ComplaintsforSt Clair Hospital

• Initial Complaint

  12/04/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  This is regarding the payment code:*************.My wife had a panic attack and called 911 so we were taken to StClair emergency department by the ambulance. We waited for almost 2 hours to get in ER due to long wait time, meanwhile she was fine & recovered herself before we got in ER. Nurse/doc talked with wife & they told we need to consult psychiatrist outside as for then she was ok. The only thing they did in ER department is they took her blood and sent for lab to test for any tablet she might have taken. No checkup or treatment of any sort or done.But I received multiple bills: one from doctor(payment code: ************) for $356 which was $121.64 after insurance and one from lab (****** *** ******* pathology) which was $160 and $45 after insurance . Both bills are payed off as of today . Also I had an ambulance bill with third party which is also settled. Again now after few months I got hospital bill payment code: ************* which is $751.41 after Cigna insurance adjustments (Pre-insurance bill $1922). When I called at St.Clair billing department they said this bill is for ER department. But as I see in the bill the ER room fees is $459 , but the Chemistry/Hemato lab fees is $1392 and microbiology bill is $71. ER room bill is for we entered there even if we dint took any medical care, but the lab bill is shocking as we already had lab bill separately and also for blood test shd not cost so much , when called they said it’s equipment’s charge. The equipment fee should not be this much nor we needed or asked for any blood tests.We feel we have been billed wrongly & incorrectly. I called twice St Clair billing department & asked for itemized charges of the lab bill which I still dint to get from the hospital, they said they would mail me but dint, nor did they replied to my email sent.Request to have review on this bill &help in this matter to correct the charges as we dint took any treatment or procedure from the hospital nor we asked/needed blood test

  Business response

  12/08/2023

  Dear BBB and Mr. *******,
  
  Thank you for reaching out to us to outline the concerns you have regarding the cost of services for your recent visit to St. Clair Hospital’s Emergency Department (Date of Service 11/21/2022, Account Number ********). We have reviewed your account and have not identified any billing errors for the Emergency Department visit in question, I am attaching supporting documents for your reference as well.
  
  For services rendered in Emergency Department, separate bills are generated by the various providers involved in your care. You can expect to receive a separate bill from the ED physician, any specialists involved, ambulance (if one was used), and a facility bill for the actual ED visit. The $45 you paid was for the pathologist’s professional fee and the $121.64 payment you made was most likely the professional fee for the ED physician. The $751.41 bill from St Clair is for the facility charges related to the Emergency Department visit. I have attached itemized statement where you can see a breakdown of all labs that were done along with Emergency Department room charge. St Clair's bill is specifically for the labs, ED room charge, and a urine culture, aka microbiology. We are not seeing any equipment charges billed to you.

  We understand that healthcare bills and cost can be overwhelming at times, and we have some programs to assist our patients. I would encourage you to call ************ on your statement to learn more about your options under our Financial Assistance program.
  
  We appreciate your choosing St. Clair Health not only to meet your healthcare needs, but also to meet the healthcare needs of your family.  If you have any additional questions, please do not hesitate to reach out.

  Customer response

  12/11/2023

  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.
  
  *** ****** ** ** ******** **** ****** ** * ****** ** ***** **** ** **** **** **** ** *** ********
  
  Regards,
  
  ********** *******

• Initial Complaint

  08/03/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Billing issue with Dr. Karin O***** of the St. Clair Medical Practice located on Oxford Drive in Bethel Park. Dr. O***** ordered bloodwork to be done on me, ***** *******, as part of a yearly physical in July 2021. Once I completed the bloodwork, I began to receive bills from Quest Diagnostics in the amount of $264.06 for one test that was not covered. It was for a general blood panel. After contacting Highmark and Quest, I was advised that Dr. O***** used the wrong code for my bloodwork tests. Multiple calls, email, and messages to their office has yielded nothing. I have been trying to resolve this myself for over a year now. I am currently on hold again with their office just to exemplify how no one ever answers the phone (8 minutes already). We've left detailed messages, my wife and I, but nothing is resolved. We are asking for intervention from the BBB. Thank you.

  Business response

  09/09/2022

  September 6, 2022 
  

  Better Business Bureau 520 East Main Street Suite 100 Carnegie, PA 15106 
  

  This letter is in response to the ********** ************ filed by ***** ******* against St Clair Hospital and referencing an updated diagnostic code submission to Quest Diagnostics. The physician's office made numerous attempts to reach the patient via phone to resolve this issue beginning in November of 2021. The patient left a message requested corrected diagnostic codes be sent to Quest Diagnostic. On November 11, 2021, the physician corrected the codes and the updated information was faxed to Quest Diagnostics. The physician's office attempted to notify the patient of this fact, but the phone number listed for the patient was disconnected. The patient again contacted the office in July of 2022. Several attempts were made to respond to the patient including July 6, 7, and 18, 2022. Messages were also left on the patient's wife's cell phone. The physician's office requires a copy of the invoice from Quest Diagnostics to further assist the patient and cannot move forward without the patient providing this information. The Patient Representative's Office left a voice message for the patient indicating what information is needed by his physician's office to resolve this concern. We also sent a letter encouraging him to contact us to discuss his concern in more detail. At St Clair Hospital we take patient concerns very seriously and appreciate the opportunity to work with patients to resolve issues and provide the best possible patient experience. We will be happy to provide updated information to the Better Business Bureau and more details of our response, once we receive clarity from the patient. 
  Thank you very much for your time and the opportunity to resolve this patient's concern. If | may be of further assistance, please contact me at ************* 
  

  Sincerely, 
  
  Amy C**** Patient Representative 
  

  
  

  Customer response

  09/16/2022

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to ********* ** ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  We began calling Dr. O******* *ffice in July of 2021 regarding the invoice. I didn't note the date and time or the content of my messages, but no one ever call me back. We continued to receive monthly invoices and in November 2021, I again attempted to contact Dr. O*****. At that time, the office had apparently changed their number, as I could only reach the main office number when I called Dr. O******* (*** ********** **** number. I looked online and found a different number, but again reached the main number. Both times I was transferred to Dr. O******* *ffice only to find the staff at lunch or just not responding to calls.
  
  Once I finally got in touch with staff, they said that they tried to call us multiple times at an old number even though my cell phone number is on file with Dr. O******* *ffice (as is my wife's cell phone number). No one ever attempted to contact either of us at those numbers.
  
  I could go around and around with this, but the point is that they entered the wrong code for their procedure and would not give us the time of day to make it right. I contacted them again and again and once I finally got connected with the office manager, still nothing happened.
  
  Therefore, I filed a complaint with the Better Business Bureau to help resolve the issue. Someone seemingly higher up, Ms. C****, eventually reached out and left a voicemail on September 9, 2022 in which she mentions needing the invoice, which I promptly photographed and sent to her via email at *********************. I specifically mentioned that no one had called us or left any messages regarding the Quest invoices (again, they have both of our cell phone numbers; I am happy to request phone records). We still have Ms. C****'s voicemail as well if that may help.
  
  This is the most contact I have had from the hospital in the past year and a half. Once we have proof that the invoices will stop, then we will be satisfied. An official apology for poor customer service by numerous people over a year-and-a-half timeframe would also be appreciated. We have since switched to Allegheny Health Network and are beyond satisfied. Ironically I need a refill on an old script from Dr. O*****, but haven't called because I figure no one will answer. 
  
  Regards,
  
  ***** *******
  
  

  Business response

  10/03/2022

  This letter is in response to the ********** ************ filed by ***** ******* against St Clair Hospital and referencing an updated diagnostic code submission to Quest Diagnostics. The patient's wife did promptly submit a copy of the needed invoice to St. Clair Health as requested on September 16, 2022 and this information is greatly appreciated. An administrative review of the patient's chart was completed. The coding for the completed lab work was reviewed and compared with the invoice from Quest Diagnostics provided by the patient. The review determined there was no clinical justification for the lab work and the physician practice will assume responsibility for the payment of $264.06 indicated on the invoice. St Clair Health issued a check for payment to Quest Diagnostics on September 26, 2022. We apologize for this error, the communication concerns, and for the length of time needed to respond to and resolve this concern. We understand the patient's frustration and apologize to the patient and his wife for this situation. At St Clair Hospital we take patient concerns very seriously and appreciate the opportunity to work with patients to resolve issues and provide the best possible patient experience. 
  Thank you very much for your time and the opportunity to resolve this patient's concern. If I may be of further assistance, please contact me at ************* 
  Sincerely, 
  
  Àmy C**** Patient Representative 
  

  
  

• Initial Complaint

  08/02/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Incorrect or fabricated notes that could delay treatment was placed in my file.

  Business response

  09/06/2022

  August 31, 2022 
  Better Business Bureau 520 East Main Street Suite 100 Carnegie, PA 15106 
  

  
  This letter is in response to the complaint, ************ filed by ***** ***** against St Clair Hospital and referencing "incorrect or fabricated notes that could delay treatment." We have made numerous attempts to reach the patient via phone to discuss her concerns. We also sent a letter encouraging her to contact us to discuss her concerns in detail. Unfortunately, we are unable to move forward with the complaint without more detailed information from the patient. At St Clair Hospital we take patient concerns very seriously and appreciate the opportunity to work with patients to resolve issues and provide the best possible patient experience. We will be happy to provide updated information to the Better Business Bureau and more details of our response, once we receive clarity from the patient. 
  Thank you very much for your time and the opportunity to resolve this patient's concern. If I may be of further assistance, please contact me at ************* 
  Sincerely, 
  
  Amy ***** Patient Representative 
  

  
  

• Initial Complaint

  02/28/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I am seeking assistance with procedures which took place on 4/6/2021 at the McMurray outpatient office. Specifically, I had x-rays and an MRI. I paid for the services out of my FSA to take advantage of the 10% discount. My insurance company - Aetna - mistakenly also paid the claim from the Health Savings Account, but without the discount applied. At the end of December, my FSA was refunded the amount of $427.33 due to the duplicate payment on the claim. My FSA was mistakenly refunded. Instead, my insurance company should have been refunded. The issue at hand is that my FSA does not roll over. The $427.33 charge must be reinstated against my FSA, or I stand to lose that amount of money. My HSA with Aetna, on the other hand, does roll over. This is time sensitive as the 2021 FSA claims period closes on 3/15/2022

  Business response

  03/29/2022

  This letter is in response to complaint ID ******** filed with the BBB on 2/28/2022 by **** ******. 
  The root cause of this error appear to be that two accounts were created in error for this patient, *********** 4/5/21 (correct) and ********DOS 4/6/21(incorrect). 
  Originally, the patient opted to provide payment upfront using their FSA card to pay for services on 4/7/21, taking advantage of the point of service discount for 12% off their balance. This payment was applied to the correct account (*********** ******* in the amount of $427.33 with a $58.27 discount applied, total value of $485.60. 
  Charges were added to the duplicate account that was created by mistake ************ ******) and a subsequent claim was sent to Aetna in error. The claim that was submitted to Aetna in error has been cancelled; Aetna has reinstated the funds to the patient's HSA in the amount of $458.60. 
  Our records have been updated to place the charges on the correct account (*******-DOS 4/5/21) and a new claim was submitted to Aetna. 
  Before the charges were corrected, the patient's FSA card was refunded in full because a credit balance for the amount of the payment was the only value on the account in the absence of charges. 
  Patients are responsible to either elect or decline the option their insurance provides them to withdrawal funds from their HSA account to pay for services provided. Since Aetna was not made aware the patient intended to opt out of paying for services using the HSA account they have setup, claim processing proceeded to withdrawal the HSA funds to provide payment for the services to St. Clair. 
  In light of this issue, St. Clair will cover the remaining patient responsibility from the claim that was newly submitted to Aetna on 3/17/2022. 
  We hope that the patient will accept this resolution and continue to choose St. Clair Health as their provider of choice in the future. If you should have any additional questions please contact me at the number below. 
  Kind Regards, 

• Initial Complaint

  02/11/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  St Clair Hospital says on their billing that they offer a 5% discount to those patients who pay in full within 14 days of the first statement. I paid my first 2 bills in less than 14 days of first statement and DID NOT get a discount. I have made 3 attempts (between December-February) to get my money back and each time they say they are looking into it. I have been trying to get it credited to my last two bills and they still are ignoring me. They are dishonest and are not customer service friendly.

  Business response

  03/08/2022

  This letter is in response to complaint ID 1******* ***** **** *** *** ** ********* ** ****** ******** 
  We have reviewed the patient's accounts and determined that they did pay within the timeframe outlined on the statement for account ******* (Date of Service 10/5/2021). We have reeducated the call representative to allow for discount review for patients who have already paid their balances in full. A refund of $9.68 will be refunded back to the patient on the credit card used to receive the payment. 
  The payments on accounts ******* ***** ** ******* ********* *** ******* **** ******** were delayed but the patient was actively working with our customer service team to see if the credit due on account ******* could be applied towards these balances before supplying additional payment to us. We will extend the 5% discount to these balances as a good will gesture in review of this patient's experience. They will receive an additional refund of $25.54 back on the credit card they used to make the original payment. 
  We hope that the patient will accept this resolution and continue to choose St. Clair Health as their provider of choice in the future. If you should have any additional questions please contact me at the number below. 
  
  

  
  

• Initial Complaint

  01/29/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  The billing practices at St. Clair are absolutely horrible. The issues started from an ER visit on 10 OCT 2020. I received several bills totaling about $2,400. In January 2021, I made a $600 payment and authorized them to make an automatic withdrawal on this account in the amount of $150 until the debt is paid. I calculated my last full payment should have been in December and left a small residual amount to be paid in January 2022. Here is the part the is really driving this complaint. On 14 JAN 2021 I had a follow up echo cardiogram done, a standard procedure to get some pictures of my heart. I looked at the St. Clair patient bill estimator, which you can enter your insurance into it and it should get you pretty close to what you owe. The estimate was for $258.88 (attached). I also ran the estimator without any insurance coverage and it was about $500. I had a pretty accurate idea that this procedure can be anywhere from $250-500. I was billed for $2,152 before insurance, $1,511.19 after insurance. There is absolutely no way that can be right. I called them and everyone I talked to and explained this to at St. Clair generally agreed something was wrong, but the only course of action was to wait for an email response after the specialist reviewed the bill. I called and emailed these people dozens, probably 50+, times. Nicole was the person that would always give me a copy/paste reply in the email that " Benefits quoted are an estimation and actual patient responsibility is determined when your insurance processes your claim." Same response every time, no response to replied emails. I emailed them every week for months without answer. Eventually they wore me down. I agreed to just start paying $74 (minimum payment) every month starting in DEC 2021 just to keep them from sending me to collections. Now they are withdrawing $224 ($74 + $150) instead of the agreed $74. My other bill is paid off and they continue to charge my card $150 and apply it to my other bill.

  Business response

  03/23/2022

  This letter is in response to complaint ID ******** filed with the BBB on 1/29/2022 by ***** ********. 
  The patient presented to the ER on 10/10/2020 (Visit ******** and a statement was issued on 11/25/2020 for $2,259.56. A second statement was issued for the same amount on 12/31/2020. As the patient states, he soon after contacted customer service on 1/11/2021 to provide a partial payment of $600 and to setup a payment plan agreement to withdrawal 15 payments of $150 and 1 payment of 9.56 by automatic payment withdrawal until his account was resolved. 
  The partial payment of $600 was not factored into the terms of the payment plan agreement which is why the plan continued to withdrawal the $150 after the account went into a zero balance. The overpayment was applied to an additional account the patient had open on account 7924227 (DOS 1/14/21). If the patient would not like the overpayment applied to this account we can initiate a refund back to the patient's HSA card upon request but he will then remain responsible for the resulting balance. 
  Now that the outstanding balance on account 7082899 (DOS 10/10/20) has been paid in full the payment plan for $150 will no longer continue to withdrawal and has been turned off. We have confirmed that the additional payment plan the patient setup for $74 on account number ******* **** *******) is the only payment plan that is actively withdrawing funds. 
  We reviewed account *********** ********** with our customer service team concerning the patient's inquires on the estimate they received for the echocardiogram. The team has been reeducated on how to route issues appropriately to our patient estimate group to gain quicker resolution to estimate discrepancies in the future. 
  In light of these issues, we will offer a 50% reduction to the patient's balance which will be reflected on the next statement issued to the patient. The newly revised patient responsibility is $554.92. 
  It is our hope that the patient will continue to choose St. Clair Health as their provider of choice if additional health care needs should arise. Any additional questions can be directed to me through the number provided below. 
  

  
  

  Customer response

  04/07/2022

  I just saw the email regarding the case I opened (ID # ********* ** ***** **********  I'm sorry I was delayed in replying.  The business did contact me and had offered me a 50% discount on the amount I still owed.  This was welcomed and I accepted it, but I was still left owing significantly more than I initially anticipated based off of their own estimates.  It was better than nothing, which at this point I had just come to accept.  Thank you very much for forcing their hand.  I don't think they would have offered me a single penny's worth of reduction without your involvement.
  
  I appreciate the help you provided.  Thank you again!

*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. ↩