ComplaintsforCleveland Clinic Foundation

• Initial Complaint

  07/10/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I have been visiting this gynecology office that is located inside Cleveland Clinic for over 7 years. I was recently charged $226.30 in Facility Charges twice for two separate visits to this office. At no point was there any letter or warning sent to me that they would now be charging these unexpected fees. Cleveland Clinic is not being transparent with their fees. They claim to have sent a letter to inform me, but there was no such letter sent. Letters are also found in mychart and there is no letter attached to mychart containing information on these new fees. There were also no email notifications sent. I should not have to pay for something I was never given a choice on. I would have never visited this office if I knew these fees would be charged.

  

  Business response

  07/16/2024

  **** *** **** ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** ******* *** ********* *** ******** **** *******
  This letter is in response to the billing complaint filed by ******** *******, to the Better Business Bureau on 07/10/24. I would like to first offer my sincere apologies for any frustration this may have caused *** *******.
  The root cause of her complaint was that *** *******’s states the Cleveland Clinic is not being transparent with our billing, for her recent visit with *** ****** ********
  A thorough investigation has been completed on *** *******’s financial concerns mentioned in her complaint. I reviewed the account in conjunction with the medical records associated with the services rendered from April 2, 2024, below are my findings:
  Facility charges:
  Cleveland Clinic's hospital outpatient areas and throughout our Family Health Centers, are classified as hospital outpatient facilities. This classification started on March 1, 2009, for Main Campus and Family Health Centers. Provider-Based Billing status is determined by the Centers for Medicare and Medicaid Services and means that the clinic functions as an extension of its respective hospital. Provider-Based Billing insures more appropriate reimbursement for physicians and facilities allowing us to maintain excellent care. Our patient bills include two separate charges - one for the healthcare provider fee and one for a facility or technical fee to partially defray the costs of providing non-physician staff, equipment, supplies, etc. Our goal is to be transparent with our patients and what their costs may be when they receive their care from us.
  · April 2, 2024, Hospital services (Reference # ***********): The Cleveland Clinic submitted the claim to Cigna for the facility charge in the amount of $293.00. Cigna sent the Cleveland Clinic the explanation of benefits on May 17, 2024. Per explanation of benefits, Cigna paid $0.00 and applied a contractual adjustment of $66.70, leaving $226.30 as patient responsibility as a deductible.
  · April 2, 2024, Professional services (Reference # ************: The Cleveland Clinic submitted the claim to Cigna for the visit with *** ******* in the amount of
  $221.00. ***** sent the Cleveland Clinic the explanation of benefits on May 9, 2024. Per explanation of benefits, Cigna paid $0.00 and applied a contractual adjustment of $148.12, leaving $72.88 as patient responsibility as a copay.
  Thank you for allowing us the opportunity to address *** *******’s concerns. Please keep in mind that it is the patient’s responsibility to understand their insurance coverage and benefits. If I can be of any further assistance, please feel free to contact me directly at ************.
  Respectfully,
  ****** ********
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  Cc: ******** *******

  Customer response

  07/16/2024

  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,
  
  ******** *******
  
  
  
  
   

  Customer response

  07/17/2024

  I have been a patient at Cleveland Clinic for over 7 years and  have never been charged a facility fee. I have no record of ever being charged this fee. In the past, I have only paid copayments so there is no way they have been charging this amount since 2009. This was a change on Cleveland Clinic's part since they decided to recently begin charging these fees at the Weston location and did not inform their patients. How was I expected to inquire about a visit when I have going to the same doctor and have never paid this fee? I was told by their billing department that the Weston location began charging facility fees this year. I asked them to send me proof that I had been informed of this change, but they were unable to provide me with any since I was never informed of these changes. That is what I mean by "not being transparent." 

• Initial Complaint

  06/28/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I am writing to formally lodge a complaint against *** ******, a Civil Surgeon, regarding the services provided to my family. In this instance, I engaged *** ****** for the completion of Form I-693, an immigration health check, for my mother as part of her green card application process. Upon payment of the requisite fee of $300, *** ****** proceeded to request that my mother undergo a series of standard tests and vaccinations as per her recommendations. Regrettably, one of the tests revealed a positive result for tuberculosis (TB), prompting *** ****** to refer us to the Department of Health for further evaluation and treatment. Subsequently, we have been embroiled in a protracted and arduous process with the Department of Health for over a year. Despite receiving clearance from a pulmonologist enlisted by the Department of Health, *** ****** insisted on awaiting formal clearance from the said department before proceeding with the paperwork. Following extensive diagnostic procedures, my mother has now obtained the necessary clearance and documentation from the Department of Health. However, *** ****** has informed me via email that her office has since closed and she is unable to complete the requisite paperwork. Furthermore, she has expressed her reluctance to refund the initial payment on the grounds of having expended effort on the case and the form potentially being outdated. It is deeply concerning that *** ****** failed to communicate the necessity of completing the paperwork in a timely manner and has withheld the reimbursement of the fee despite not fulfilling her professional obligations. My primary request is the prompt refund of the payment made for services that remain unfulfilled. I trust that the Better Business Bureau will investigate this matter thoroughly and facilitate a resolution that upholds the standards of professional conduct expected within the medical community. Thank you for your attention to this matter.

  

  Business response

  07/01/2024

  Good afternoon -

  The physician noted on this complaint *** **** ****** is not a Cleveland Clinic employed provider and therefore the Cleveland Clinic cannot assist further.

   

  Seems as though she is a independent provider in the community.

• Initial Complaint

  06/18/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  4/26/2024 Arrived at an appointment to see *** ******* ******* ** ****** ********* ******* This doctor was in network with my insurance plan, I knew I would have a $50 copay to see this provider which was paid for on the date of service. A few weeks later I received another bill from Cleveland Clinic for “Facility Charges” on 4/26 that amounted to $226. I spoke to billing which stated it was for the procedure done on that date but I had no procedure done. It was only a consult and the most they did was take my weight and vital signs. I sat in a chair and spoke to the doctor. The response from the billing specialist when I explained this was “This is how we charge because the provider does not own the building.” From my understanding I’m helping pay his rent which I have been to many doctors who do not own their office or building they practice out of outright and have never had to pay a facility charge. Furthermore as a client I should be aware of this beforehand. When I asked for an itemized statement the bill went down to $216 without explanation. This seems like price gouging.

  

  Business response

  06/26/2024

  **** *** **** ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** *******   *** ********* *** ******** **** *******
  This letter is in response to the billing complaint filed by ******** ****** to the Better Business Bureau on 06/18/24. I would like to first offer my sincere apologies for any frustration this may have caused *** ****** The root cause of her complaint was that *** ******s states the Cleveland Clinic is overcharging her for her recent visit with *** ******* ******** She also believes she should only owe her copay, and not be charged a facility fee, as she did not have a procedure done.
  A thorough investigation has been completed on *** ***** financial concerns mentioned in her complaint. I reviewed the account in conjunction with the medical records associated with the services rendered from April 26, 2024, below are my findings:
  Facility charges:
  Cleveland Clinic's hospital outpatient areas and throughout our Family Health Centers, are classified as hospital outpatient facilities. This classification started on March 1, 2009, for Main Campus and Family Health Centers. Provider-Based Billing status is determined by the Centers for Medicare and Medicaid Services and means that the clinic functions as an extension of its respective hospital. Provider-Based Billing insures more appropriate reimbursement for physicians and facilities allowing us to maintain excellent care. Our patient bills include two separate charges - one for the healthcare provider fee and one for a facility or technical fee to partially defray the costs of providing non-physician staff, equipment, supplies, etc. Our goal is to be transparent with our patients and what their costs may be when they receive their care from us.
  ·         April 26, 2024, Hospital services (Reference ************): The Cleveland Clinic submitted the claim to ***** for the facility charge in the amount of $293.00. ***** sent the Cleveland Clinic the explanation of benefits on May 13, 2024. Per explanation of benefits, ***** paid $0.00 and applied a contractual adjustment of $66.70. Patient paid $10 on April 30, 2024, leaving $216.30 as patient responsibility as a deductible.
  ·         April 26, 2024, Professional services (Reference *************: The Cleveland Clinic submitted the claim to ***** for the visit with *** ******* in the amount of $481.00. ***** sent the Cleveland Clinic the explanation of benefits on May 10, 2024. Per explanation of benefits, ***** paid $139.35 and applied a contractual adjustment of $291.65. Patient paid $50, leaving $0.00 as patient responsibility.
  I apologize for any frustration this may have caused *** ***** and thank you for allowing us the opportunity to address her concerns. Please keep in mind that it is the patient’s responsibility to understand their insurance coverage and benefits. If I can be of any further assistance, please feel free to contact me directly at *************
  
  Respectfully,
  ****** ******** ********* ********* ******* ***** *********** **** *** ******** *****

  Customer response

  06/27/2024

  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. 

  I am appreciative of the explanation of their charges now but this explanation would’ve been more appreciated prior to my appointment. 

  I knew prior to my appointment that I would have a $50 copay which I paid on the date of service 4/26/2024. I also knew IF I had any procedures done that there would possibly be more charges. However I only had my weight and vital signs taken and then sat on a chair and spoke to *** ******* *******
  

  the $10 on 5/30 was not paid towards this bill, this payment was made towards my scheduled outpatient surgery copay. 
  

  I understand my explanation of benefits, which is why I knew going into my appointment I would have a $50 copay. If Cleveland clinic is going to also charge a facility fee it should let their patients know beforehand not send a surprise charge without my knowledge.
  
  Regards,
  
  ******** *****
  
  
  
  
   

• Initial Complaint

  06/05/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  On 6/2/24 at approximately 9 pm, My wife and I were here for the birth of our second child. A nurse gave an idea of placing my wife’s wedding (silver princess cut 1K) and engagement (silver multi diamond) rings inside of a bio hazard bag because of seeing people having to get their rings cut off due to swelling. So we placed the rings in the bags and put them on the windowsill next to my car key, wallet and other personal items. We had to go to the Operating room then recovery room and in the recovery room, all of our belongings were on a cart. Once we were moved to our newborn room we cleared the cart to find the rings were gone. We weren’t told where the rings were placed in any of our bags and weren’t told we were allowed to go check the first room incase it was left behind. We spoke to several nurses, lost and found, security and filed a report. I was also told the charge nurse and management was aware of the incident but no one ever came to speak to us or even apologize about the incident. I have also been calling the ombudsman daily, leaving voicemails which have not been returned. So now I’m stuck with a hospital bill and the replacement of my wives rings. And we will be seeking a lawyer.

  

  Business response

  07/02/2024

  On behalf of Fairview Ombudsman Department, the patient's husband was contacted directly and his concerns were both documented and investigated. An outcome was provided to the husband.

  Customer response

  07/03/2024

  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,
  
  ***** ******
  
  
  
  
   

  Customer response

  07/08/2024

  I’m choosing to reject this response due to the fact of clear negligence on the hospitals part. They heard our complaint and not once came to us personally. They also put the blame on us for the incident when the employees did not even ask whether they could gather our belongings. I’ll be seeking legal action.

• Initial Complaint

  05/21/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  This complaint is against the Cleveland Clinic - Akron General Stow health center, Radiology dept. I had an order from a CCF specialist to get xrays. CCF had them on computer & I also asked for a written order to get them taken elsewhere is needed. I CALLED the Stow Radiology dept for a cost estimate, they had the order, and they said it would be zero. When I went to the facility, I again asked what the cost would be with my insurance (on file), and again was told zero. I explained that I had a written order in hand, and that there is a free-standing, in-network imaging place I go toin Beechwood with low or zero copay for ALL imaging (x-rays, ultrasound, etc.). Since I was told zero, I had them taken locally so as not to make the drive. My insurance states my responsibility is $95 because I'm being billed as a "Hospital." Tht's why I called 1st & asked them. I just got through another grievance for Cleveland Clinic / Akron General Express Care in Kent. For the 4th or 5th time, I was billed a copay & paid at the desk, only to get another bill later because of a person being "uncredentialled," or other reasons. There seems to be a major disconnect between the Cleveland Clinic and their locations concerning costs. I dispute the $95 charge because I CALLED & ASKED at the desk & had an alternative with zero copy for x-rays. I have cancelled my 60th birthday travel plans as a result of this. I just realized that I will be in a never ending cycle of being told one thing & billed another, and I have more appointments & scheduled. Cleveland Clinic "wins" either way, because all the other disputed charges resulted in me spending hours on the phone, filing grievances, etc. which cost me time. I lose.

  

  Business response

  05/24/2024

  May 24, 2024
  
  Better Business Bureau
  2800 Euclid Ave, 4th Fl
  Cleveland, Ohio 44115-2408
  ***** ****** *****
  
  Complaint Number* ********
  
  Dear *** ******
  
  This letter is in response to a billing complaint from *** ******, filed in your office on May 21, 2024.This was sent to the Financial Ombudsman department to review and respond back to you.
  
  I would first like to offer my sincere apology for any frustration this may have caused *** ******. The root cause of his complaint is to have his balance adjusted for the date of service 5/16/2024, for being given an inaccurate estimate prior to receiving services.
  
  A review on the account has been completed. *** ****** was seen on 5/16/2024 for an x-ray. However, we have not yet received a response from *** ******’s insurance company regarding his out-of-pocket cost. The estimate he was provided had an error, and his out-of-pocket price was not listed correctly. Due to this Cleveland Clinic is willing to adjust the balance of $95.00 *** ****** is stating his insurance company told him he will owe. Please allow up to 30 days for Cleveland Clinic to receive a response regarding this date of service from his insurance company.
  
  Should *** ****** have any further questions he may contact me directly at *************
  
  Respectfully,
  ****** ******** ****** ******** ********* ********* ******* ***** *********** **** *** ******* *******

  Customer response

  05/24/2024

  [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 have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.   I also spoke with *****, BillingSupervisor on 5/23.  I related a past claim in 2022 with CCF/Akron General Orthopedic where I was not charged extra for x-rays, they were included with the specialist copay (which has been paid in this case already).  That office visit WAS at the hospital main campus location in downtown Akron, yet I was not charged as "Hospital" x-ray copay.  I also received an injection at that appointment which added less than $1 to the copay.  It's strange that I was charged $95 patient responsibility for x-rays as a "hospital" CCF/AGMC satellite location. And once again, I had a written order in hand & needed no appointment to go to a free standing, in-network radiology facility.  I told ***** I'd like documentation of zero balance.  I accept this response as documentation (i.e., "adjusted off.").
  
  Regards,
  
  ***** ******
  
  
  

• Initial Complaint

  05/09/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  My insurance has requested 4 times now at this point including email requests and multiple phone calls for extra documentation for a er visit I had back in March. Each time I have been told they would resolve it that day and absolutely nothing has been done. It’s been almost 2 months now, I still haven’t hit my out of pocket like I should have and am having to pay a lot out of pocket because they will not follow through on their promises. I just need them to fax the requested info over as my claim has been denied to to their delays and I am going to be expected to pay the full bill since no one will send the documents over that ***** has requested multiple times.

  

  Business response

  05/14/2024

  May 15, 2024
  
  ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** *******
  Complaint Number: ********
  
  Dear *** ******** 
  
  This letter is in response to a billing complaint from *** ***** filed in your office on May 9, 2024. This was sent to the Financial Ombudsman department to review and respond back to you.
  
  I would first like to offer my sincere apology for any frustration this may have caused *** ***** The root cause of her complaint is to have her medical records for her emergency room visit on March 19, 2024, submitted to her ***** insurance.
  
  A review on her account has been completed. Cleveland Clinic faxed her medical records to her insurance company ***** on May 8, 2024. We have confirmed that ***** did receive them on May 8, 2024. In addition to faxing her medical records, Cleveland Clinic also uploaded her records through *****’s web portal as well.
  
  Should *** **** have any further questions she may contact me at *************
  
  Respectfully,
  ****** ******** ****** ******** ********* ********* ******* ***** *********** **** *** ***** ********* **** **** ****** **** ******* ****** **** ************ ** ** ** ******************************* *** *********** ** *** ********* ********** *******

• Initial Complaint

  05/08/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Cleveland clinic performs unfair, illegal, unsafe and incomplete medical practice. I was denied to open a disputed on unfinished and late appointment service by this business. They send me a surprise bill that violate current medical bills laws. Cleveland clinic must withdraw their balance on my account for lack of reasonable accommodative service. When I showed up on scheduled appointment, stuff made me wait for 2 hours in the office for scheduled appointment. After, the refused to explain my bill and when questioned refused to answer a billing questions

  

  Business response

  05/10/2024

  *** *** **** ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** ***** *** ********* *** ********
  
  Dear ****** ******
  
  This letter is in response to the billing complaint filed by ***** ****** to the Ohio Better Business Bureau on May 8, 2024. This complaint was received in the Financial Ombudsman office for review and respond back.
  I would first like to offer my sincere apology for any frustration this may have caused *** ******* I have undertaken a full review of the concerns mentioned and I am satisfied that all issues raised have been researched and addressed appropriately.
  After reviewing our records, we have confirmed that *** *******s insurance is indeed in-network with our facility, and the information provided to him at the time of his visit regarding his benefits was accurate. During the verification process, it was indicated that no copay was required for the services rendered.
  Allow me to clarify that surprise billing can occur when a patient receives an unexpected balance bill. This can happen when patients can’t control who is involved in their care, like when they have an emergency or when they schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
  Regarding *** *******s specific case, the claim submitted to **** totaled $481, which was processed and paid. However, he is now responsible for a deductible amounting to $242.41; deductibles, co-pays, and co-insurance amounts are not considered a part of surprise billing.
  We understand that unexpected medical expenses can be challenging, therefore we can offer interest free payment plans. For the amount owed, *** ****** qualifies for a monthly $40.41 interest free payment plan for six months.
  If *** ****** has any questions or concerns regarding how his insurance benefits were applied or about the billing process in general, I encourage *** ****** to contact **** directly. They will be able to provide him with detailed information and clarification regarding his benefits and coverage.
   I apologize for any inconvenience this may have caused and thank you for bringing these concerns to our attention. If we can be of any further assistance, don't hesitate to contact me directly at ************.
  Respectfully,
  **** ******  ********* *********  ******* ***** ********** *** ******* ***** 

  Customer response

  05/10/2024

  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.   Unfortunately business has not provided a quality care service that could charge that high, also business has not dressed all my concerns!  The business charged me for a new doctor appointment which isn’t the case because new doctor appointment was not requested. I’m offering to pay what I should have been paid ( 100$) and close this matter even though I will never come back to this business. If business refuses tot ape what offered, there will be no other payments offered or brought up to negotiations. This is the only way for business to get anything from me. My offer, is reduce the bill to what it should have been billed for aka a normal doctor appointment, otherwise you will not get paid at all for the issue o stated above. 
  

  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,
  
  ***** ******
  
  
  
  
   

• Initial Complaint

  04/29/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  In June of 2023 my dependent had to have a number of blood tests and other exams in order to qualify for college athletics. We have been fighting billing ever since. Once some of the billing issues were resolved, the bill was paid with a memo noting the account number. The payment was applied to the wrong account. I have called every month to try to get it corrected. Every month a billing agent assures me that they moved the payment to the correct account. Then the following month I get a bill saying it needs to be paid immediately. Last month, after being told they couldn't find the payment and I need to call my bank to send proof, I asked to speak to a supervisor. Eventually, the supervisor found the payment and said they fixed it and I would receive an email shortly. I never received the email and called back to verify it was taken care of. No response to my phone message and another bill. I have spent way too much time on the phone with people who are clearly unable to do their jobs. The billing system is ridiculous and needs to be fixed.

  

  Business response

  05/17/2024

  *** *** **** ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** ******* ********* ******* ******** **** *** ********
  
  This letter is in response to a billing complaint from *** ****** on behalf of her dependent, **** ****** *iled in your office on April 29, 2024. This was sent to the Financial Ombudsman department to review and respond back to you.
  
  I would first like to offer my sincere apology for any frustration this may have caused *** ******. The root cause of her complaint is to have the payment made of $549.00 applied to her dependent **** ******** account like she intended.
  
  A review on the account has been completed. *** ****** sent in an electronic payment from her bank that was received on February 13, 2024. However, the payment had applied to her own account instead of her dependents account like she intended. The electronic payment had listed her account number not the account number of her dependent. Cleveland Clinic was able to transfer $239.71 to her dependents account upon her request. The remaining amount of $309.29 was refunded since she had no pending or open balances on her account. *** ****** was advised of the refund check on May 13, 2024.
  
  Should *** ****** have any further questions she may contact me at *************
  
  Respectfully,
  ****** ******** ****** ******** ********* ********* ******* ***** *********** **** *** ******* ********* **** **** ****** **** ******* ****** **** ************ ** ** ** ******************************* *** *********** ** *** ********* ********** *******

• Initial Complaint

  04/29/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My daughter ******* went to Beachwood Cleveland Clinic for her FIRST preventative gynecology exam on 3.12.2024. When I scheduled the appointment, I told them that it was her first preventative exam. While at the visit, my daughter mentioned to the doctor, Hanna Lisbona that she was interested in getting the birth control shot. The doctor gave her the prescription and my daughter left. 2 weeks later, I see Cleveland Clinic submitted a claim to my insurance company. It was coded correctly as a preventative visit with no charge to us. They also submitted another claim under Hanna Lisbona name coded as an "office visit" of which we owe $196.17. WRONG.. I called the CCF billing office and told them of error. They told me they can't fix it, the doctor has to fix it. I said, then have the doctor fix it and they tell me they can't do that! Then I get Aetna, my insurance company involved and we are on a 3 way call for an hour with CCF and nothing gets resolved. I put in a dispute for the claim through Aetna and nothing is resolved because CCF won't have the doctor recode it and resubmit the claim. I've put in 2 calls to CCF ombudsman and never receive a call back. Just received the $196.17 bill from CCF today in mail. This bill will not be paid. I can promise them that. This was a preventative visit that by law should not be the patients financial responsibility. This is the 2nd time in 2 years I have dealt with this exact situation with CCF billing for preventive visits. I'm done wasting my time calling, writing and begging for what's right and legal for months trying to get a bill corrected. If this doesn't get resolved ASAP this time..I'm getting my lawyer involved.

  

  Business response

  05/09/2024

  *** ** **** ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** ***** *** ********* *** ********
  
  Dear ****** *****,
  
  This letter is in response to the billing complaint filed by ***** ******* on behalf of her daughter ******* ******* to the Ohio Better Business Bureau on May 2, 2024. This complaint was received in the Financial Ombudsman office for review and respond back.
  I have undertaken a full review of the concerns mentioned and I am satisfied that all issues raised have been researched and addressed appropriately. As per coding guidelines, when a patient comes in for a physical, these types of visits are typically focused on preventive care. During such visits, our primary goal is to assess *** ********* overall health status, provide preventive care services, and discuss any lifestyle modifications or screenings that may be necessary for her well-being.
  However, if during the visit the patient presented with other medical concerns that were actively symptomatic or ongoing, it is essential for our providers to document and address these issues. According to Center for Medicare and Medicaid Services guidelines, documenting and addressing such concerns may necessitate coding for an additional office visit beyond the routine preventive care, which may result in additional charges.
  Regarding the billing for the office visit, we can assure *** ******* is being charged appropriately based on the services rendered. The ongoing medical concern that rendered an office visit charge was: Excessive and frequent menstruation with a regular cycle.
  Please be advised that as a provider-based billing provider, our facility operates under specific billing guidelines that include separate charges for professional services provided by the physician and facility charges covering the use of the room, medical supplies, equipment, and support staff. This applies to all patients, regardless of insurance type, and is in accordance with regulatory requirements.  
  Unfortunately, after a thorough review, we have confirmed that the charges on *** *******’s bill are accurate and have been billed correctly according to the services rendered.   As such, no further adjustments will be made to *** *******’s account. 
  Additionally, I would like to address *** *******’s statement regarding the calls made to me. While I understand *** *******’s frustration with the communication process, please note that my phone is a voicemail system. This is designed to ensure the security and privacy of all communications. I do not receive notifications unless a message is left. To date, my records reflect that only one voicemail was recently received.
  
  Despite my efforts to assist and clarify any discrepancies in a previous telephone conversation with ***** *******, it was evident that she was dissatisfied with the explanation provided and disconnected the call. For this reason, a letter to *** ******* was being prepared explaining the same as above.
  
  I apologize for any inconvenience this may have caused and thank you for bringing these concerns to our attention. If we can be of any further assistance, don't hesitate to contact me directly at ************.
  
  Respectfully,
  **** ******  ********* *********  ******* ***** ********** *** ******** *******
  

• Initial Complaint

  04/23/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  **** ****** completed an accommodation form for my job back in March during an office visit. She gave me a copy and she put the original form in my file. The HR department at my job told me to have the doctor add “Do not send to the pick department “. On 3/28 I sent a my chart message to **** ****** to update my accommodation form for work. All I asked her to do was to update the date on the form and to add “Do not send to the pick department”. She responded to me in my chart that she completed the form and faxed it to my job. On April 22, my job removed me from the schedule because Tara did not refer to the form she put in my file, she did a whole new form and my job said they are unable to accommodate me. I went to ***** ******* ****** and I asked the people at the front desk if I could see her to ask her why she changed my whole form when all I asked her to do was to add “Do not send to the pick department” I asked to speak to a supervisor they said she doesn’t have a supervisor. Then they told me she was busy and I would need to make another appointment. The people at the front desk told me she added a my chart message saying that she wasn’t doing another form. I spent the whole afternoon arguing with this woman on my chart. She told me to make another appointment with her. Why would I make another appointment with someone that has an attitude problem, and who didn’t do what I asked them to do originally. I can’t even go to work because she did this. Cleveland Clinic charges for my chart messages. I do not want to be charged for arguing with their doctor when she wouldn’t speak to me in person and I don’t want to pay for the doctor filling out a medical form incorrectly. I need a corrected medical form so I can go back to work.

  

  Business response

  04/23/2024

  Hello, 

   

  I was able to speak with this consumer this morning and identified this concern. I confirmed with her I will further investigate this issue and call her directly when I am able to obtain an outcome or resolution. I appreciate her patience as I work to resolve this issue.

   

  Thank you,

  *****

  Ombudsman

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