ComplaintsforCarilion Medical Group

• Initial Complaint

  09/12/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I have received a balance bill from Carilion as they claim my insurance is out of network. I had a pulmonary test on 04/18/22. Carilion billed me $2000.00. My insurance check the fair market prices and paid them accordingly. I then received a bill for $1485.19. I sent it to my insurance who then sent it to an attorney to dispute. My attorney sent them a cease and desist letter which advised them all contact regarding the bill was to be made to the attorney. They have disregarded that stating their attorney has "told them to continue to bill me then send to collections". I am pretty sure this falls under the Virginia law prohibiting balance billing. Carilion is know to overcharge for a facility that is supposed to be none profit. They continue to ignore the letter for the attorney acting on my behalf and plan to send the bill to collections because "they can". But they did advise me to get better insurance if I can't afford to have medical procedures done.

  

  Business response

  09/13/2022

  Dear ******* *****,In response to your complaint, I would like to give a brief reply here.  Anytime a patient presents at one of our facilities with an out of network insurance, the patient is responsible for any remaining balance remaining after the insurance has made a payment.  There is no contractual adjustment because there is no contact with your insurance provider.   Our attorneys have advised that since these insurance plans are out of network, we do not negotiate any type of settlement offer, therefore we do not engage with the attorney for the insurance company.   We are sending you a letter giving further details about your situation. Sincerely,Carilion Billing Customer Service ************

  Customer response

  09/13/2022

  I have reviewed the response offer made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.Pretty much Carilion is ignoring my rights and refusing to speak to my attorney. If this goes to court will the provider remain quiet since they don't speak to out of network  insurance attorney? I will continue to fight this and make sure that I am only charges the fair prices for the procedure. Regards, ******* *****

• Initial Complaint

  04/27/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I tested positive for COVID on a home test kit after becoming sick. I was spiking a temperature and oxygen was low and went to Franklin Memorial Hospital Carillon on August 31,2021; they did a chest x-ray, and took blood. The doctor came in and asked me if I was wearing a gold necklace or anything and I answered no. He said well there was a little spot on the x-ray but it was nothing. He then told me that I was "too damn healthy to be there" and sent me home with no treatment options. Four days later, Saturday, Sep. 4th, I was much worse, and my wife now also had COVID, Carilion (RMH) was diverting patients, so we went to Carilion Velocity Care. We waited in the car for three hours with fever and difficulty breathing before taken in. They did no tests. The doctor said there was nothing else they could do for us. I asked (they never suggested or offered) if we could get the antibody infusion treatment. I received a call on Sunday from the infusion staff who told me they could only do it if I were within the ten day period. The next day (Monday) would have been my ten days but they told me "we only do them on Tuesday." Our oxygen levels and breathing worsened and Monday (Sept. 6, 2021) we went to RMH Carillion and were immediately placed on oxygen and admitted. We were in the Hospital for 7 days, both had pneumonia. We were asked to participate in a trial and both said no yet they treated us with remdesivir, an EAU experimental drug. My wife was given the recommended treatment, load dose and a dose for 4 or 5 days. I was only given the load dose and charged $5,200 for it. The manufacturer of the drug (Gilead), the FDA, EAU recommendations the dosage my wife received. I inquired why I was given what I did not authorize and why only one dose once started. I received a letter saying they can't give after ten days with COVID. I had past that at admittance. They would not remove the $5200 or reduce it to what they paid for it. Would not reduce bill for payment.

  

  Business response

  04/29/2022

  Carilion Clinic has received your letter dated April 27, 2022, regarding a consumer complaint filed relating to health care services and billing.  As the letter you provided to us may require review of protected health information, Carilion cannot release such information without an authorization.  As such, Carilion has reached out directly to the individual to review and address any concerns.Sincerely,*** ***, RN, BSN, MBA, CPHRMSenior Director, Clinical Risk Management and Patient Advocacy

  Customer response

  04/29/2022

  I have reviewed the response offer made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. Carilion failed to properly treat me in two of their facilities and then violated my wishes to undergo a experimental treatment. They charged $2600 per vial of the experimental drug Veklury (AKA Remdesevir), which is associated with kidney and liver problems, and gave me two full doses as a load ($5200) according to their billing. According to the notes, they gave me three doses on one day (load) and stopped. The use did not follow FDA Protocol of the emergency use and when asked why they said IN A LETTER that their protocol was to not use it after a patient has had COVID for ten days. I had it 12 days at admission, also in their record. The record also shows several of their "hospitalists" comments saying giving it to me would do nothing. They refuse to do anything to correct their mistake, I still have some difficulty breathing but how many others have been mistreated and were severely harmed by such misuse and lack of care at what the patient said. How many were, like I was, hit with a massive bill for a drug they pay $500 per vile and charge $2600 per vial? They will not accept responsibility because they are a corporation, not a true health care facility. They were offered full payment absent the $5200 and refused. Their response to this BBB complaint was, we already reviewed it and since there is nothing new, we will do nothing.  Regards, ******* *********

*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. ↩