placed a charge hold on the patient's account to ensure that she will not receive any further billing statements regarding these dates of service. We apologize to ************ for any inconvenience or frustration caused by our system issue. 

      Please be advised that system errors of this kind are extremely rare and in no way indicative of a trending issue. Only after an in-depth investigation into the payment postings were we able to locate the root cause of this unfortunate incident. We have initiated a more intensive inspection into this specific issue to prevent any future occurrences. 

      We are committed to creating a seamless process that promptly escalates patient inquiries through the BBB to the appropriate management or executive levels within our company and tracking those inquiries through completion. 

      Your assistance and cooperation in achieving a resolution for this inquiry is greatly appreciated. 

    • Complaint Type:
      Billing Issues
      Status:
      Resolved
      I had two visits to Lenox Hill Radiology in October and November 2023 and paid ****** out of pocket via credit card between both of those visits. I subsequently contacted my insurance company who told me that this should have been fully covered. They said they cannot process the claim as it's never been received by Lenox Hill Radiology (still not submitted as of March 2024). I have called Lenox Hill Radiology nearly 10 times and each time I'm told that it's being processed, resubmitted, refunded and I must wait between 30 and 45 days between each call. I received a check of 8.44 from Lenox Hill Radiology and they told me that was an error and to get the remaining refund I have to send back that check and they also refused to tell me how they calculated the 8.44. My insurance company still has no claims received because Lenox Hill Radiology is not submitting to them. I have not had any change of insurance during this time frame. Lenox Hill Radiology is not following correct billing procedures as a way to keep money from patients.

      Business response

      03/05/2024

      After a thorough review of ********************** complaint, it has been determined that there are two dates of service at issue: 10/12/23 and 11/21/23.

      The claim for the 10/12/23 date of service was submitted and received by the patient's insurance (Cigna). Unfortunately, there was a processing issue with the claim and it was not paid. This has caused a negative balance on the patient's account for that claim. We have manually resubmitted the claim today (3/5/24). Claim processing customarily takes ***** days. We are unable to initiate a refund for the 10/12/23 date of service at this time as the insurance originally quoted a time of service patient responsibility of $304.44 for the breast ultrasound. The payment made by the patient on 10/12/23 will need to be held until the claim is correctly processed by the insurance and a credit balance is reflected on the account. This is done to avoid the situation of refunding the patient and then requesting the refund back if the insurance estimate originally quoted turns out to be accurate. I will personally track this claim through to adjudication and will follow up once more information is received by *****. 

      The insurance also quoted a patient responsibility of $370.54 for the 11/21/23 date of service. We received payment and an Explanation of Benefits showing no patient responsibility from Cigna on 12/19/23. Due to the fact that there was still a balance showing on the account for the 10/12/23 date of service, a refund was not automatically issued in the system. We have expedited the refund process and the full payment of $370.54 was remitted to the patient's credit card today (3/5/24). We apologize for any inconvenience this issue may have caused ******************. 

      We are committed to creating a seamless process that promptly escalates patient inquiries through the BBB to the appropriate management or executive levels within our company and tracking those inquiries through completion.

      Your assistance in achieving a resolution on this inquiry is greatly appreciated.

      Customer response

      03/08/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

      While I appreciate the partial refund, I will not consider this issue resolved until my full balance is refunded.  My first visit is expected to be fully covered according to my insurance company and Lenox Hill Radiology still needs to resolve their "billing issue" and expedite getting this claim processed and my refund issued.  As I stated in my original complaint, I never had a change of insurance and all of the details for claim submission were provided at the time of my visit.  Lenox Hill Radiology has been giving me excuses as to why they've been unable to process this claim since October.  I've called Lenox Hill Radiology numerous times and I've been yelled at by countless representatives while I simply tried to explain that my insurance company had not received the claim.  Each time I called, I was brushed off and told to wait ***** business days, I would wait the requested time, call back and nothing would be resolved.  I will consider this issue resolved when my entire refund has been successfully processed.  Thank you.

       

       

       

       

      In order for the BBB to appropriately process your response, you MUST answer the question above.


      Sincerely,

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




       

      Business response

      05/14/2024

      We received payment from the patient's insurance yesterday (5/13/24) and have initiated a refund in the amount of $296.00. Please be advised that it may take 5-7 business days to receive the check via standard mail. We apologize for the delay in processing the claim with ********************** insurance and for any inconvenience this issue may have caused. 

      Customer response

      05/20/2024

      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 and the matter has been resolved.

      Sincerely,

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



       

    • Complaint Type:
      Billing Issues
      Status:
      Resolved
      Account #: ************ Concern Regarding Overcharged Exam Cost on 8/16/2023, Covered by Insurance I am writing to bring to your attention an issue I recently encountered in relation to a medical exam performed at your facility on 8/16/2023. It has come to my attention that I was overcharged an amount of $185.55 for this particular exam, which was supposed to be fully covered by my insurance. After that, I received the bill from the collection agency, that I paid an additional $24.14.I would like to kindly request your immediate attention to rectify this matter and provide a refund for the overcharged amount. As a diligent and responsible individual, I have continuously adhered to the terms and conditions of my insurance policy and have remained aware of the coverage provided for medical services.Upon verifying the details with my insurance provider, it was confirmed that the exam conducted on the specified date was indeed meant to be covered fully without any additional cost to me. Therefore, it is clear that an error has occurred, resulting in the aforementioned overcharge. I have been harassed by the incorrect bill claiming that I still owe $1,614.26 even though I have informed the firm that my insurance company has paid, and I have received pre-authorization.

      Business response

      04/09/2024

      This is to confirm that we have reviewed all aspects of **************** complaint. 

      After a thorough investigation into the patient's account, it has been identified that an adjustment failed to post in our system which caused an incorrect balance to show for the 8/16/23 date of service. We have since rectified that error and the patient was refunded the $24.14 overpayment amount on 3/18/24. We apologize to ************ for any inconvenience or unnecessary stress caused by this situation. 

      We are committed to creating a seamless process that promptly escalates patient inquiries through the BBB to the appropriate management or executive levels within our company and tracking those inquiries through completion.

      We greatly appreciate your assistance and cooperation in achieving a resolution.

       

      Customer response

      04/19/2024

      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 and the matter has been resolved.

      Sincerely,

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



       

    • Complaint Type:
      Billing Issues
      Status:
      Answered
      I have received a bill for lab work on 8/24/2022. They did not code it right and I have been calling them along with my insurance provider for over 2 years now. Every month I get told they will recode and send correct bill for $50 dollar copay. I get a bill monthly for 1231.00.Not only did they billing wrong, they messed up labs saying they were clear and I had to have emergency surgery to get cysts removed. I would not goto this place if I was on fire.I am ready to call a lawyer.

      Business response

      02/27/2024

      After a thorough review of ********************** account and complaint, it has been identified that the patient was sent a billing statement in error due to a payment issue with the patient's insurance which is causing a balance to be showing on the account. The balance is not the responsibility of the patient and we have placed a billing hold on the charge to ensure that the patient receives no additional statements regarding this date of service. We apologize for any inconvenience or frustration this may have cause ******************. 

      We are committed to creating a seamless process that promptly escalates patient inquiries through the BBB to the appropriate management or executive levels within our company and tracking those inquiries through completion.

      We greatly appreciate your assistance and cooperation in achieving a resolution.

      Customer response

      03/08/2024

      Better Business Bureau:

      I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

      The discussion regarding this service matter has persisted since 2022. Despite making over 14 calls, both my insurance company and I were assured each time that the issue would be documented and resubmitted. However, I continued to receive the same bill with the identical code. Regrettably, it was only after reaching out to the Better Business Bureau (BBB) that I received any form of response. My satisfaction will only be complete upon receiving documentation from Lenox Hill Radiology confirming that no payment is owed for the specified date of service, as the time period for the provider to adjust the bill has expired.

       

       

       

      In order for the BBB to appropriately process your response, you MUST answer the question above.


      Sincerely,

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




       

      Business response

      04/09/2024

      This is to confirm that the ****************** has no balance owed with Lenox Hill Radiology at this time. She will not be receiving further billing statements for the 8/24/22 date of service and we apologize for any inconvenience as a result of the error which caused in incorrect balance to show on her account. 

      Thank you for your assistance in resolving this matter. 

    • Complaint Type:
      Service or Repair Issues
      Status:
      Answered
      My name is ***************************** a patient with Lenox Hill..have been try to get a appointment,.but each time i do someone call an cancel my appointment.giveing me 3 months aways reschedule time...and always have a nasty attitude..

      Business response

      02/26/2024

      Thank you for reaching as we will investigate and reach out to the patient and expedite his service with us 

    • Complaint Type:
      Product Issues
      Status:
      Resolved
      For my appointment and services at *** ******** on 1/5/24 I was charged on-site $416.19.As you will see according to the Aetna EOB attached, the amount I owed for these services was actually $152.96.Therefore, I am owed a refund of $263.23.I have emailed and called several times and no action by *** has been taken to refund me the monies owed to me.MRN#********* RECEIPT# ******************** IMAGINE PAYMENT REFERENCE # **************** ACCT# ************

      Business response

      02/09/2024

      This is to confirm that we have reviewed and responded to all aspects of ******************** complaint. 

      After a review of the patient's account, it has been identified that we received payment from the patient's insurance on 1/17/24. The refund process was initiated and customarily takes up to 30 days. The patient was issued a refund of $263.23 on 2/7/24. It may take 2-5 business days for the refund check to arrive via standard mail. We apologize to **************** for the delay in receiving her refund and any inconvenience this may have caused. 

      We are committed to creating a seamless process that promptly escalates patient inquiries through the BBB to the appropriate management or executive levels within our company and tracking those inquiries through completion.

      We greatly appreciate your assistance and cooperation in achieving a resolution.

      Customer response

      02/15/2024

      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 and the matter has been resolved.

      Sincerely,

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



       

    • Complaint Type:
      Product Issues
      Status:
      Answered
      I received a CT scan at Lenox Hill on 8/7/2023 and paid for the scan in person that day. I then realized that I was owed money back since my insurance covered the cost. Lenox Hill sent a reimbursement check to an old address they had on file and the check was not forwarded to my current address. I called them about this and have provided a new address multiple times but am yet to receive a reimbursement almost 7 months later. I have been following up every two weeks but each time I call, I just get the standard response of "Wait another 15 days and call back". The billing staff's lack of urgency or responsiveness is highly concerning and I question how much money they owe patients in aggregate.

      Business response

      01/30/2024

      This is to confirm that we have fully reviewed and responded to all aspects of **************** complaint. 

      After an in-depth review of the patient's account and complaint, it has been identified that a refund check was supposed to be sent to the patient's updated address but failed to send due to a system issue. We have expedited the refund process and a check was sent today (1/30/24) to the updated address on file. We apologize for any inconvenience this may have caused ************* 

      Please be advised that system errors of this kind are extremely rare and in no way indicative of a trending issue. Only after an in-depth investigation into the payment postings were we able to locate the root cause of this unfortunate incident. We have forwarded the account to our Cash and Reconciliation leadership team for research and they will be reaching out to our reconciliation software teams to further determine what caused this to happen and work on solutions for preventing any future occurrences.

      We are committed to creating a seamless process that promptly escalates patient inquiries through the BBB to the appropriate management or executive levels within our company and tracking those inquiries through completion.

      We greatly appreciate your assistance and cooperation in achieving a resolution.

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