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SSM Health St. LouisThis business is NOT BBB Accredited.
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Complaints
This profile includes complaints for SSM Health St. Louis's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 123 total complaints in the last 3 years.
- 34 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe 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:03/20/2023
Type:Billing IssuesStatus: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.
They say I had a pr function test on Nov 10th 2022 and a evaluation of bronchospasm on Nov 10th 2022 and a pr co2/membrane diffuse capacity on Nov 10th 2022 the Dr that ordered those tests was ******* ****** from ******** ******** ******* ***** she is a ear nose and throat doctor ssm health is billing me and I never been in there facility I been calling everytime I get a bill and they would tell me that they are working on itBusiness Response
Date: 03/28/2023
The correspondence serves as SSM Health's response to BBB Complaint # ********
The consumer states he was never seen by a provider at SSM Health and is disputing the validity of the bill.
The consumer was seen at **** *** ****** 11/10/2022 and the provider did order Pulmonary testing. The tests require interpretation and were sent to SSM Health provider Dr. ***** *******. The charge from SSM Health is for the interpretation of the tests. This was confirmed with **** ** as a valid test and charge. The consumer may call SSM Health Customer Service to discuss the billing. He is encouraged to call the ordering physician to discuss the results of the study.
Thank you for allowing us the opportunity to respond to this complaint.
***** ** SSM Health - Patient Financial Services
Customer Answer
Date: 03/29/2023
Complaint: ********
I am rejecting this response because: the test went to ******* ****** the ear nose and throat doctor and plus I have Medicare and medicaid and if you want to bill me for something I didn't know about send the bill through my insurance
Sincerely,
**** *****Customer Answer
Date: 03/29/2023
I would like this case to be closed. My insurance has handled the issue and rebilled it so I no longer owe any money.Initial Complaint
Date:02/28/2023
Type:Billing IssuesStatus: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.
In 2021 I was seen by my primary care doctor to get a second opinion on a diagnosis. My primary care doctor referred me to Doctor ******* ******. When I called Dr ******* office to book an appt they told me I needed an MRI first. When I went to tell my primary Dr (** ******) that I needed an MRI, he ordered an MRI based off the other offices requirement however when I called Dr ******* ******* office back they made me aware that they could not see me for my condition, **** ******** ***** *****. The MRI that was supposed to be used to get a second opinion by a specialist was never evaluated by the specialist that ordered it. Now I am being charged $700 for a procedure that should have never been ordered.Business Response
Date: 03/01/2023
This correspondence serves as SSM Health's response to BBB Complaint # ********
The Complainant states he is being billed for an MRI that was ordered by his ****** **** ******/PCP in error .
SSM Health completed the MRI as ordered by the patients Primary Care Provider (PCP). The PCP ordered the MRI at the patients request, not at the request of another provider. The patient states" my PCP ordered an MRI based off the other offices (specialist) requirement". That statement is inaccurate. The PCP ordered the MRI at the patients request because the patient states he was told that would be a requirement prior to scheduling an appointment with a specialist/neurologist. The ** of the medical practice reviewed the patients complaint and chart and stated there is no documentation from the neurology office/neurologist requesting an MRI, and the imaging was appropriate for the symptoms.
The billed charges are correct for the services provided and the test was completed according to the orders in the medical record. The balance is applied to the patients deductible per his benefits and the balance remains his responsibility.Thank you for allowing us the opportunity to respond to this complaint.
***** ** *** ****** ******* ********* **********
Customer Answer
Date: 03/01/2023
Complaint: ********
I am rejecting this response because:
I was sent by my Primary care doctor to get a 2nd opinion from a neurologist on a condition that has been already known and evaluated by my primary care doctor, two orthopedic specialist and another neurologist. This condition has been well documented and tested before. All of this was known by my primary care doctor. After I voiced dissatisfaction that there wasn’t an answer to fix my condition, my primary care doctor suggested for me to get a second opinion and told me to call Doctor ******* ******. (All of this should be well documented and if it’s not that’s an even bigger problem. ) However, Dr ******* ******, the doctor who my primary care doctor referred me to doesn’t even see patients for my condition! I should have never been sent there at all. And when I called to make the appointment Doctor ******* office, they told me to get an MRI. I then told my primary care doctor and he ordered the MRI to get a second opinion from Dr ******* ******. And when I called Dr ******* office I found out that his office doesn’t see people for my condition.All of this was known by my primary care doctor’s office immediately after I was informed that Dr ****** doesn’t see people for my condition. Every part of this should be well documented as I’ve communicated everything with my doctors office and they suggested for me to go to Dr ******* ******. I did not get a second opinion from anyone and the MRI that was ordered by my primary care doctor for a specialist that doesn’t see people with my condition. I would never have got an MRI done if my doctor was trying to evaluate my condition after he already did, two other orthopedic specialist and a neurologist. I also, would never of thought to see another neurologist without his referral. It was a lost cause to me then & now. And to say that my ******* would have ordered an MRI just so he could reevaluate something that he and three other specialist confirmed is ridiculous.
******** *****Initial Complaint
Date:02/27/2023
Type:Billing IssuesStatus: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.
SSM billing has made several errors in regards to my billing. I spoke to ***** ********** for almost a month back and fourth to get this correct. They had not billed several of my appointments. My balance was 2010.41 after getting these rebilled correctly it brought my total to 782.41. I sent several emails per ***** to his supervisor ***** who never responded until I sent a third email. Then *****'s manager called me and said she would look into it. Again never heard back from her either until I emailed ***** asking for his manager to follow up with me. She was very hostile and refused to do anything to make it right. She refused to pull them out of collections even though I did not sign allowing that and they are violating HIPAA by giving a third party my hospitalization dates and information that again I never signed for, I asked for proof of signature and it was an electronic signature which I confirmed via messages that it was not my signature nor did I electronically sign anything. ***** was so kind and said he was zero out my bills if he could because he saw the mess that he was trying to fix. I am not asking for a zero balance but the past month has been a nightmare because employees did not do their job. I had to do it for them. I also never received a bill ever! Not in my email or via mail. I also sent proof I spoke with a ******* and I was approved for financial assistance in 2019, SSM can not find it but I have our email correspondence. SSM doesn't seem to care and sill refuses to correct this situation.Business Response
Date: 03/03/2023
This correspondence serves as SSM Health's response to Complaint No. ******** dated 2/27/23.
The consumer states several dates of service were not correctly billed to her insurance, SSM health violated her HIPAA rights by giving a third party (bad debt agency) hospitalization dates and billing information, and she did not sign any authorization permitting the sharing of information.
Three date of service have been billed to the complainants insurance and are in good standing. Five dates of service are seen in bad debt. The placement with collections is appropriate per SSM Health's billing policy. Signed Consent to Treat is on file. The electronic signatures are associated with Video Visits where the patient would not have been present to sign in person.
Beginning 9/1/209 monthly statements were sent through MyChart to the patients email provided in the BBB complaint. SSM can see the date sent ,the email address and if the statement has been viewed in MyChart. The first statement viewed in MyChart was on 7/22/2022. She received monthly notifications and chose to not view them in My Chart. Patients have to accept an activation code and sign up for My Chart, so they are aware of the choice to receive electronic notifications.
SSM Health has corrected all accounts that can be corrected and retuned the accounts that were sent to collection without being billed to insurance first. The remainder of the accounts are in collections and will remain there.
Thank you for allowing us the opportunity to respond to this complaint.
***** ** SSM Health Patient Financial ExperienceInitial Complaint
Date:02/16/2023
Type:Billing IssuesStatus: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.
2/16/23
This is a Summary of Our Horrible Experience with SSM Billing.
Customer service request regarding: Billing.
Account number: ************.
Account type: Physician Billing.
We have been on a Payment Plan for a Physicians Bill
Everything was fine with our Payment Plan until:
12/29/22-Paid $50 w/ our online bill pay check.
1/5/23 Check Cleared but was Not Applied to our Account
1/18 Spoke to Customer Service/**** and he said we'd get a call from Supervisor. No Call .
*Received My Chart email said it was found to have been applied to an account in Oklahoma.
1/20 Customer Service/***** said it was in Review w/ Management and we'd get called. No Call.
1/23 Was told by Customer Service/***** that she was going to a Supervisor. No Call received
1/25 Customer Service/***** said we need to fax front and back of check. We did that.
1/25 Customer Serice/**** confirmed they received the check copy and would inter-office to Missing Payments Dept.
1/31 Customer Service/***** said there was nothing she could do-Manager would call back in 2 hours.
No Call.
2/13 Makingthe next payment(last payment still not applied)but don't want to be behind.
Made Payment through SSM IVR @7:06 am/Confirmation #******. Was not applied to our account. (Maybe check the Oklahoma Account our first payment went to)
2/14 Customer Service /**** ,once again, said nothing he can do and will get Call Back from Manager. No Call
2/15 Customer Service/***** made the effort to really try to understand. Neither Payment credited to our account. Could not find IVR with Conf.# ******. Said she was going to a Manager and she would call us.
I believe the Customer Service reps can't do anything...and are told to say that. Thay are a buffer for those who can.
It's been 6 weeks and we have had two Late Notices, but we made the payments!
**** *******
Showing 1 of 1Business Response
Date: 03/01/2023
This correspondence serves as SSM Health's response to Complaint # ********
The complainants account has been placed in a "Contested" status while we work to resolve the payment posting issues. One payment has been identified and posted to the correct account. A second payment has been located and is in the process of being received and posted to the correct account. It is expected this will be completed March 3-8. This information has been communicated to the complainant via email communication. Once this is completely resolved and the payments posted, we will communicate this information and remove the "Contested" status from the account.
Thank you for allowing the opportunity to respond to this complaint.
***** ** SSM Health Patient Financial Experience
Customer Answer
Date: 03/08/2023
Complaint: ********
I am rejecting this response because:Today is the last day SSM said the missing Oklahoma Payment , from December last year, would be posted.
On 2/22 SSM said.
We do show we are waiting for the refund from Oklahoma, which will be sent today and posted between March 3-8th to your account. We are working with Management regarding the phone payment issue posting. Again, we do apologize for this inconvenience you have had with these two payments. We will reach out to you as as we have a resolution.
Patient Financial Experience
SSM Health Medical Group
************
*****************As of 6:30pm on 3/8 the missing payment from December of 2022 has Not Been Posted to the account. This has been going on for 3 months!
Sincerely,
**** *******Business Response
Date: 03/22/2023
SSM Health continues to work to a resolution for the consumer. According the documentation in the account, as of 3/2/23 a status of CONTESTED has been placed on the account to indicate patient dissatisfaction and the need for follow up. The missing payment of $50 is now expected to be printed and the check expedited overnight on the 29th of March. Until that happens a $50 customer service adjustment was posted to the account and will only be reversed when the payment is received and posted.
SSM Health does not deny there is an issue with patient payments posting correctly and in a timely manner. Leadership is aware of the issue and working toward an improved process. We are committed to resolving our patients concern and will continue to follow the account until resolved.
Sincerely,
____________________
Initial Complaint
Date:02/01/2023
Type:Billing IssuesStatus: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.
We continually receive a bill in the mail for an appointment that took place in July 2022 in the amount of $100. I have spoken with someone at SSM Health 3 times and have mailed copies 3 times of the check in which they cashed, emailed a copy 4 times. I have even faxed them copies so many times I cannot count! Each and EVERY time I'm assured that this is taken care of on their end and it's their mistake and yet they continue to harass us and continue to send past due notices in the mail. I can't call anymore. I can't email anymore. I can't mail anymore as it does NOTHING. They are lazy on their end and will not take care of it. I expect them to stop sending this bill that was paid for and cashed by them back in August. I also expect a written apology in the mail to both myself as well as to the owner of the company.Business Response
Date: 02/13/2023
This correspondence serves as SSM Health's response to Complaint # 18963269
A review was completed and it was discovered the payment for date of service 7/20/22 was cashed on 7/21/22 but not posted until 2/13/23. We apologize for the inconvenience this has caused. The account balance is now $0.00. Thank you for allowing us the opportunity to respond to this concern
Sincerely,
************** Senior Patient ************************** Experience SSM Health
Customer Answer
Date: 02/13/2023
Better Business Bureau:
I have reviewed the response made by the business in reference tocomplaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
******************** & Propane *********************Initial Complaint
Date:01/04/2023
Type:Billing IssuesStatus: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.
SSM charged me $266.00 for a preventative visit with Dr. **** on 6/14/21 even though I had active insurance coverage at that time. SSM has sent this $266.00 to collections which has lowered my credit score by almost 100 points, and I have spoken with my insurance representative, ****** and she stated that ***** never received a claim from SSM. ***** stated that I should request proof of timely filing and a copy of the bill be emailed or faxed to her. This was originally requested from SSM by myself on 11/8/22. Then, I called SSM on 11/17/22 and spoke with ***** who stated this request could take 30-45 days to be completed, I then called SSM again on 12/12/22 and spoke with ***** who stated the request was still in the work queue and would request a status update and call me back (which she never did), I called SSM again 12/15 and spoke with ******* who stated she spoke with ***** on 12/14/22 who confirmed ***** never received the bill and ***** still needed proof of timely filing and a copy of the bill. ******* stated this request was sent to her supervisor, ******** and to call back in 3 weeks to make sure this has been completed. I called SSM again 1/3/22 and spoke with ******* who stated it has still not been completed.
I believe SSM is unable to produce these documents because they did not properly bill my insurance in the first place. I am getting the runaround and need this corrected as my credit score has been wrongly impacted. At this point, I need a closure letter sent to me explaining my was insurance was verified as being active at the time of service but never billed properly. My account balance of $266.00 being billed needs to be adjusted to zero, and an email needs to be sent to the debt collection agency requesting the account be closed and returned in addition to any adverse credit rating removed from my credit report. Thank you.Business Response
Date: 02/09/2023
SSM Health
has received your concern regarding the billing issues that you reported to the
Better Business Bureau of Missouri. We thank you for bringing this issue to our
attention, so that we may address your concerns. It is always our goal to
provide an exceptional patient experience.
A review of this account was completed for billing
purposes.
The patient did present a valid insurance at time
of service. However, her last name was different than the ins card (presumably
due marriage) and when the claim was submitted to ***** it was rejected due to the
patient not being identified as their member. The complainant updated her COB
information with ***** (not indicated when) and ***** requested we send a claim
for processing. A claim form was faxed to ********* ********* 2/1/23.
The account was sent to collections appropriately.
Seven statements were sent to the patient beginning 1/10/22 with the last sent
11/1/22. She utilizes SSM Health's My Chart online billing portal and had
access to the statements. The first call received regarding billing came in Nov
2022 (after bad debt placement) from the administrator of the plan requesting
was fax the claim form. SSM Health Medical Group has sent a claim and will need
to allow time for the claim to process. If the insurance carrier processes and
pays the claim the account will be recalled from collections and any balance
due from the patient will be billed to her updated address.
We apologize
for the inconvenience that this might have caused you. We appreciate the
opportunity to address your concern.
Sincerely,
******* * ********* ******* ******* * ******* ********* *********** ***Business Response
Date: 02/14/2023
SSM Health received notification of a rejected claim from *****
with this reason: “claim rejected – Patient eligibility not found. Name in system does not match
ins info - may need to update with insurance co.” That was on 1/10/22, four
months after the date of service so as of January 2022 ***** could not process
the claim with the patient name as submitted. The name provided at time of service is the name that was submitted to *****.
As
of 2/13/23 the **** claim form has been faxed in it’s entirely to *** as
requested. The account has been put on hold with the collection agency and will
remain so until payment is received from *****. The patient address has been updated
and any correspondence will be mailed via USPS.
Thank
you for allowing us to respond to this complaint.Customer Answer
Date: 02/15/2023
Complaint: ********
I am rejecting this response because:
Please confirm the updated address in your system is ** ** ** ** *** **** **** ****** ** ******
Sincerely,
******** *******Initial Complaint
Date:01/03/2023
Type:Billing IssuesStatus: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.
SSM Health in Madison, WI where my son ******* was seen for medical care in January of 2022. There were no bills pending or balance shown for any visits for him in January of 2022. We received a bill in September from SSM that was dated Jan. 19th, 2022 in the amount of $282.60. No communications prior to receiving this bill were made to us. We have SSM MyChart access, upon checking the accounts there is no balance shown for this amount. This bill appears to be in error as it does not show up in any of our online statements, where we pay all our bills in a timely manner.
No less then 5 calls have been made to the billing department to inquire about this bill and find out additional information.
1. Why are we receiving this bill 9 months after services? SSM Billing response: Don't know, must be an insurance problem
2. Why does the bill not show up in our MyChart account to be paid? SSM Billing response: Not sure, we have had some issues after an upgrade, will look into in and get back to you. This was in November of 2022.
3. Latest bill received sent us to collections for a bill that does not show up to be be paid and no information can be provided to allow us to pay it like we have all other bills in a timely manner. Bill states must be paid immediately but when you type in account number or scan QR code states invalid information.
4. I am concerned our information has been accessed in violation of HIPAA resulting in this bill showing up without any reasonable explanation as to why it is not online or why there was a 9 month delay.
Resolution requested:
-Clear explanation as to why there was a 9 month delay in receiving a bill
-Pull amount owed from collections as we have in good faith attempted to resolve the issue but SSM has not provided any information
-Clear explanation as to why bill does not show up online, QR code does not work, and account # on bill not valid.
-Investigation for potential PHI violationsBusiness Response
Date: 01/05/2023
The consumer stated
he did not receive notification of outstanding balance in a timely manner.
The claim processed on the following dates.
Date of service 1-19-22 completed by patient, services submitted to insurance for processing on 1-20-22.
2-1-22 insurance processed claim –no payment received. Carrier requested medical record to be submitted to complete claim process.
3-24-22 SSM Health mailed medical record to carrier for review to complete claim processing.
8-30-22 received notification from carrier- insurance processed claim applied 282.60 to patient liability according to his benefits.
SSM
Health Care bills patients based upon insurance payments and your contractual
agreement with your insurance carrier. Your insurance carrier should have sent
you an Explanation of Benefits (EOB) for this date of service that explains
your out-of-pocket expenses.
Patient received statements on the following dates
8-30-22 First statement mailed to guarantor’s verified address on file.
9-7-22 Guarantor contacted SSM Health to verify claim was billed to insurance. Provided explanation insurance processed according to her benefits.
9-27-22 Second statement mailed to guarantor’s verified address on file.
10-25-22 Third statement mailed to guarantor’s verified address on file.
11-22-22 Fourth statement mailed to guarantor’s verified address on file.
12-20-22 Final statement mailed to guarantor’s verified address on file.
12-30-22 Account sent to Bad Debt Vendor per SSM Health Patient billing guidelines.
Guarantor also stated she does not have access to
minor child’s electronic my chart. This has been activated and guarantor- has
access to patient’s electronic billing and medical information.
We appreciate the opportunity to respond to this
complaint.Customer Answer
Date: 01/05/2023
Complaint: ********
I am rejecting this response because: Again SSM continues to blame and provide false information. It was NEVER stated we did not have access to his account, it was stated we do not see a BILL or a BALANCE to pay under his account. (Please see attachments). We attempted to pay in our usual manner but the account and account # show a ZERO balance which does NOT ALLOW us to pay. To be clear, SSM does not offer any solutions, they merely refer to their policy book to ensure they have checked all their boxes, including sending to collections 7 days after final notice was sent for a ZERO balance account. SSM does not take any responsibility for delays in communications, inability to see the bill online or a zero balance shown on account. We have auto payments set up for other balances which continue to be paid online and on time monthly. This bill and balance does not exist within their own system that is visible to us to pay. We have attempted to pay the bill over the past months online, but the issue continues to remain.We have attempted to pay online over the past 4 months, due to issues with SSM billing this was not available stating a ZERO balance. That is a very short period of time to send someone to collections when they have attempted to pay. SSM shows no support for their issues.
Why are we not able to see the bill in his MyChart account?
When we scan QR code or enter his account number we receive errors, why is that?
I have attached what was displayed when attempts were made to pay the bill. It is disgraceful that SSM take no accountability for their issues. Sending someone to collections for bed debt 7 days after receiving final payment notice, and after 4 months of trying to pay. They only noted one conversation but there were additional attempts to rectify this issue but no help or support was given by SSM.
Sincerely,
**** *** ********* ********Business Response
Date: 01/10/2023
As previously stated, we mailed 5 paper statements to
the guarantor’s verified mailing address as per our billing guidelines. We
apologize for a system error not allowing the guarantor to make a
payment using MyChart application. SSM Health has identified a system error and
it has been resolved.
SSM Health offers a variety of easy and convenient ways
to pay your bill including MyChart, online or over the phone, these methods are
listed on our billing statement
Once an account transitions over to collection status
it is no longer in our system. The guarantor was provided with Amer-Collect
contact information, and they would need to be contacted directly for payment options.
We apologize
for the inconvenience that this might have caused you. We appreciate the
opportunity to address.
Sincerely, ******* * Corporate Patient Liaison - Patient Financial Operations- SSMCustomer Answer
Date: 01/11/2023
Complaint: ********
I am rejecting this response because: SSM has openly admitted it was their error that did not allow us to see the bill AND pay the bill. I have auto payments currently active for the bills I am able to see and verify. We have contacted them numerous times to get this resolved but no one was able to fix this issue. SSM has a policy that customers who have current payment plans they will work with them add the outstanding balance to their payment plan, this was not followed. See prior BBB complaint for this information directly from SSM response attached to this response. SSM did not act in good faith following their own policies as stated in their BBB response to another customer. We are in good standing with a payment plan, we always pay our bills online and on time.It is great to see a ****** ********* type organization take no steps to remedy their error and even after acknowledging it was their system error. SSM claims to offer a variety of ways to pay but none of them worked in our case. We reached out to SSM to get assistance but no one resolved the issue but they did continue to send bills. We are so very happy to have high quality heathcare facilities in our area that are honest and responsible that have nothing to do with SSM.
Bill arrived approximately 9 months after services with no reason
Called to ensure this was a correct bill as we were not able to see it online September
--Attempted to pay bill online MyChart, via QR code, and account number with no balance to pay
Called again wanted to pay bill but not available online and issue was being working on November
--Attempted to pay bill 2nd time online Mychart, via QR code, and account number with no balance to pay
Called again trying to pay bill but issue still remained December
--Attempted to pay bill 3rd time online MyChart, via QR code, and account number with no balance to pay
Bill arrived around December 27th threatening to send to collections if not paid. Attempted to pay but errors were still present.
Amount sent to collects 3 days later leaving no opportunity to get response to their issues.
Why was the balance amount owed not added to our payment plan? Or was this another system error that no one wants to deal with.
Conclusion: SSM had a system error creating a billing ISSUE from their end that affected our ability to see balance due and pay it. SSM did not act in good faith to work with us to remedy their admitted system issues. SSM did not follow their own billing policy for customers who have active payment plans. SSM did not give time to make payment upon final bill notification sending to collections before any payment or questions could be answered. SSM acted in bad faith for their errors and instead of working with customer, did NOTHING to resolve THEIR issues. No calls were made BY SSM to remedy this issue.
Sincerely,
**** *** ********* ********Initial Complaint
Date:12/20/2022
Type:Billing IssuesStatus: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 have spent numerous hours on the phone with SSM billing team and Cigna (our healthcare provider)- we have a claim that was adjusted for updated coverage on a service provided and SSM has been informed of this and it does not seem to get resolved. They will not update their balance of the patient- according to ***** and the most updated explanation of benefit, they are still harassing us to pay the original invoice instead of updating what the payer has covered and updated invoice amount. They are threatening to send us to collections even though the bill has been paid in FULL based upon records with what ***** has on file on what we owe.Business Response
Date: 01/12/2023
This is in response to the letters you sent to my client. The *************** Clinic, dated December 21, 2022, and again on December 28, 2022. Please not that this response is somewhat delayed because the letter was addressed to the main mailing address at ***************. *************** Clinic has an office in the adjoining doctor's building, but it took a week or so for the correspondence to make its way to ***************'s office.
****************** complaint seems to be related to related to his contacts with ***, not with ***************. *************** staffs the radiology department at a number of *** facilities, but sends out bills entirely separate from those that ************** would have received from ***. In his letter he mentions hours spent on the phone with *** about the bill, but ***************'s billing service does not have any records of communications with ************** about the ***************'s bills, and he paid those bills without any apparent disputes with ***************. This is not an unusual situation. Hospital patients are often confused that they receive bills from both the institution and then perhaps from radiology and/or anesthesiology and/or pathology.
In sum, it would appear that ****************** complaint, if he has one, is with the *** facility itself where his service was rendered.
Business Response
Date: 02/13/2023
BBB Complaint # ********
SSM Health is in receipt of consumer complaint # ********.This correspondence serves as SSM Healths response to this matter
February 13, 2023
*************************
6631 ****************************** ** 63050
Account Number: ***********
Date of Service: April 8, 2022
Dear **************,
SSM Health has received your concern regarding the billing issues that you reported to SSM Health - **************************** We thank you for bringing this issue to our attention, so that we may address your concerns. It is always our goal to provide an exceptional patient experience.
The account has been reviewed, and it has been determined that a clerical error was made, and a statement was sent in error. Appropriate corrections were made on 12/21/22 and account was paid in full.
Please accept our apologies for any inconvenience this may have caused you.
Sincerely,
************ Patient ************************** Operations
SSM HealthCustomer Answer
Date: 02/22/2023
We have worked with our attorney on this matter and the hospital has refunded a portion of our money.Initial Complaint
Date:12/16/2022
Type:Billing IssuesStatus: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 to this facility on 7/9/22 to have a covid test done. When I left I asked what I owed and they told me nothing, which seemed right as I have had family members have free covid tests before. I was charged a bill of $979 on 7/13/22. I contacted them shortly after and they told me it was an emergency room, which is not how it is authorized. I do not think this is fair.
account *********** *** *******Business Response
Date: 02/21/2023
February
21, 2023
******* ****
**** *** ********* **
*** ******** ** *****
Account
Number: ***********
Date
of Service: July 9, 2022
BBB Complaint # ********
SSM Health is in receipt of consumer complaint # ********,
this correspondence serves as SSM Health’s response to this matter
Claim was
billed with Revenue Code **** which indicates to the insurance company services
were rendered at an Urgent Care. ******* allowed reimbursement assigned copay
to patient responsibility amount according to the member plan. Professional
fees resubmitted on November 17, 2022 and currently still pending insurance
processing.
Billed charges are correct for the
services rendered to the patient, coding is correct according to the
physician's documentation of services. SSM follows CMS (Centers of
Medicare/Medicaid Services) who set the billing guidelines for these services
SSM Health Care bills patients based
upon insurance payments and patient’s contractual agreement with her insurance
carrier. The Patient’s insurance carrier should have sent her an Explanation of
Benefits (EOB) for this date of service that explains her out-of-pocket
expenses. If patient has any additional questions regarding her benefits, she
needs to contact her insurance directly.
Sincerely,
**** ** ********* ******* ******* * ******* ********* *********** *** ******Initial Complaint
Date:11/28/2022
Type:Billing IssuesStatus: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 had surgery on 8/20/2020. It took SSM Health over 4 months to issue me a bill so I could start payment arrangements on my account through them. SSM Health kept saying that it was still pending insurance however I received my EOB from **** ***** with in a month of my surgery telling me what I owed. Every time I called SSM Health to set up my payment arrangements they told me that it was still pending insurance and I was unable to set up any arrangements. I finally was able to make arrangements to pay back my bill through ********* **** on 12/11/2020 I made payments every month in the amount of $85.00 I made a payment on 12/24/2021 then on 12/27/2021 SSM Health reimbursed the money that was owed for my surgery back to ********* **** which on 12/27/2021 the bank issued me a check in the amount of $925.00 which is what I had paid toward the outstanding bill. I called both SSM Health and ********* **** to find out what was going on and SSM Health told me not to worry about the bill. Fast forward to May 2022 and SSM Health is now telling me that I owe the money they gave back to me because they resubmitted the claim on 5/10/2022. I have been trying to get finical assistance on this bill and another that is going through the same process now they are saying that the 8/2020 bill is to old to get finical help with even though it was their screw up. My other bill was for services rendered on 8/26/2021 I received my EOB on 9/28/2021 stated what I owed but according to SSM Health it is still pending my insurance. I can see this bill doing exactly what the other bill did. I am sick of SSM Health giving me the run around about this outstanding bill. I have called and talked to different representatives only to get different answers from them all and what can be done to help out this situation I am at a loss on what I can do now.Business Response
Date: 12/06/2022
December
6, 2022
Dispute Resolution
Department
BBB Complaint # ********
SSM Health is in receipt of consumer complaint # ********
We have completed review as per requested by consumer.
Patient stated SSM Health did not bill her in a
timely matter.
Patient’s insurance originally processed
claim and submitted payment on 11-20-20 processing payment according to patient
benefit agreement with her insurance carrier the patient insurance recouped
payment on 12-3-2020 for services. The carrier resubmitted payment on 5-13-22
applying balance to patient’s benefits.
SSM Health Care bills patients based
upon insurance payments and the patient’s contractual agreement with their
insurance carrier. The Patient’s insurance carrier should have sent her an
Explanation of Benefits (EOB) for this date of service that explains her out-of-pocket
expenses.
SSM Health
has an established billing policy that outlines our billing policies and
procedures. It addresses First Party Collections, Bad Debt Collection Efforts
and Consumer Credit Reporting. The policy also outlines our financial
assistance guidelines.
We have
received and processed patient’s financial application, the patient qualifies
for 50% charity on balances exceeding 2000.00 per the financial assistance policy.
Her accounts do not meet the eligibility requirements that are eligible for assistance.
SSM Health offers several
options for repayment, including a six-month payment plan and a no interest
line of credit offered through our health services financing program with
Commerce Bank
Sincerely,
******* **
Corporate Patient Liaison – Patient Financial Operations-
SSM HealthCustomer Answer
Date: 12/09/2022
Complaint: ********
I am rejecting this response because:
Sincerely,
***** ****
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