Complaints

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:09/12/2023

  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.

  I went in for a mammogram in March 2023, which was the first mammogram Id had in years. I was told my portion was $704.70. I explained how this didnt make sense when I get a free mammogram each year. If anything, Id have a standard copay. I provided my insurance information and was told the $704.70 was my copay. Because I did a self exam and felt like I needed an immediate mammogram, I paid. I later reviewed my explanation of benefits and noticed $0 went toward my deductible. BCBS said my mammogram was free and they billed them and got paid but also got paid from me and they owed me a refund. I was told by the imaging center that they never received payment from me. This was false. I provided all documentation over the phone and was told there was no payment made. I made several attempts by phone to resolve this, speaking to a gentleman who claimed this info was forwarded and there was no one else to talk to. I called a few times over a few months and finally expressed I would be forced to make a personal appearance at the location and desired to resolve this before this happened. The gentleman called me back and said they saw the payment and would provide a refund Asap. This never happened. I asked for an email or something stating this and was told he was unable to do so. I never received it. Over a month went by and still no refund. I called back and I spoke with a woman who was the billing supervisor and she explained its a mistake by a 3rd party billing company that never posted the payment. I dont believe this. She later said I would receive a refund within 2 weeks. Its been a month. If I owed them $704.70 they wouldve ruined my credit and called me all day and night for their money. They pushed me over my credit limit, and Im forced to pay fees. They are holding me up from a much needed surgical procedure that I cant afford to pay for because BCBS said I havent met my deductible. Why am I chasing my refund? We are now in September 2023absurd.

  Business Response

  Date: 09/21/2023

  Good morning and thank you for the opportunity to respond to this complaint. 

  ***************************** did have services with our company and based on the out of pocket calculated via the national online tool, Availity, we estimated her OOP at $704.70.  NOTE-This amount is auto-calculated based on the type of exam the patient is having and their specific insurance policy/benefits.   Unfortunately, the system is not full proof and we are reliant on the accuracy of the input by the insurance companies as it pertains to group benefits and policies.  **************** paid the estimated OOP amount at the time of her visit.  Subsequently, the claim was billed to **** and an explanation and payment were received and posted in our billing system in March 2023.  The final adjudication showed that **************** did NOT have any OOP/patient responsibility.  Meaning she owed nothing for this date of service and would be due a refund.

   It is important to note at this time that Women's Imaging Specialists uses and outside billing company called DEXIOS. This third-party billing company is responsible for posting all insurance and patient payments in our billing system.    We provide them with all of our deposit records on a daily basis and we rely on them to accurately and expeditiously post all payments to the proper patient accounts.  The **** payment was properly posted to ******************** account at the time the payment was received.  Unfortunately, the payment that **************** made on the day of her visit did not get posted until months later and after several calls to DEXIOS by *****************  Women's Imaging Specialists was not aware of ******************** overpayment until this complaint was sent to us.  No one at DEXIOS ever engaged us in the process of ******************** calls. Further, when asked, the DEXIOS account rep could not tell me why the patient payment was not posted until August.  Only "We apologize this was an error on our part and we have since corrected it and addressed the customer service issue with the appropriate manager."   

  Today, September 21, 2023 , I spoke at length with this patient to inform her that we did authorize the release of her refund check number **** for $704.70.  Dexios confirmed they sent the check priority mail on September  and released for mailing on September 19th.  I promised **************** a follow up phone call this Tuesday and she was satisfied that we are handling her issue.  She was very nice throughout the conversation and appreciated my honesty in explaining what happened and what we are doing about it.

  Please contact me at ********************* for any additional information or questions.