Business ProfileforLauderdale Community Hospital

Good morning This complaint is regarding a full refund which was paid to the Lauderdale Community Hospital for out-of-pocket expenses. On April 06, 2023, the Lauderdale Community Hospital provided services to me as a patient. Days before the procedure, I contacted my ******care provider *****, and ***** advised me that the Lauderdale Community Hospital was in the network. However, after the procedure was completed, according to the billing department representative, *************************, Someone had entered the incorrect billing code; showing the hospital out-of-network, which ***** refused to pay the claim, due to the incorrect billing codes entered. Cigna did not pay the balance due to the error of the Lauderdale Community Hospital; the Hospital (*************************) sent me the full balance owed; and it was their error of not filing the appropriate billing codes for the claim. I am sure that Lauderdale Community Hospital was intended to keep and retain all the payments which I had sent them and the full amount that ***** had paid. There was an upfront out-of-pocket expense for $668.00. Lauderdale Community Hospital requested a down payment of the sum before the procedure on April 06, 2023. There are three parties involved in the repayment Billing to Cigna which includes the anesthesiologist (PAID), the Surgeon (PAID), and the hospital Lauderdale Community Hospital (PAID). Subsequently, after arbitrating continually for several months with the Hospital, Cigna, and myself; and Lauderdale Community Hospital concealing the fact of their error or intentional billing practices, ***** finally rectified the full amount of the bill on October 05, 2023, in the amount of ******** (minus the discount). Lauderdale Community Hospital is basing my refund from the payments sent to ************************ office. *************************** is the Surgeon who performed the procedures and used the Hospital to perform the procedure. This is incorrect billing practices and procedures. My Out-of-pocket expenses from the claim amount of *************************** were sent to ************************ private physicians office at *******************************************************************************************, since April 06, 2023, and it was not disclosed by the billing department of the Lauderdale Community Hospital; that Dr. ***** office manager was hand-delivering the receipts of payments which I had made to his office to the Lauderdale Community Hospital. This information was only disclosed after the complaint to the Lauderdale Community Hospitals billing department (*************************), regarding the refund. The Hospital has been paid a total sum of $1,050.00. Cigna has paid the Hospital the full amount and I am seeking reimbursement of the $1,050.00 that was paid to the Lauderdale Community Hospital. This refund has nothing to do with ************************ office. This was never disclosed to me as the patient that either physician or Hospital was collecting both forms of payments from both the physicians office and the Hospital. Lauderdale Community Hospital never advised me that I was due a refund, I had to contact them regarding the refund. The Hospital was going to keep and retain the full amount. As Cigna has assisted me in arbitrating this for the last several months, and ***** has stated the following:?Lauderdale Community Hospital owes you the full amount that was paid to the Hospital.?Cigna has all voice recordings regarding of all contacts made between myself and Lauderdale Community Hospital and will submit them over.The receipts that I have showing that I have paid these amounts are totally different from the amounts paid to ***************************, which I know there are unethical billing practices occurring at the Hospital.This is why I would always contact Cigna for support and verification of my rights as a patient, whereas Lauderdale Community Hospital has concealed much information. Last Friday, October 27, 2023, ***** placed ************************* (billing consultant-clerk), *********************** (Hospital Administrator), and myself on a three-way call to rectify the amount owed back to me. The Hospital is not considering the amount that I paid to them, but the amount that they are subtracting from ************************ amount, which is still $1,400.00 total to both the physician and the Hospital. As ***** stated, The claim submitted by the Lauderdale Community Hospital was paid in full and all amounts paid to the Lauderdale Community Hospital (NOT ***************************) is owed back to the patient. Lauderdale Community Hospital is attempting to return only $366.16. After the arbitration call last week, I decided to drop the complaint and settle for $366.66. However, after speaking with Cigna again on Tuesday, October 31,2023, the insurance company stated, No, the patient (*************************) is due the full amount paid to Lauderdale Community hospital. While on the phone with *********************** and ************************* with *****, it was never disclosed when the refund would arrive, not an itemized bill of the refund as to what went to whom, where, and why. The billing staff is attempting to get me to understand their practices of billing but as I mentioned to *****, I am a three-year law student, and the course that I am enrolled in this semester is, ******care Fraud and Abuse. This is how I can detect fraudulent activity. I am sure that the Hospital is aware of their procedures and practices as well and perhaps has filed many other claims as such whereas the patient is blind to the billing and what is owed to the patient. As I mentioned to the billing clerk consultant by letter, *************************, This was intentional. The Hospital was not going to refund me anything, and the receipts that I have differed in the amount that was paid to the Surgeon (***************************); which should not have anything to do with my refund that was paid to the Hospital. All receipts paid to the Lauderdale Community Hospital and ************************ office was sent to the Lauderdale Community Hospital on October 09, 2023, for verification of payment. I do not desire the Hospital to contact me via phone, because the communication is tarnished at this point. I am aware of how billing should go and how to detect fraud, I am seeking what I submitted to the Lauderdale Community Hospital. I am also going to submit this to my professors at the university; who are licensed attorneys, to review this, and also file claim with the ***** of ****** in ********* for these unethical practices.