ComplaintsforBaylor Scott & White Medical Center - Pflugerville

• Initial Complaint

  10/11/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  FORMAL COMPLAINT - since I didn't hear back after leaving billing a follow-up question on how to file a complaint. I asked my *** Doctor for a referral to a specific specialist at this facility. I was told that the referral was placed. I went ahead and booked my appointment through the *** website online. I went to see the specialist without any issues, but then all of the sudden I was hit with an out of network bill of $108.99. My total payment should have only been the $40 copay because I specifically asked for this specialist because she was in network. *** failed with the following - 1. They did not submit the referral timely. I requested it on 3/25 and was told it was placed on 3/25. It was not submitted to my insurance until 4/7! 2. They should have checked that the visit was in-network at least a few days before the appointment, like when there is a usual estimate given. They could have also checked that my referral was in place when I checked in. Would I have known, then I would have waited until 4/7 to see the specialist. 3. The specialist's billing department is claiming that the issue occurred because I didn't call in to schedule the appointment directly with them (they supposedly would have caught the referral issue before the appointment). WHY ARE THERE BILLBOARD ADS to use the *** online portal/app if you can't schedule something online after being told a referral was placed? A customer shouldn't have to worry so much about the sloppy internal controls and processes with a large health care network. 4. Who knows how many other people have had referrals not placed timely only to find out to get hit with a bill. There are millions of clients and I don't want this to happen to them as well. The scheduling through the app/website should go through the same checks.The bill is in collections because I don't think it's fair to be told the referral has been placed only to find out it actually wasn't. *** billing said it's my fault after following up..

  Business response

  10/12/2022

  Thank you for contacting us. A review of this concern indicates patient has already been working with the *************************** The review further indicated patient scheduled his appt through the portal and didnt speak to anyone to validate authorization date and appointment took place prior to the authorization approval date. Our review concludes, patient was approriatley charged. Feel free to contact ********* Services at ************  to see if you qualify for financial assistance.

  Customer response

  10/12/2022

  Complaint: 18196310
  
  I am rejecting this response because: The billing office is not looking into this further and billing actually agreed that I had a case because I provided the support.. I have an email that states that the REFERRAL was placed well ahead of the appointment date. Someone clearly dropped the ball. Why was I told the referral was placed if it actually wasn't?? Since when did it start taking a clinic two weeks to actually submit a referral??? WHY ADVERTISE AN APP AND WEBSITE IF IT DOESN"T WORK CORRECTLY!!! This is not the first time a referral isn't placed correctly, and that other time I actually called to schedule the appointment on the phone instead of using the website. I had to cancel that appointment the day before because the formal referral was not placed either....

  
  Regards,
  
  *********************************

  Business response

  10/13/2022

  Again, thank you for your reaching out. Again, this is currently being worked with the *************************** Please work with them by calling ************.

  Customer response

  10/13/2022

  Complaint: 18196310
  
  I am rejecting this response because:Again, Ive tried that with no luck. There is clearly no accountability here.
  
  Regards,
  
  *********************************

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