ComplaintsforDayton Gastroenterology, Inc.

• Initial Complaint

  12/12/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  5/22/2022 I was seen at Dayton Gastro Endoscopy for a screening colonoscopy. The sedation was provided by Western Ohio Sedation Associates LLC. The procedure itself was covered by my insurance because it was coded correctly. However, Western Ohio Sedation coded the procedure as diagnostic and was not covered by my insurance. I received a bill for $2160.00. I attempted multiple times to contact the billing department at Western Ohio Sedation. I spoke with multiple people who did not speak very clear English, I explained it was coded wrong and I was told "It will be sent to the back office for further review" which never happened. To note -There is no other way to contact Western Ohio Sedation and their address is the same as Dayton Gastro. Dayton Gastro also sent me a copy of my chart which clearly shows it was screening. After multiple failed attempts I contacted Dayton Gastro several times. Throughout those conversations I was told the following: I was not the only person to have this complaint with Western Ohio Sedation, they will send you to the collection, they are contracted and have access to charts and code their procedures. I thought it was resolved on 9/2023 after speaking with 3 different individuals at Dayton Gastro one of which stated the amount was way too high even if it was coded correctly, and they would contact them and take care of it. 12/2023 I received a bill from collections. Western Ohio Sedation and Dayton Gastro are fully aware that this was coded incorrectly and refuse to correct the issue. 12/4/2023 I spoke with the "manager" of billing at Dayton Gastro who assured me she would reach out to Western Ohio Sedation and would call me back. I had to reach back out to her on 12/7 and 12/11 only to get the same run-around. An investigation of how many patients this is happening to needs to be done. Dayton Gastro is very aware that it is happening to patients. Patients are getting sent to collections wrongfully. Something needs to happen.

  Business response

  12/27/2023

  Dayton Gastroenterology had been awaiting response from Western Ohio Sedation regarding **** ******* anesthesia bill as Dayton Gastroenterology does not bill for these services.  I received a response on 12/19/2023 stating that the anesthesia balance was adjusted off and that the account was pulled back from collections and that Western Ohio Sedation contacted the patient.

  Thank you,

  ***** ******

  Customer response

  12/27/2023

  
  Better Business Bureau:
  
  I was never contacted by Western Ohio Sedation. After filing a BBB compliant for both Dayton Gastro and Western Ohio and giving Dayton Gastro a one star google review, I was contacted by the collection agency that the bill was "zerod" out. After a year, this happened in a matter of a couple days after filing my complaint and google review. I never asked for the bill to be written off, I simply asked for it to be coded properly to be paid be insurance. I am not the only patient this is happening to as evidence by the other BBB complaint. I was the squeaky wheel they wanted to go away which doesn't help the other patients this is happening too. I hope there is further investigation into this Western Ohio Sedation for the sake of other patients. 
  
  Sincerely,
  
  ******** *******

• Initial Complaint

  09/07/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had a consultation with my DR who advised me of a medical procedure to move forward. I had my first procedure on 8/3. I was never made aware or called about any pricing on my procedure. I then had two additional follow up procedures that I was not made aware of pricing. I received my bill to which my insurance company is not covering anything because of the way it was ran. None of this was disclosed to me. I filed a complaint with the billing department as I feel I have received unfair treatment. ***** from the billing department reached out to me the same day as the complaint 9/7/22, and stated that she is aware that they made a mistake in not reaching out to me. She stated that with every procedure patients are to be called with a price breakdown. She claims that they were in the middle of a system change and short staffed, so I was never called. They had THREE opportunities for different procedures over an entire month, and not once was my cost disclosed to me. I am aware of my insurance coverages, which I signed for I agree. However, I had NO WAY of knowing how my procedures were being recorded as it was NEVER disclosed to me before hand. ***** fully admitted to me that this was a mistake on their part, and not their normal practice, however she had no solution or help for me. This is completely unacceptable and unfair treatment of a patient. If others are called to have disclosure, there is no reason I should have been missed, THREE times. Completely crooked.

  Business response

  09/07/2022

  On 9/7/2022 I spoke with Ms. ****** and did explain that Dayton Gastroenterology did go through a practice computer system.  Our policy is to try to contact all patients prior to diagnostic procedures to review their insurance benefits.  I did offer Ms. ****** a payment plan option, which Dayton Gastroenterology does not charge interest rates or late fees.  The documentation that Ms. ****** received after each visit did state the reason for the procedures.  Ms. ****** also received in her procedure packet prior to procedure documentation to contact her insurance to check on her own benefits.  Ms. ****** did understand that she has a deductible with her current insurance carrier and did understand that it is her responsibility prior to her insurance paying any physician balances.  Dayton Gastroenterology offers all patients payment plans that fit into the patients current budget, at the time of our call Ms. ****** declined the payment plan.

  Customer response

  09/12/2022

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

  The only document that was made readily available to me through my patient portal was the final discharge document. I have attached proof of this. The other documents I was provided lacked information crucial to me to make the decision on if I would move forward. As I stated, I did understand my own insurance. However, the office never disclosed any of THEIR pricing to me. Had the procedures been ran as preventative care, like I was under the impression they were, this would all be avoided. 
  

  This issue is far from resolved. Offering a payment plan to me does not help with Dayton Gastros inability to properly provide patients with the tools they need to make a sound decision on their medical needs. 
  
  In order to make things right these issues need to be ran through as preventive care. 
  
  Sincerely,
  
  ******* ******

*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. ↩