Complaints

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• Initial Complaint

  Date:12/09/2024

  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.

  I received treatment on zoom which qualifies as telehealth. I saw practitioner ****** *****, and I never did see ***** ***** as claimed. On my explanation of benefits, I am being billed for hospital and facility charges. Treatment was not rendered inside the facility for me, the patient. I was solely inside my own home receiving treatment. ****** ***** additionally shared patient details over zoom to other patients to keep touch after treatment, this is a HIPAA violation. Hospital charges were $300 for each day, in which all days I was at home receiving telehealth treatment. I was also being billed for a few days I did not receive telehealth treatment and provided doctor's notes from other appointments.

  Business Response

  Date: 01/03/2025

  Thank you for bringing your concerns to our attention
  regarding your recent experience at The Brook Hospital Dupont. We take all
  customer feedback seriously and sincerely apologize for any inconvenience or
  dissatisfaction you encountered.  The
  Brook Hospital Dupont maintains that the patient was billed correctly for the
  services rendered.  We have provided all necessary
  documentation to the insurance company to support this claim.
  

  The Brook Hospital Dupont provides both zoom and in-person
  hospital based intensive outpatient services to our clients.  The Brook Hospital Dupont bills as a facility
  and as a result, the insurance company applied the patient’s deductible and co-insurance.  The Brook Hospital Dupont correctly billed
  for telehealth intensive outpatient services by using a billing modifier 95,
  indicating that telehealth services are provided in real-time, using
  interactive audio and video communication systems.  Patient filed an appeal with ****** **** on
  5/9/2024.  On 6/14/2024, The Brook Hospital
  Dupont was notified by an ****** **** representative that the facility billed correctly,
  and the patient’s appeal was denied.  On
  6/19/2024, patient called facility to request we bill differently so they would
  only be responsible for copays and not the deductible and co-insurance.  The Brook Hospital Dupont acknowledged the
  patient’s concerns and explained that intensive outpatient services are billed on
  a facility level.  The Brook Hospital Dupont
  offered to arrange a payment plan for the patient, and it was declined. 
  

  Upon beginning the intensive outpatient program, the patient
  had met $91 of the $1000 deductible. 
  Intensive outpatient services were billed at a rate of $184 per day
  until the $1000 deductible was met. 
  After patient met the deductible, they were charged a daily rate of $46
  (25% of $184). After a detailed review of charges, The Brook Hospital
  Dupont confirms that the patient was not billed for days they were absent.

  Customer Answer

  Date: 01/08/2025

  To whom it may concern,

  The billing for treatment was not formally explained on the day of my evaluation. My explanation of benefits state that The Brook Hospital billed me on the date of 11/07/2023, in which I did not receive telehealth services. I provided a doctors' note to the practitioner to excuse myself for that day. See the attached letter of the days I attended telehealth and did not attend. I have also attached the doctors' note that I provided and the EOB from my insurance company that shows I was billed for 11/07/2023.

  The telehealth visits were in real-time but they were not interactive. ****** ***** would frequently put on a Youtube video for us to watch and have us turn off our cameras and microphones, or read materials to us. We only interacted as a group on Wednesday's. This is not the telehealth service I expected. With the lack of interactive telehealth services received, the billing does not appear to be accurate. Given we would have to turn off our cameras and microphones everyday off the week for Youtube videos and meditations, I am only responsible for copays on every weekday aside from Wednesday. I would not like to take a chance to receive satisfactory telehealth services given my experience, but rather a fixed bill.

  
  
  Sincerely,
  
  
  
  ***** *******