Business Profile

Clinic

Emory Healthcare SBO Billing.

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Complaints

This profile includes complaints for Emory Healthcare SBO Billing.'s headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

70 total complaints in the last 3 years.
28 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. 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.

Initial Complaint
Date:07/23/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I visited Emory Decatur on 7/24/2023 at 4:20am for a foot injury that has gotten worse. I had to pay to park in order to be seen in the Er. I waited for atleast 2 hours before I was brought back for a X-ray. After I was told to sit in the waiting room to be called back. I waited an additional 3 hours in the waiting room when they sent me a text saying I had an additional 2+ hour wait before being seen by a doctor. I actually witnessed someone fall out in the waiting room because he was in severe pain and still wasnt being tended to. Once he finally fell on the floor someone came out and wheeled him to the back. The wait time to be seen in this emergency room is utterly ridiculous as I sat in that waiting room for hours and they were barely calling people back to be seen. I had to pay a baby sitter as well as pay for paring and over a 5 hour wait just to waste my time is unacceptable. I would like a reimbursement for my parking for $6.00 since I couldnt be seen and also on my insurance if that is possible. Also someone needs to review this hospitals overall practices because this is not the 1st time I have been here with these ridiculously long wait times.
Business Response
Date: 11/11/2024
We apologize for the late response in regards to your concern. You may contact patient relations directly at ************ for your questions or concerns. We thank you for allowing us the opportunity to respond to your concern.
Initial Complaint
Date:07/13/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I saw an MD on 11/10/22 for my annual physical. I used another MD at this same facility for about 10 yrs but he retired in 9/22. In previous years, my financial responsibility for my annual physical had been somewhere around $50. Much to my surprise I got a bill for $536 a few weeks later. I contacted my insurance company and told them what had happened. I was told that the labs were probably not coded as preventative and to contact the clinic's billing **** which I did. I have been trying to get this resolved since December of 2022. I have made several calls and each time I am told that they have a new computer system and it is taking time to get everything checked out. I spoke with someone on 7/6 and explained everything again for at least the 5th time what was going on. He assured me a manager would call me by 7/10. After not receiving a call on 7/10 I called them back on 7/11. I spoke with someone who agreed to reduce the charges to $100 if I would give them my credit card info. I told her I was driving and couldn't do that right then but if she would call me back in ***** min I would be glad to give her that info. She agreed to do that and even verified that she had my number. As of today 7/13 still no call. I am SO TIRED of dealing with Emory's billing department. Nobody does anything they say they will do. It seems like I am the only one making an effort to get this handled. AT this point I want my balance to be ZERO because of all the broken promises and the HUGE aggravation this has been. This had been going on since 12/22 and still nothing. I called again today and asked to speak to a manager but was told I couldn't speak to one. I will never darken the doors of this facility agin. Emory Healthcare may be a world class healthcare facility but their billing department is third world at best.
Business Response
Date: 07/17/2023
We are pleased that you have chosen Emory Healthcare as the provider of your health care services. We pride ourselves on providing excellent medical care and customer service. Please accept our apology for any dissatisfaction. We have forwarded your complaint to the correct department for their review. They will be reviewing the coding on the claim to determine if it is correct and if any changes need to be made they will refile the claim back to your insurance company. Thank you for allowing us the opportunity to investigate your concern we will be looking into the details of your concern.
Initial Complaint
Date:06/14/2023
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Since October 2022, Emory has not credited my account for secondary insurance payments. The oldest date of service is October 20, 2022 which shows that I owe $45.05 to St. ******* ************* for a CT scan. This amount was paid by my secondary insurance on November 5, 2022 and deposited by Emory on November 8, 2022. Check # ********. This payment was made by EFT by ****. On June 8, I had a three-way conversation with my insurance, GEHA, Emory and me. The Emory employee stated that they would stop billing me and have this resolved in 30 days. Emory is still showing that I must immediately pay this amount. I have statements from secondary insurance that this was paid. I have other charges from Emory for service on December 9, 2022, December 22, 2022, and February 10, 2023 that have been paid by my insurance, but Emory have not credited my accounts for the payments. No one in Emory accounts receivable seems to know what they are doing or why these payments have not been credited to my charges. If you need statements from my secondary insurance, let me know.
Business Response
Date: 06/14/2023
We are pleased that you have chosen Emory Healthcare as the provider of your health care services. We pride ourselves on providing excellent medical care and customer service. Please accept our apology for any dissatisfaction. We have forwarded your complaint to the correct department for their review. Thank you for allowing us the opportunity to investigate your concern we will be looking into the details of your concern.
Initial Complaint
Date:06/13/2023
Type:Product Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
While on a business trip to **********, **, on April 22, 2023, an unfortunate slip and fall accident resulted in a broken patella (kneecap). Given the severity of the injury, I made the decision to return home to ******* for the necessary surgery. On April 27th, a pre-surgery appointment confirmed that a $1,500 co-payment was required for the scheduled surgery on April 28th. I paid it on my **************** card.Thankfully, Workers Compensation approved all my medical expenses, and Emory, the healthcare provider, has appropriately billed Workers Comp for all my medical costs. However, despite their awareness of the situation, I have encountered difficulties in obtaining a refund for the $1,500 co-payment. Despite investing considerable time on numerous phone calls with their billing department, my efforts to recover the overpayment have been fruitless.The situation is disheartening, as Emory demonstrates promptness and determination when pursuing owed funds, yet they seem to lack the same level of urgency in reimbursing me for the excess payment. Considering the financial strain of not being able to work, $1,500 is a significant amount of money. I am in dire need of this refund as soon as possible.
Business Response
Date: 06/14/2023
We are pleased that you have chosen Emory Healthcare as the provider of your health care services. We pride ourselves on providing excellent medical care and customer service. Please accept our apology for any dissatisfaction. We have forwarded your account over to the department that will file your claims to workers compensation and once the claims are processed by workers compensation we will see the available refund due to you. Thank you for allowing us the opportunity to investigate your concern.
Customer Answer
Date: 06/14/2023

Complaint: 20180924

I am rejecting this response because: no date or time estimate to conclusion was included. I have been out-of-pocket for almost eight weeks and my only response from Emory is that they will look into it. That is no longer an adequate or believable response.

Sincerely,

***************************
Business Response
Date: 06/14/2023
I do understand. I can advise that your account was redirected to worker's compensation today and we have to wait on them to process the claims. I can not give a specific date as to when this process will be complete but it typically takes a minimum of 14 days.
Customer Answer
Date: 06/14/2023

Complaint: 20180924

I am rejecting this response because:
On May 16th, I was informed that my case had already been redirected to worker's compensation. However, there has been no progress since then. I followed up with a call on June 6th, and I was assured that I would receive $1000 within a day or two, but I have yet to see anything. I made another call on June 13th, requesting an update, and was told that a supervisor would contact me, but I have not received any communication. Now I am being told that it will take a minimum of fourteen more days. I am running out of time, and I am extremely frustrated with the dishonesty, delays, and incompetence of Emory billing. I simply want my money refunded. If I owed Emory a similar amount, they would aggressively pursue collection. If the Better Business Bureau is unable to resolve this issue, my next course of action will be taking the matter to small claims court.
Sincerely,

***************************
Initial Complaint
Date:06/12/2023
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I had surgery on August 31, 2022. Every follow up appointment has been billed as a hospital visit, not an office follow up. I have been billed a $100 copay for almost every appointment. I have repeatedly tried to contact Emory billing to correct this issue to no avail. My insurance company informed me the coding being submitted by Emory billing continues to be as a hospital visit which generates the $100 copay. All I would like is a refund on my copays in excess of what is required, which is normally $40 for a specialist. This is a copy of what Fed BCBS sent me in response to my question about billing Message Type: Medical/Dental Claims Member ID: ********* Message ID: ************ chevron_rightView Claim Information Subject: Re: Why do I have this balance From: ***************** and Blue Shield - Georgia To: *********************** ID Number: ********* Regarding: Why do I have this balance Dear *********************:In reply to your recent email, we would like to give you the following information:Thank you for your concern on the patient responsibility of $150.00. We received two claims from the facility for date of service April 18, 2023.Claim number 23142F040035CA is processing procedure code G0463 - Hospital outpatient clinic visit for assessment and management of a patient. The hospital copayment applied.Claim number 23111F031354CA is processing procedure code ***** - Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral and G0279 - Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to ***** or *****). This claim applied to the mammogram benefits and processed with a patient responsibility of $0.00.Here at ********** and Blue Shield we are dedicated to providing the highest level of service possible. I appreciate having had the opportunity to assist you in this matter. Sincerely,**************Federal Employee Program
Business Response
Date: 06/13/2023
We are pleased that you have chosen Emory Healthcare as the provider of your health care services. We pride ourselves on providing excellent medical care and customer service. Please accept our apology for any dissatisfaction. I was able to review your account and see that you were billed for a facility fee which will be listed as treatment room on your statements. Oncology is a hospital outpatient based service, resulting in a professional fee charge for the provider and a facility fee charge for the hospital. Oncology became hospital outpatient based in 2015. The facility fee charge is subject to your out of pocket fees.
Customer Answer
Date: 06/17/2023

Complaint: 20174726

I am rejecting this response because:
Here is a list of bills with questionable copay: 22251P024799SA, $200 copay; 2278F029935CA, $100; 2294F031425CA, ******; 22308F03211CA, $400; 223611F04302CA $100; 22339F04157CA, $100; 22348F033825CA, $100; 23142F040035CA $150
I want these charges reviewed and the incorrect copay charges refunded to me.
Thank you

Sincerely,

*********************
Business Response
Date: 11/08/2024
Hello Ms. ***** *****,
Just wanted to follow up with to you to see if this was ever resolved. Please let us know if you still would like us to review your account.

Customer Answer
Date: 11/08/2024

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

***** *****
Initial Complaint
Date:05/19/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On May 3, 2023, I made a mistake filling out my Arbitration Agreement form on Emory's My Chart online portal before my upcoming annual physical appointment. I contacted Emory's My Chart customer service who informed me after denying my request to speak to a supervisor, that the only way the form could be corrected was when I checked in for my appointment on May 10 at the Emory Clinic Perimeter. I contacted my doctor's office at the Emory Clinic Perimeter and was told they would have the form available for me to correct when I arrived for my appointment. When I arrived for my appointment, I instead was rudely informed that the Emory Clinic Perimeter could not perform any document preparation and that must be done through Emory's ***************** I immediately contacted Emory's My Chart customer service and was once again refused to speak to a supervisor and told my only option was to have the issue "escalated', which she stated that she had done. I have contacted Emory's My Chart customer service by phone twice since then and continue to get the run around and no one from their supervisory or "escalation" team has reached out to me. I am including a screenshot of the message that I also submitted to My Chart customer service on May 10 which has been completely ignored. I have been very happy with the medical care I have received from my physician, but am facing the very real possibility of having to change providers due to extremely poor patient service by Emory's My Chart team.
Business Response
Date: 05/22/2023
We are pleased that you have chosen Emory Healthcare as the provider of your health care services. We pride ourselves on providing ********************** and customer service. Please accept our apology for any dissatisfaction. We have forwarded your complaint to the correct department for their review. Thank you for allowing us the opportunity to investigate your concern we will be looking into the details of your concern.
Customer Answer
Date: 05/22/2023

Complaint: 20080801

I am rejecting this response because: Once again, the Emory Clinic is just passing along my complaint instead of attempting to resolve my issue. I would appreciate being informed at least of the proper channel to file a BBB complaint against Emory rather than just once again forwarding the complaint to another party when this has been a continual response by Emory, and I am still unable to resolve my issue.

Sincerely,

*****************************
Business Response
Date: 05/26/2023
I apologize again the only thing I can do is send it to the correct department to handle the complaint in which this was done. I will ask that the office contacts you personally in regards to this.
Customer Answer
Date: 05/26/2023

Complaint: 20080801

I am rejecting this response because: while I sincerely appreciate the good faith efforts of the BBB to try to assist in resolving this matter, it is clear Emory has no desire to assist in the resolution since no one at the "proper department" which I assume is the supervisory staff at Emory's MyChart has made any attempt to reached out to me even though the issue has been "escalated" for three weeks from multiple attempts on my part to contact them. I will definitely take this into account the next time I choose my medical care provider, as it is a warning sign that maybe this health care organization has become too large and unresponsive for my medical needs.

Sincerely,

*****************************
Initial Complaint
Date:05/15/2023
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On April the 29 Saturday I can to visit my brother their around the afternoon *********************** while their I slipped on the floor I think it be that they might just finished polish it bridge area; any way I fell hurt my right side of my body all those I seem fine but I begin have problem I end up going to ER I am having so much pain now it what do I do about it I going to sports doctor for a shot in my right shoulder also my step of walk is so slowly help please help me
Business Response
Date: 05/16/2023
We pride ourselves on providing ********************** and customer service and I am sorry to hear about the pain that you are in. If you were seen here at Emory you can call Patient Relations directly at ************
Customer Answer
Date: 05/20/2023

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

*************************
Initial Complaint
Date:05/11/2023
Type:Product Issues
Status:
UnresolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Emory billed my insurance (UHC) over $12k for services performed on 2/7/23. UHC paid Emory at the beginning of March, exclusive of my $6k deductible. The 2/7 bill has never appeared in my patient portal (I did receive the *** from UHC, which is how I know Emory billed them and that UHC paid). I need to pay this $6k deductible by 5/23/23 in order to not forfeit an LLS ***** ($4.5k). I have been asking for a bill from Emory so that I can pay this deductible and seek reimbursement from LLS since the beginning of March. I have spoken to countless reps, asked for supervisors, pleaded for help and gotten nowhere. I have made at least 20+ phone calls and sent over a dozen emails, to no avail. I can't fathom why it is so difficult for Emory to produce an invoice for me when they clearly billed UHC (twice, I received another *** last week that denied the claim as it had already been paid!). The reps are completely uninterested in being helpful and I am getting nowhere. I am not willing to forfeit $4.5k because of Emory's ineptitude. I am trying to pay them, and time is running out quickly.
Business Response
Date: 05/11/2023
I have reached out and spoke to *********** regarding her concerns and discussed an agreeable resolution. I will be following up with her to ensure that the matter has been addressed to her satisfaction.
Customer Answer
Date: 05/12/2023

Complaint: 20045956

I am rejecting this response because:
The document attached does not resolve this problem. I need an itemized bill from Emory for services dated 2/7, which clearly exists, as they billed UHC for those services. LLS will not accept this document that Emory created, as it is not a bill (which it states), it does not accurately list the procedures done, and the total does not match what Emory billed UHC for services that day. I remain perplexed why there is such difficulty in getting a bill to me when the bill has been sent to UHC and paid months ago. I have been trying to get this bill, and pay Emory, for over two months now, to no avail.

Sincerely,

*******************
Initial Complaint
Date:05/08/2023
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On Jan 3rd, 2023, I did my routine 5yr colonoscopy at ********************************** office at Emory Hillandale. I had no problems with my colon. In fact, I was initially told to return in 10yrs after my previous colonoscopy, but my PCP recommend that I do it in 5. I paid $50 dollars at the front desk and I was prep just like before. Everything went great! A pulp was found and tested to be ok. I was told to return in 5yrs for my next routine colonoscopy. To my surprise, I received a notification from Emory My Chart that I owe $731.29. I knew that colonoscopy was a wellness care that is covered by my insurance Ambetter. I contacted the billing department, and I was informed that the balance was my responsibility for the colon surgery I did on Jan 3rd. After a tireless explanation that I did not go in for surgery, and an insisting that I will not pay for what I did not receive. I was told to contact the doctor's office and that they will suspend payment on my account until it is resolved. I contacted the doctor's office and expressed my concerns. They reluctantly asked for some days to review the account. Surprisingly, they insisted that the amount I owe was correct. My routine colonoscopy was a colon surgery. ******** informed me that the charges were incorrect. Emory had submitted the wrong code on their claim. They submitted a ***** code when it should have been G0464. Armed with new information, I contacted Emory. However, being Emory the Difficult, I was told that the insurance company need to contact them directly. I eventually got the insurance company to speak with the doctor's office. I thought all would be settled. It has been 5 months, and Emory is still insisting that their initial claim is correct. Now they are sending me an Account Final Notice and suggesting that *** be sent to a collection agency. I am tired of calling billing and submitting enquires that go nowhere. Hopefully, I can get some help through this medium. If not, I will take this to other media.
Business Response
Date: 05/09/2023
We are pleased that you have chosen Emory Healthcare as the provider of your health care services. We pride ourselves on providing excellent medical care and customer service. Please accept our apology for any dissatisfaction. I sent this to the section for review and they stated that the code G0464 is not a code that can be used on your claim as it is not a code for the service that you had. The code ***** is the correct code. They also stated that they will add a modifier to the claim to see if that helps with your insurance processing the claim. Thank you for allowing ** the opportunity to investigate your concern we will be looking into the details of your concern.
Customer Answer
Date: 05/10/2023

Complaint: 20031007

I am rejecting this response because: I'm not certain how this modifier is going to help me and this "Final Notice" bill. No one is addressing this issue. I spoke to my ***************** today, 05.10.2023, again, and they told me that I covered for colonoscopy screening. Ambetter case number, I-103501434 (G0464 is the cpt code for screening). Even the printout from the doctor's office, after the procedure, indicated that screening was done. No one told me afterwards that "surgery" was done or contact my wife, who was present, to let her know that I had to do "surgery." I was not informed during the consultation or at the front desk that my screening could become surgery, and I will need to pay more out of pocket if it did. I was told that they found a pulp, and it was removed...which is part of my routine screening, which I'm covered for. ************* and Emory is insisting it was surgery. Ok, is it because this code for surgery pays more than screening. I understand that the doctors need to paid for their services. However, if I'm covered, I'm covered. It is between Emory and Ambetter. Not my pocket!
Sincerely,

*****************************
Business Response
Date: 05/11/2023
Your concerns have been sent to the section to review. They will not be able to change the *** code, they have added the modifier to the claim and resent it back to your insurance company for reprocessing.
Initial Complaint
Date:05/03/2023
Type:Service or Repair Issues
Status:
UnresolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Emory Hospital at Midtown double billed two insurances for the same bill for an appointment in March and collected the money from both. Since once of those insurances I did not have an approved referral for (the other, I did) I am being asked for payment by my insurance. I have copies of both bills, and have reported this the Insurnace. This is a repeated offense. For an October 22 appointment first, Emory billed an insurance company I did not have. Then when I tried to resolve the matter, they billed my correct insurance at the time, TWICE. That insurance paid the bill, so they denied the duplicate, and so Emory demanded I pay a fine/ payment. For months I left messages on both the portal and billing voicemail, I received no help. I was getting harrassed, weekly texts and emails threatening they would report this if I did not pay. I had to get an insurance agent to conference call. Once it was clear the insurance agent had proof the bill had already been paid, immediately the responses and manner of reply from Emory changed. Another large red flag showed, there was NO date and NO remarks about what the fine and bill-the one I was being harassed to exploit my payment-was in reference to. The agent at Emory didnt even know what it referred to, so it cancelled out. Lastly, for both the BBB and anyone who reads these reviews, I find nothing comforting about the business replies on here, something along the lines of how there is no balance now. Emory finally sent messages back on MyChart AFTER I had to get an agent to conference call, saying there was no balance and so no issue to resolve. Which would raise into question what saved texts I received for months would were about. This is a medical hospital demanding incorrect payment from insurances and patients, who like myself may be ill and whom stress can take quite a toll. I am confused on if this is either by an inability to properly handle billing or on purposeboth of which are concerning.
Business Response
Date: 05/10/2023
We are pleased that you have chosen Emory Healthcare as the provider of your health care services. We pride ourselves on providing ********************** and customer service. Please accept our apology for any dissatisfaction. I was able to review your account and I have completed a refund of $90.79 to the VA. Once this is complete your account will show the payment of $54.79 from Tricare and the patient balance due of $36 for the copay. Thank you for allowing ** the opportunity to investigate your concern we will be looking into the details of your concern.
Customer Answer
Date: 05/10/2023

Complaint: 20011816

I am rejecting this response because:
This is completely unacceptable and exemplifies that there is a failure in understand correct billing.
Emory needs to refund TriCare, NOT the VA. The referral for the 9 March appointment was THROUGH the VA, they need to be the ones billed. TriCare, should not.
Your proposed solution is leaving me, the patient, with a co-pay I should not be paying. Hence why I went through a process of placing a referral through the VA, not TriCare.
To summarize plainly: the correct solution is to keep the VA billing as that is who the referral is through and the insurance I gave. The correct solution is to refund TriCare, as that is not the insurance I gave nor who my referral was through. Steps need to be taken to ensure the patient, me, is not billed a co-pay that should not have existed in the first place.
Lastly, part of what I requested in my BBB complaint as needed in solution is an explanation as to how this double-billing occurred. I didnt see that in the response.

Sincerely,

*****************************
Business Response
Date: 05/11/2023
Per your communication sent through the portal: I already called customer service a month ago in regards to this bill. Emory was given my insurance information at the time of my appointment, TriCare Prime, but instead chose to bill the VA (incorrect). I am not responsible for this bill, and this was reclarified when I called a month ago.
I have not received a response to any message I've sent, or voicemail.
I called a month ago about this bill, I gave the agent my insurance because Emory decided to bill the VA and not TriCare, assuming all soldiers belong to the VA even though I provided the authorization number.
The agent said she would fix that, clearly that did not happen. Please stop texting or emailing me about the bill if you can't respond to messages.
You can also clearly see the message sent on NOV 20 in regards to this bill, that was never responded to, that required me to call later. This needed to be billed to my TriCare Prime. The date of the appointment was in October. I have since switched insurances.
There is no acceptable reason to have billed the wrong insurance as the office had the authorization number for the TriCare referral, as it was the same of the last appointment. This is not a bill I am responsible for.
*******You gave Emory your Insurance information to bill your insurance and we also had you VA information and authorization. Both were billed because the patient provided ** with the information. The system showed a credit on your account after Tricare paid and would eventually automatically refund the insurance. Because of your request above stating that the VA should not be billed the VA has been refunded and the Tricare payment remains. Per the *** you attached and that we received from Tricare there is a patient copay of $36.
Customer Answer
Date: 05/11/2023

Complaint: 20011816

I am rejecting this response because:

The complaint I posted talked about two different appointments.
The messages you are quoting are from an October appointment. For clarity, at that time there is no possibility I gave two different *********s. I was active duty at the time, and would not have VA ********* and so I never gave it.
The current issue is for a March 9 appointment. My complaint did not state which Insurance for the appointment was wrong. It stated that one of said *********s (TriCare vs VA) has a proper referral. A look through records would show that being the VA.
To restate clearly, you need to refund TriCare and keep the billing for the VA for the MARCH appointment. TriCare is tracking an appeal, as I am not paying for an appointment that I properly set up through the VA-both in prior referral and multiple reiterations throughout the appointment. That is the only correct action in this scenario.
I stated the October billing issues in the complaint to make clear this is not an isolated incident, and at the time even when Emory fixed the issues by switching that bill to TriCare, the billed them twice and then harrassed me for months to pay a $100 fine while very inconsistently responding to MyChart messages or voicemails.

Sincerely,

*****************************
Customer Answer
Date: 05/24/2023
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID .********, , and find that Mediation is necessary. To the heat of my knowledge, Emory has refusen to reimburse the incorrectly billed insurance for the 9 March appointment (TriCare) for which I am now left with co-pay I should not owe. At the same time, they refunded the correct insurance, VA, whom I went through a lengthy process to get a referral through. Additionally, the have not offered an explanation of how double billing two different insurance companies for the same appointment could happen, nor did anyone since the start of this respond to the Emory MyChart messages.
I have attached both bills again for reference.
Thank you for your help, BBB, in resolving this matter.
Regards,
*****************************

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