Complaints

• Initial Complaint

  03/03/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  July 21, 2022 I took my daughter, *********************, to a Wellspan East York Urgent Care facility with ear complaint, for which we were billed over $300, which we paid. Despite noting both an inner and outer ear infection, they gave her only ear drops. No surprise that the following day her ear was worse. I called the urgent care location 7/22 to follow-up, and instead of calling in an RX like they SHOULD HAVE DONE ON THE SPOT, CONSIDERING IT SHOULD HAVE BEEN ISSUED THE PREVIOUS DAY, they told me to take her to the ER, where we were seen and billed $1,500 + $157 for ER visit and MD fees respectively (acct #********, visit date 7/21 and 7/22). First, there is the neglect of medical treatment on behalf of the urgent care. Then there is the additional pilfering of money by sending us to the ER UNESCESSARILY. Finally, there is the actual ER BILL, which is OUTRAGEOUSLY OUT OF PROPORTION TO THE COMPLAINT, the attention we received, and the amount of time they spent with us (less than 5 minutes). I am especially outraged that they did NOT do their due diligence and call in a prescription as soon as it became clear their initial treatment recommendations were NOT working, instead opting to pilfer more (and an exorbitant amount at that) money out of us. That's doctors NOT DOING THEIR JOB. This is NOT MEDICAL CARE... IT'S BAD BUSINESS.

  Business response

  03/17/2023

  March 17, 2023
  
  RE: Complaint ID ********           ***********************
  
  Dear *******;
  *************** on behalf of WellSpan Medical Group Urgent Care-East York in follow-up to your letter dated March 6, 2023 regarding a response from the complainant received by the Better Business Bureau (BBB). The complainant maintains dissatisfaction with the initial WellSpan response related to charges for services received at the WellSpan York Emergency Department on 7/22/22.
  The complainant rejected our initial grievance response because: “July 21, 2022 I took my daughter, to a Wellspan East York Urgent Care facility with ear complaint, for which we were billed over $300, which we paid. Despite noting both an inner and outer ear infection, they gave her only ear drops. No surprise that the following day her ear was worse. I called the urgent care location 7/22 to follow-up, and instead of calling in an RX like they SHOULD HAVE DONE ON THE SPOT, CONSIDERING IT SHOULD HAVE BEEN ISSUED THE PREVIOUS DAY, they told me to take her to the ER, where we were seen and billed $1,500 + $157 for ER visit and MD fees respectively (acct #********, visit date 7/21 and 7/22). First, there is the neglect of medical treatment on behalf of the urgent care. Then there is the additional pilfering of money by sending us to the ER UNESCESSARILY. Finally, there is the actual ER BILL, which is OUTRAGEOUSLY OUT OF PROPORTION TO THE COMPLAINT, the attention we received, and the amount of time they spent with us (less than 5 minutes). I am especially outraged that they did NOT do their due diligence and call in a prescription as soon as it became clear their initial treatment recommendations were NOT working, instead opting to pilfer more (and an exorbitant amount at that) money out of us. That's doctors NOT DOING THEIR JOB. This is NOT MEDICAL CARE... IT'S BAD BUSINESS.”
  As indicated in the initial response to the complainant, care received by the patient was appropriate and met the standard of care. In addition, the leadership and the clinical site director further explained the rationale for the care on March 15, 2023.
  A review of the bill was completed by leadership in customer service and collections. The results of the review were shared with the complainant by the Urgent Care leader via letter dated November 16, 2022. The billing was found to be appropriate per the care received. However, a 20% discount was approved by leadership and applied to the bill.  If there is a financial need due to ability to pay, WellSpan has a financial assistance program that could be an option once an application is submitted.
  Thank you for allowing us the opportunity to respond on this matter. Please feel free to contact me if you should have any questions or need additional information.
  Sincerely, 
  
  ********************* MSN *** RN, CPXP, CPC
  Regional Director, Patient Experience

• Initial Complaint

  02/07/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  My son was in a car accident. The other driver took full responsibility. My son went to Wellspan health to have his leg checked due to a large hematoma on the thigh from the accident. Wellspan submitted the charges to ********* due to the injuries resulting from a car accident. Wellspan stated ********* rejected the claim so they submitted to my ******** insurance. I contacted ********* and they made me fill out a number of forms and have them notarized so that they could speak to Wellspan. I have placed numerous calls to both parties and no one has resolved this. Myself and my wife have both sent detailed emails explaining how this claim should be submitted in full to ********* and no one has done so. Wellspan stated they resubmitted the claim to ********* in December and ********* rejected it again. ********* denies that they ever received a claim. I asked for a copy of the denial from Wellspan and received no response. Both parties have been silent and will not tell me if they have resolved the issue. Last evening I received a call from a debt collector so clearly they still have not resolved the billing issue.

  Business response

  02/15/2023

  February 15, 2023
  
  *****************************
  *********************************************
  
  RE: Complaint ID  ********  ***************************
  
  Dear ******************,
  
  Thank you for taking the time to contact us regarding the concerns that were brought to your attention surrounding this customers experience at WellSpan Health.  At WellSpan Health, we aim to provide care and services that are easy to use and are delivered in a safe, respectful, and compassionate manner. We are very sorry that we did not achieve that in this case.
  
  We thoughtfully reviewed the concerns about the billing issue identified in this complaint to the Better Business Bureau.  To summarize, it was stated that due to the claim being submitted incorrectly, it was denied by the car insurance company and was paid by the customers health insurance carrier. Despite the customers best efforts, they hadn't received a response as to whether the issue was resolved before being contacted by a debt collector. The findings of our investigation are summarized below.
  
  The claim was billed to ********* Insurance but was denied due to not being able to identify the patient as insured. Once the denial was received, the billing department submitted the claim to the patient’s health insurance to ensure it was received by the filing time limit. This information was provided to the family on August 23, 2022. At this time, the account started through the aging process with statements being generated reflecting the balance due.
  In November 2022, updated ********* Auto information was received, added to the claim, and billed out.
  We were contacted in December 2022 by *********. They denied the claim because it had the incorrect claim number. It appears that a good bit of the communication regarding this account was with our early out vendor and the account was continuing through the aging process.  
  On February 2, 2023, another email communication was received notifying that the correct claim number was obtained, corrected on the claim, and that a bill was being sent out to ********* again.
  Due to the delay in the correct claim information being submitted, we will have this account closed with the collection agency as “sent in error”. This will cease any further contact from the collection agency.  WellSpan does not report to credit bureaus. When a payment or response is received from ********* insurance, a corrected claim/refund request will be submitted to the patient’s health insurance.
  
  If ********* pays all of the charges, then we will do a corrected claim back to the health insurance company and request for them to take their money back, as the health insurance did pay a portion of this claim when it was billed out with the original denial that was received from *********.
  
  We appreciate you sharing these concerns with us. Your feedback gives us a great opportunity to review the care and services we are providing and to improve where necessary to be a trusted health care partner for our community. We deeply regret the disruption in trust this situation may have created with our patient and family.
  
  Sincerely,
  
  *************************
  Patient Experience Regional Director
  WellSpan Health
  ************************************

  Customer response

  02/17/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because: According to your representative, ***********************, in an email on Feb. 7, 2023: "********* has now been billed and your ******** will be reimbursed.  Please accept my apology and If you have any questions, please call customer service at ************  opt *."

  
  Thank you,

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

  Patient Financial Specialist, Customer Service and Collections

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

  *************
  Wellspan Health

  112 North 7th Street
  Chambersburg, PA 17201

  
  

  ************** did not provide any documentation and told me to call customer service, and now you're stating that you still have not received payment from Travelers. So, I am receiving the same response from your company that I have been receiving for many months and no resolution. Why has this still not been worked out correctly with the insurance company? Please provide documentation of rejections and provide documentation if this has been resolved as ************** stated.
  
  Regards,
  
  ***************************
  

  Business response

  02/24/2023

  February 24, 2023
  
  *****************************
  *********************************************
  
  RE: Complaint ID  ******** ***************************
  
  Dear ******************,
  
  Thank you for taking the time to contact us regarding the concerns that were brought to your attention surrounding this customer’s experience at WellSpan Health.  At WellSpan Health, we aim to provide care and services that are easy to use and are delivered in a safe, respectful, and compassionate manner. We are very sorry that we did not achieve that in this case.
  
  We thoughtfully reviewed the concerns about the billing issue identified in your second complaint to the Better Business Bureau.  To summarize, it was stated that due to the claim being submitted incorrectly, it was denied by the car insurance company and was paid by the customer’s health insurance carrier. Despite the customer’s best efforts, they hadn’t received a response as to whether the issue was resolved before being contacted by a debt collector. The findings of our investigation are summarized below.
  
  All the information that was in our original response of what took place on the claim is correct. Attached is a copy of the first denial that was received from ********* stating that they were unable to locate a claim for the patient. Claim information was then received and submitted however there was then a phone conversation with our adjustor, on 12/23/22 stating the claim was denied for an incorrect claim number. Corrected information was received and was not handled appropriately, and a corrected claim never got sent back out to ********* insurance until 2/7/23. We need to allow time for ********* insurance to receive the claim, review and then process the claim for payment.
  
  By the way of explanation, once a response was received from Travelers insurance then that information along with a corrected or voided claim will be sent to the health insurance company to request, they either re-process for any balance remaining after ********* as a secondary coverage or to take their entire payment back that was originally made. This activity with the health insurance company can't take place until we have a proper response from Travelers to show why. This could have been explained better in the response that was sent by **** *****.  A phone message was left for the father, ****** on 2/21/23 to reach out so a better explanation could be provided as to what has taken place.  However, at this time he has not returned our phone calls.
  
  Again, we appreciate you sharing these concerns with us. Your feedback gives us a great opportunity to review the care and services we are providing and to improve where necessary to be a trusted healthcare partner for our community. We deeply regret the disruption in trust this situation may have created with our patient and family.
  

  Sincerely,
  
  *************************
  Patient Experience Regional Director
  WellSpan Health
  ************************************

  Customer response

  02/27/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because: I have contacted the claim handler at *********, **** ***, and she has emailed you again that nothing was received from Wellspan. Nothing has been submitted to ********* for payment. Unfortunately I could not see any attachments if the rejections were attached. Also, I prefer everything in writing since I have spoken to multiple Welspan representatives and none have been able to correct this billing issue. 
  
  Regards,
  
  ***************************
  

  Business response

  03/17/2023

  March 17, 2023
  
  *****************************
  *********************************************
  
  RE: Complaint ID  ********  ***************************
  
  Dear ******************,
  
  Thank you again for taking the time to contact us regarding the concerns that were brought to your attention surrounding this customers experience at WellSpan Health.  We have been actively working on resolving these concerns for the patient.  Below is an update regarding this account.
  
  The charges related to the service provided on 3/11/2022 were submitted to ********* Insurance Company again on 2/23/2023. Our Manager, Customer Service and Collections, ****** *******, had communication with the claim adjustor, **** ***, on 3/15/2023 where she advised that they only received a bill for one of the charges – $63.00. Our WellSpan billing department resent out another claim for the $180.00 charge on 3/16/2023 to ********* Insurance.

  A payment has been received from ********* Insurance Company on the charge for $63.00 which was posted in our system on 3/17/2023 covering that amount.
  *** ******* continues to monitor this claim to make sure that this does get resolved with the Auto Carrier and that no further statements will generate out to the patient or parents regarding this.
  

  Sincerely,
  
  *************************
  Patient Experience Regional Director
  WellSpan Health
  ************
  ************************************

  Customer response

  03/24/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because: It is still not completely resolved. Please notify me regarding returning the payment you received from my ******** Insurance, and please notify me when this has been completely resolved.  
  
  Regards,
  
  ***************************
  

  Business response

  03/30/2023

  March 30, 2023
  *****************************
  *********************************************
  RE:Complaint ID  ******** ***************************
  
  Dear ******************,
  
  Thank you for taking the time to contact us regarding the concerns that were brought to your attention surrounding this customers experience at WellSpan Health. At WellSpan Health, we aim to provide care and services that are easy to use and are delivered in a safe, respectful, and compassionate manner. We are very sorry that we did not achieve that in this case.
  
  We thoughtfully reviewed the concerns about the billing issue identified in this complaint to the Better Business Bureau.  To summarize, it was stated that due to the claim being submitted incorrectly, it was denied by the car insurance company and was paid by the customers health insurance carrier.  There was no actual payment received from the health insurance, it was only a contractual adjustment that was applied towards the deductible.
  
  In summary, there is an itemized bill attached but this is a breakdown:
  ******** Insurance Company on 8/17/22: $0.00 payment, $100.35 adjustments.
  ********* Insurance Company came through and paid towards the charge amount of $63.00: payment posted on 3/17/23 reflecting payment & adjustment.
  We are still waiting on a response regarding the $180.00 charge from ********* Insurance Company.
  
  Lastly, several phone call attempts have been made to the father with no response. Again, we appreciate you sharing these concerns with us. Your feedback gives us a great opportunity to review the care and services we are providing and to improve where necessary to be a trusted healthcare partner for our community. We deeply regret the disruption in trust this situation may have created with our patient and family.
  
  Sincerely,
  
  *************************
  Patient Experience Regional Director
  WellSpan Health
  ************************************Tell us why here...

• Initial Complaint

  02/06/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  On 12/3/22 I used Wellspan Online Urgent Care. I was directed to them from the "My Wellspan" account that my primary care doctor is associated with. In order to use the service, they state that you must provide a credit card for the fee of $49, which I did, it being a Saturday my doctor not in. I submitted a claim form to my insurance carrier (**** ***** **** ******) along with the bill for this service, which is covered under my policy. A few weeks later I received a letter from **** stating that they could not process the claim because they requested additional info from Wellspan and received no response. I called **** and was told that the NPI#********** is incorrect. It comes up as Wellspan Eye Care. The **** agent as well as myself were on a two hour call with Wellspan attempting to get the correct NPI# to NO avail! **** has made numerous attempts as well as myself and I could not get the necessary info other than that although the website and the bill represents itself as a Wellspan entity, using their name, address and phone, in reality they are using a third party entity for their online urgent care. This is an extremely deceptive practice! No where on the website does it state that I was being directed to somewhere other than Wellspan! I have even sent an e-mail to Wellspan's Customer Care requesting the correct NPI and they have ignored ALL requests for this info. I know this isn't a large amount but I am 64 years old, recovering from cancer with enormous medical bills and every little bit counts. Thank you for your assistance.

  Customer response

  02/16/2023

  I just wanted to inform you that my complaint against Wellspan Online Urgent Care has been resolved.  They issued me a full refund of the $49.  Thank you for your assistance.  It was greatly appreciated.
  
   

• Initial Complaint

  02/02/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have documented my crisis calls to wellspan crisis york hospital when it need of a CIT counselor several times recently in 1 year. I have tried to no avail to entertain several of their psychirist, munesses, ********* and several other practitioners there for 14 years. My chart reflects a new diagnosis from each physician. Six or seven **** prognosis. When I reach out to crisis york hospital, I am at home, I am told that they are toooo busy treating patients in their care ( obviously someone in their care is SAFE) the person on the phone in crisis may not be SAFE ! Seems that this is illogical and Dangerous, (SOP) standard operating procedure. Recently I called and was asked to supply my phone number 3 times and my address twice. Having fully complied with the lovely ladies request, I started to inquire as to why she continued to ask me for the same answer for approximately 2 minutes. While I was politely asking my question, I was rudely interrupted and told if I keep talking that she will hang up on me...she did ! Knowing that time is of the essence when a citizen is calling crisis from outside of the hospital, no one should be threatened by your associates. Especially when the purpose of crisis is to listen, document and give undivided attention to the victim. I was strangled by a human, knocked my teeth out and a pit bull chewed on my arm for 3 minutes. There are other crisis companies in our lovely community that care for and employ an Empathetic service...not a service of condemning and making the victim feel GUILTY. My call was to achieve assistance for my autistic 6yr old nephew who I believe that is in need of cps. I would request that My doccumented contact with the township associated with the autistic child and my previous reports to the other crisis company about your associates lack of training and their arrogance should not be tolerated ever in our lovely community. I implore of you to reach out to me immediately, ***********************, NIST ************.

  Business response

  02/16/2023

  February 16, 2023.
  
  *****************************
  *********************************************
  
  RE: Complaint ID  ********;  ***********************
  
  Dear ******************,
  
  Thank you for taking the time to contact us regarding the concerns you brought to our attention regarding Mr. ******** experience at WellSpan Health. At WellSpan Health, we aim to provide care and services that are easy to use and are delivered in a safe, respectful, and compassionate manner. Please extend my apologies if we did not achieve that in this case.
  
  We thoughtfully reviewed the concerns about the reported experience with Crisis Intervention. To summarize, Mr. ******** grievance includes the following issues:
  He reported calling Crisis Intervention several times in the last year and didnt feel that he was given the proper attention or was listened to about his medications
  He recently called and was asked to give his phone number and address several times
  He wanted to get assistance for his nephew whom he believes needs CPS.
  
  The results of our investigation are as follows:
  ****************** called on two occasions; both calls were made during the weekend, and he was advised to follow up with his PCP and to present to the emergency department if he felt unsafe or was in any pain.
  There was a policy matter resulting in a discontinuation of service for a three-month period, for which **** received a letter in the mail.
  A voicemail was left for the patient on January 13, 2023, regarding him again engaging with our services for care.
  ****************** contacted the Access Center on January 16, 2023, looking to follow up with *********** after missing the call. Our Access Center attempted to provide ****************** with a number to call and the business hours during which he could make the call.This led to some confusion and frustration on Mr. ******** part.
  ****************** confirmed interest with receiving the services that were offered, and a referral was made on January 18, ************************************** met with a provider on February 2 and February 8, 2023. An additional appointment was set for February 14, 2023, to address another aspect of his care needs.
  Regarding one final point, we have no record of the patients concerns for his nephew or inquiring about CPS.
  
  We appreciate you sharing this concern with us. I have attempted to respond to the concerns cited while restricting some of the details out of respect for Mr.******** ************** Please know that this feedback gives us a great opportunity to review the care and services we are providing and to improve where necessary to be a trusted health care partner for our community.
  
  Sincerely,
  
  
  *************************
  Patient Experience Regional Director
  ************
  

• Initial Complaint

  09/19/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On July 7 I went to wellSpan wound healing clinic on ***** ****** for a new patient appointment. When making the appointment I asked for upfront pricing and how much this visit would cost me. I was sent a new patient packet prior to the visit explaining what services would be included for my visit. During my appointment one of the nurses came in and prepared me for a wound cleaning. Telling me Just in case the doctor wants to clean your wound. I made it very clear to the nurse that I had an extremely high deductible and was only interested in what was included for a new patient visit. When I saw the doctor I made it clear I had a high deductible I was only here for a new patient visit. At no time did a nurse, the doctor or Front office indicate that the wound cleaning was not part of the new patient visit. I clearly asked for upfront pricing and was only there for what was included in a new patient visit. To my surprise I received a bill for $800 when I was told all I would be paying was a $50 co-pay. I immediately reached out to customer service On August 2 at 9:30 AM speaking with Amanda. Amanda said call ********* *******. I talked to Kalia On August 10 at 1:30 PM. She told me to call The practitioner manager at the wound care center on ***** ******. On August 10 and August 11 I called only to get an automated system that no one was available at that time and to leave a message, which I did. I have yet to receive a call back. I’m done being run around by WellSpan and they’re inability to fix their mistake. I’m hoping they can rectify their mistake with not providing me with upfront pricing. Not letting me know that the services the doctor provided were not included in the new patient visit I specifically wanted done. If WellSpan is unable or unwilling to do what’s right, then my next step is to file a complaint with the attorney generals office and the Pennsylvania department of health. 

  Business response

  09/28/2022

  We had this issue reviewed by both the nurse manager and patient finance. Each new patient is sent a letter explaining what possible procedures (and corresponding procedure codes) can be performed at a new patient appointment and to contact their insurance company to find out if it will be covered. It is not unusual for a procedure to be performed at a new patient visit, if it is deemed necessary. No estimate can be provided because it is not known what might be required until the office visit occurs.  The charges that were incurred were because the insurance deductible had not been met. The nurse manager is planning to call the patient to discuss this further.

• Initial Complaint

  09/07/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My husband donates blood every 8 weeks to blood bank at Wellspan, and due to this he developed anemia. He went to wellspan physician who confirmed the anemia after received blood work results. We were billed 397.00 dollars for the blood work, which insurance does not cover. I phoned billing department and and ask if some adjustment could be made to the charge of lab work. Told no adjustment could be made, and no thank-you for all the blood donations. We are on a fixed income and they did not seem to care. I believe Wellspan certainly could have made some adjustment for all the time and blood donations my husband has made over the past years

  Business response

  09/21/2022

  Patient was called and bill was written off and forgiven as a patient courtesy and a thank you for being a long term blood donor.

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