Complaints

This profile includes complaints for SSM Health St. Louis's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

close

Find a Location

SSM Health St. Louis has 33 locations, listed below.

*This company may be headquartered in or have additional locations in another country. Please click on the country abbreviation in the search box below to change to a different country location.

BBB accredited

Near

Country

USUnited States

Please enter a valid location.

Filter

• 

  SSM Health St. Louis

  1015 Corporate Square Saint Louis, MO 63132

• 

  SSM Health St. Louis

  6420 Clayton Rd Saint Louis, MO 63117-1811

• 

  SSM Health Pharmacy

  145 N. Main Street Fond du Lac, WI 54935

• 

  SSM Health Pharmacy

  730 North Margaret Street Markesan, WI 53946

• 

  SSM Health Ripon Wellness Center

  845 Parkside St. Ripon, WI 54971

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:02/01/2024

  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 have ribs that are not just broken are clearly misplaced if you put a hand over each side you can tell with this injury occurring November 20th 2023 (2 months ago) that they are not healing on their own.I initially saw *************************** January 18th 2024 thinking I just had a lumbar hernia. She said I do not have any hernia.(NY surgeon just confirmed I have 3 hernias and I'm only 34 years old) and she says that 'most lumbar hernias usually go away on their own) She orders xrays of my ************* I go back the next day on January 19th and the person taking my X rays (******) acted deliberately in not taking an image of the section where the most pain is at. She did the other side and the machine lit up and made a sound each time she went back to the room to press the button while I stood against the board. When it came to doing the side that's in the most pain at a 45 degree angle with half my back against the board (left oblique) she walked back real fast the MACHINE DID NOT EVEN GO OFF IT CLEARLY DID NOT TAKE AN IMAGE. I addressed this to her and she said it did take an image and said "It's overheating it does that sometimes".Dr. ******** office upon calling back and letting each new staff member that got on the phone I am recording the call, individual by the name of '*******' schedules me an appointment with Vascular orthopedic surgeon ************** for Friday Feb 2nd 2024 Yesterday January 31st I receive a call from '*******************' who is a 'nurse Navigator' I explained that the most important image was not taken and she completely ignored it on a recorded line that she was informed of being recorded and said '************** has your images and will figure out what needs to happen then.' SSM Healths Administration hangs up any time I call. SSM health does not have a phone number to a customer relations department or a patient care advocate that comes up at this time on google.I have a print out of an X ray at urgent care showing my ribs completely dangling.

  Business Response

  Date: 02/12/2024

  Thank you for providing SSM Health-St. Louis with the concerns you received regarding our organization.  SSM Health takes all customer concerns very seriously.  Upon receipt of this notification, we began to review all aspects of the concern and will follow up on any potential opportunities for improvement necessary as part of our complaint and grievance process.  We are actively working to resolve the concerns with the customer directly but are unable to share any details with the BBB regarding our review and response due to patient privacy laws.

• Initial Complaint

  Date:01/29/2024

  Type:Customer Service 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.

  I am reaching out for help to resolve a dispute I have with *** *** ***** ******* ** ******** **. I do not have a computer to send this
  online, so am having someone type this letter for me.
  
  In a
  nutshell, I feel that I was overcharged for my husband's most recent
  stay at *** ***** *******. He came in under hospice care and we were
  told his death was eminent. He was only there for about 2 ½ days before
  we pulled him out for a reevaluation and retrieved his belongings the
  same day. They are charging me for a bed hold that I never authorized
  and are saying that hospice is not covered under Medicare in nursing
  homes. Based on some research, I have found that costs associated with
  room fees in nursing homes is covered for hospice patients that are
  experiencing a medical crisis due to symptom exacerbation and are
  staying in an inpatient unit for the short term. I would say that a
  stroke and heart failure along with internal bleeding and being there
  for only 2 ½ days should fit this category.
  
  Please see the enclosed copies of letters regarding this matter. Thank you in advance for your time and assistance.

• Initial Complaint

  Date:01/11/2024

  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.

  The *ur*ose of my com*laint was to layout the details and summarize the encounter with SSM Urgent Care, Florissant MO, and how my misdiagnosis has im*acted my life and the life of my family. Went to SSM Urgent care in Florissant MO on 11/25/23 with sym*toms of COVID, congestion, headache, funny nose, sore throat, body aches, chest tightness, and coughing s*ells at night and during the day. I was diagnosed with Acute cough and Viral URI with cough. I requested a COVID test and was refused by the nurse *ractitioner stating my sym*toms has gone on for a long time and if I had COVID test would not ca*ture the sym*toms. Well, I was refused the COVID test and I did not get any better. In addition, I had another added sym*tom, *ain in my right leg. So in addition to my medical sym*toms with cough, cold, congestion, chest *ain and tightening, my u**er right leg was giving me issues.
  
  12/21/23 I was 1st seen by the nurse. I gave her my sym*toms. She stated, we are going to do a COVID and other test to determine while I was still having the cold sym*toms. After being seen by the nurse *ractitioner she checked my leg and said I could have s*asms but she *refer that I go to the emergency room and get it checked out. She said my test came back and was negative for COVID. She said it did come back *ositive for Stre* throat and gave me a *rescri*tion.
  My sym*toms for my leg s*asms as well as the intense coughing, fever, chils, dry cough, shortness of breath, body aching and feeling very fatigued had intensified. 12/23/23, I went to the ******** ******* Medical Center Emergency Room I was diagnosed with muscle s*asms, COVID and RSV. According to the doctors, I have had COVID for some time. Because I was not diagnosed *ro*erly, my entire family including my husband, my children and my grandson develo*ed COVID as a result of SSM Urgent Care telling me I did not have COVID when I did.

  Business Response

  Date: 01/16/2024

  Thank you for *roviding SSM Health Urgent Care with
  the concerns you received regarding our organization.&nbs*; SSM Health takes
  all customer concerns very seriously.&nbs*; U*on recei*t of this notification,
  we began to review all as*ects of the concern and will follow u* on any
  *otential o**ortunities for im*rovement necessary as *art of our com*laint and
  grievance *rocess.&nbs*; We are actively working to resolve the concerns with
  the customer directly but are unable to share any details with the BBB
  regarding our review and res*onse due to *atient *rivacy laws.”

  Customer Answer

  Date: 01/16/2024

  Com*laint: ********
  
  
  
  I am rejecting this res*onse because:
  
  
  
  The res*onse seems to me like they are trying to justify the events that trans*ired without taking any accountability.&nbs*; I would like this com*laint to stay onfile and the com*any to receive a rating of B or below.&nbs*; Not only was I treated rudely and was refused medical attention at that time when I was clearly in distressed, I was misdiagnosed stating I had did not have COVID when I was *ro*erly diagnosed 2 days later by *** ******** ******* ********.&nbs*; I infected my family including my 2 year old grandson with asthma who has not clearly recovered.&nbs*; I was quarantined u* til the time SSM Urgent Care told me I was negative for COVID. Once they told me on a Thursday I did not have it and went among my family, they incurred sym*toms afterward.&nbs*; I am not satisfied how they are trying to s*in the events to their advantage.&nbs*; Not sure if the COVID test SSM Urgent Care had ex*ired or administered incorrectly.&nbs*; I counted on SSM Urgen Care to *rovide me with the best care.&nbs*; Another issue is, everytime I go to urgent care, and *ay my co*ay of $35.00, I receive a medical bill charging me an Emergency Room co*ay. That is not right as well.&nbs*; I am racking u* co*ays for a service they did not *rovide very well. You can never get your health back so I counted SSM Urgent Care to *rovide the best care and they failed me as a *atient, so no I reject their res*onse.&nbs*;&nbs*;
  
  
  
  Sincerely,
  
  
  
  ******** *****

  Customer Answer

  Date: 01/25/2024

  <*>I reject the res*onse from SSM. On 1/16/24 when I was contacted, the conversation was recorded. There was no no resolution.The two ladies just called to to justify the action of their workers. The information they *rovided to BBB is not corrrct. I give BBB *ermission to get co*ies og the ta*e and listen to it. I am giving *ermission for SSM to release any records to BBB. Do not close my case based on one sided information from SSM that they tried to come u* with a resolution. They did not. I would like for them to *rovide information they submitted to me. My com*laint still stands and want the rating changed. I want BBB to stand u* for my rights as a consumer

  Customer Answer

  Date: 02/07/2024

  Com*laint: ********
  
  
  
  I am rejecting this res*onse because:
  
  I have not resolved any issies with anyone at SSM. I received one *hone call from two individuals one i recall was Laura Knight. The *hone call consisted of the ladies attem*timg to justify the actions of the em*loyees. It was a recorded meeting meeting in which I said nothing.&nbs*; I felt minimized by their justification of my mistreatment and my misdiagnosis which affected my whole family. Now i am having nightmares about my treatment and I get anxiety when I think about having to go to an urgent care. When i think about what ha**ened to me and my family I feel anxious knowing my misdiagnosis could have cause the death to someone I love. There is no justification. They also charged me emergency room fees for an urgent care visit. I com*leted the form BBB ask me to com*lete and I faxes the necessary docoments requested about my health insurance. SSM will not get away with my.mistratment, telling I did not have covid when I did which affected my whole family which has caused traumatic e*isodes.&nbs*; So no a fake a*ology is not a good enough remedy for me. I want their rating changed and I want my com*laint to stand.&nbs*; I want the emergency charges they charged me for an urgent care visit investigated. *atients should know this informarion, and not hidden until we get the bill. Hold SSM accountable.
  
  
  
  
  
  Sincerely,
  
  
  
  ******** *****

  Business Response

  Date: 02/09/2024

  <*>This corres*ondence serves as SSM Health’s res*onse to
  Com*laint # ******** rebuttal, dated February 8, 2024. The original com*laint is
  dated 1/11/2024.<*>
  The consumer states in her rebuttal she wants SSM Health’s BBB
  rating changed and her com*laint to stand, and wants the charges investigated
  for accuracy in billing.<*>
  SSM Health bills ******** claims using universal billing codes. Current
  *rocedural Terminology (C*T) codes indicate to the insurance carrier the
  cost and service *rovided. Revenue Codes tell insurance the location of service. SSM Urgent Care locations are billed with revenue code ****, which
  indicates the location as an urgent care level of service (Emergency
  De*artments are billed with revenue code ****).
  SSM Health Urgent Care o*erates
  as a ********-based, also known as “*rovider-based,” out*atient de*artment.
  This relationshi* reflects a national model of *ractice for integrated delivery
  systems, where the ******** has oversight of clinical staff, *hysicians, and
  advanced *ractice *roviders (*hysician Assistants and Nurse *ractitioners)
  involved in *atient care and ensures the safety and quality of services
  *rovided. The urgent care de*artment, as a *art of a *arent ********, is also
  subject to strict quality and *erformance standards *ut forward by both the
  Centers for Medicare and Medicaid Services and The Joint Commission, the
  ********’s accrediting body. Accreditation by The Joint Commission is
  recognized nationwide as a symbol of quality reflecting an organization’s
  commitment to quality, coordination of care and exce*tional clinical outcomes.
  
  Two dates of service are billed with revenue code ****,
  which indicates an Urgent Care location. SSM Health has a contractual
  obligation to bill the *atient the amount assigned as *atient res*onsibility by
  the carrier. Members should contact their insurance carrier if they have
  questions regarding benefits.<*>
  SSM Health *osted a onetime courtesy adjustment to two dates
  of service alleviating the *atient of any further financial res*onsibility.
  SSM Health cannot s*eak to how the BBB determines a com*any’s rating
  and has no control over what is *osted on the BBB website.<*>
  This res*onse constitutes SSM Health’s final determination and
  res*onse to this consumer com*laint.
  
  ***** *. SSM Health *atient Financial Services&nbs*;

  Customer Answer

  Date: 02/14/2024

  &nbs*;I do not agree with the determination of BBB.&nbs*; A good faith effort by SSM was not done.&nbs*; All tney *rovided was excuses and justification.&nbs*; There will be no consequences for their action.&nbs*; I feel because they are a big business, BBB decided to fold and go&nbs*; with the com*any instead of the consumer.&nbs*; I thought BBB did not do their due diligence.&nbs*; I want someone else at BBB to look at my case.&nbs*; &nbs*;I am a**ealing your determination and ask that someone else take a look at it.&nbs*; If all that requires a good faith is that SSM give me a call, and when they called it was not genuine, all they did was *lace blame and justify, and that closes a case, then why do we have BBB.&nbs*; They are not for the consumer.&nbs*; Its hard to file a com*laint against a big com*any for the wrong they have done, and to finally have the courage to do it, and for BBB to close the case because SSM made a non genuine *hone call to me and thats it, that is enough for BBB to say they made good faith effort and close the case.&nbs*; Shame on BBB they have failed me as well.&nbs*; I want this case reviewed by someone else higher.

• Initial Complaint

  Date:12/27/2023

  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.

  Was seen on 03/15/2023, 03/23/23, 04/11/23 and 05/3/23 for a diabetic ulcer each visit the ulcer was debriding it and putting the foot in a cast each and every time and was classified as "surgery" I asked them to confirm the insurance and that we were in network and was told each and every visit we are. To find out we weren't at all and it was all out of network costing us $10,151.27 for just these 4 visit out of pocket and to make matters worse the debriding and casting made matters worse causing a severe infection we ended up in the ER on 06/12 and was admitted into the hospital for 4 days he was close to going septic. Ended up having to have surgery on his foot on 10/9/2023. Due to all of this we have paid over $13,000 out of pocket so far.

  Business Response

  Date: 01/03/2024

   

  A billing review was completed for wound clinic services for date of services 3/15/23, 3/23/23, 4/11/23 and 5/3/23 The billed charges are correct for the service(s) provided, as is the billing and liability assigned to the member according to his benefits. SSM
  follows CMS (Centers of Medicare/Medicaid Services) who set the billing
  guidelines for this service.  Anthem's explanation of benefits (EOB) can be reviewed to verify how this claim was
  processed and should be contacted with any further coverage questions.

  Additional review was completed on dates of service June 13-June 17, 2023, for inpatient services - The billed charges are correct for the services provided, currently the claim is pending to Anthem for processing, at this time patient liability is unknown. Anthem's explanation of benefits (EOB) can be reviewed to verify how this claim was
  processed and should be contacted with any further coverage questions.

   

   

• Initial Complaint

  Date:12/22/2023

  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.

  SSM Over charged me for My Visit was March 4, 2023 for a procedure. My Health Insurance sent me the amount due as $256.00. But SSM told me that I owe $516. I sent the the EOB. They told me they will escalate issue then get back to me. I made payments until they resolved issue. Payments 5/22/23 $56.00, 6/13/23 $25.00, 7/5/23 $25.00, 8/7/23 $38.00, 8/28/23 $112.00. Total of $256.00. I called them & sent communication to the that they still have a balance of $256.00. They said they will escalate it & is working on. Shortly after that I received mail stating that they placed my account in collections. I contacted them & asked why did they tell me they were working on this but sent it to collections. I disputed the charge with the Collection Agency by sending them the payments I made as well as the EOB from my insurance company so they dropped my account & closed it because they said they had no grounds to pursue. Still as of today 12/22/2023 SSM still has me down for owing $256.00. SSM REp stated that they don't see a balance but in SSM My chart I still see the balance. I would like for SSM to update my balance in mychart as well as send me a letter stating that my balance in zero ($0). My Health Insurance called them as well as myself & they said balance would be removed but still has not.

  Business Response

  Date: 02/07/2024

  This correspondence serves as SSM Health's response to Complaint # ********. 

  The consumer states he was overcharged for a procedure and sent to collections while waiting for SSM Health billing office to review the issue. 

  SSM Health billed a claim for services provided. SSM Health and the insurance carrier have a contractual agreement which dictates how much SSM Health is paid for the services they provide. The insurance carrier and member have an agreement that dictates how much the member/policy pays for services provided (cost share).  SSM Health was underpaid per contract by Aetna for this service, but the amount assigned to the member as patient responsibility was correct. SSM Health did bill the member an incorrect amount. 

  This error is now corrected. The patient did pay the amount assigned by the insurance carrier and the account is now closed with a $0 balance. There has been no negative impact to the patient's credit. We sincerely apologize for the inconvenience this has cause and hope to provide exceptional customer service in the future. 

  ***** P. SSM Health Patient Financial Services

   

• Initial Complaint

  Date:11/29/2023

  Type:Order Issues
  Status:

  UnansweredMore 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.

  Ive been seeing my doctor for a little over a year for a work related injury I have signed all of the necessary paperwork for them to release the information to Workmens Comp. They keep telling me I have to sign paperwork every time to release the paperwork even though there is a release on file that is good for a year. With them refusing to release the paperwork I have not been paid for six weeks because of it it has pushed my Workmens Comp. claim back I have to call every time I go to the doctor and asked to have the information released and every time they tell me Ill have to have a release of information signed there is one on file. On November 29th I saw the doctor, I called to tell them to send the paperwork to Workmens Comp. they called and told me again I had to have a release of information signed, I told them I had one. I asked the lady from the records department if I had one and she said yes I did have one and it was good until 2024 but I still need to have one signed. With them refusing to send the information I have not been paid because of them!

• Initial Complaint

  Date:11/28/2023

  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.

  On January 10th of this year I had a preventative visit with Dr ****** ******** and received a bill from their office for $256.00 and then received an explanation of benefits from my insurance golden rule stating that the max allowed billable cost was $151.14. I called to inform them them many times. First they said they billed it again to the wrong insurance and then rebilled the right insurance. They then wanted me to fax them a copy of the explanation of benefits which I did twice and now when I call they are saying they never received the fax after one of the ladies I talked to said they did. I just feel like I am being run in circles and even though it isn’t that much money it is the principle that it’s wrong and they aren’t trying to fix it … I have called multiple times and they always say please call back next week. This has been going on for several months. Please help
  
  
  
  Sincerely
  ****** ******

  Business Response

  Date: 02/07/2024

  This correspondence serves as SSM Health's response to Complaint # ********.

  The consumer states SSM Health is billing an amount over and above the amount indicated on her EOB as her responsibility. 

  The consumer provided a copy of her EOB for services provided at SSM Health. The EOB provided indicates the member does not have a benefit for this service and the provider may bill the total amount. 
  SSM Health did bill the patient the total amount as indicated on her EOB. A onetime courtesy adjustment was posted to the account reducing the patient responsibility for this date of service to $0.00.

  The patient should contact her insurance carrier and review her benefits prior to scheduling services in the future. 

  ***** P. SSM Health Patient Financial Services 

• Initial Complaint

  Date:11/27/2023

  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.

  On November 01, 2023, I was refunded co-pays of $26.85,$20.00, and $40.00 to the original payment method. On November 10, 2023, I called *********************** billing and spoke to ****************** to receive my other co-pays totaling $358.55 which she stated I would receive within 10 business days. It has been past 10 business days. I have not received a refund or a follow-up response. I have uploaded documents and am requesting my refund. I have friends with the same type of insurance who never paid a co-pay.

  Customer Answer

  Date: 01/02/2024

  I have not heard anything from the company. 

  Business Response

  Date: 03/01/2024

  This correspondence serves as SSM Health's response to Complaint # ********. 

  *********************** states she called and requested refunds for overpayments made on accounts where ******** and ******** were billed. A comprehensive billing review has been completed on professional visits billed January 2021 through December 2022. During this time, ************************ had ******** as her primary coverage and ******** ******** as her secondary coverage, however the ******** plan was a pharmacy benefit only. She had no medical benefit through ********. The balances billed to and paid by ************************ are correct. No refunds are forthcoming.
  
  Three refunds for the amounts $26.85, $20.00, and $40.00 were refunded due to overpayment on a hospital account from date of service 2/13/2023.

  SSM Health responded directly to a previous complaint filed with the ******** Attorney General sent a response to both the patient and ** Attorney General on January 3, 2024. 
  
  Thank you for allowing us the opportunity to respond to this complaint.

  ************ SSM Health ***************** Services 

• Initial Complaint

  Date:11/26/2023

  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 have a service date of 04/02/2023 where I was seen by SSMHealth. They did not submit the claims to both of my insurances. i have called them numerous times to resolve this and they refuse to follow up with any written correspondence to confirm they have submitted my claims to TriCare. The first time I called in August when I received the bill, they did not have my correct TriCare information. The next time I called, i was told it was submitted. The next representative I spoke to said not only was the TriCare never submitted, they actually deleted the insurance information from my bill. I checked my records and they have never once submitted this claim and are trying to bill me for $416.47 and they refuse to send me an email to prove they have submitted the claim for processing. I had another representative tell me they could not "resubmit a claim" unless something had changed - they never submitted it to begin with. I called last week and spoke to a representative and asked for a supervisor to call my parent. They never called and instead sent a letter stating it was to late to submit a claim. ******* stated this is not true and the should submit the claim. I can't get a hold of anyone who will do their job and help with this submitting the claim to my insurance for this bill.

  Business Response

  Date: 11/27/2023

  This correspondence serves as SSM Healths response to Complaint # ********.

  
  The consumer states SSM Health failed to submit a claim to her secondary insurance carrier, Tricare.

  
  SSM Health submitted a claim to the primary carrier, Cigna on 4/13/23 and received payment per the members benefits. SSM Health submitted a claim to the secondary carrier, Tricare on 5/4/23. Per the *** on file this claim rejected and, denied for the following reason - Patient has not met the required eligibility requirements.
  SSM Health submitted the claims in a timely manner. The denial from Tricare is a benefit issue and must be taken up with Tricare.

  
  ************** SSM Health ***************** Services

  Customer Answer

  Date: 11/27/2023

  Complaint: 20918505
  
  I am rejecting this response because:

  Ask SSMHealth to provide the call logs for the numerous times I have tried to get this resolved since August. They had the wrong sponsor information, no claim was ever filed by them. I gave them the correct information and asked them to resubmit. I contacted TriCare and can verify in my portal that this claim was never submitted. I have attached screen shots of all of the claims submitted in my TriCare portal for that date of service and proof that I am entitled to TriCare benefits. I have spoken to numerous representatives that keep giving me different stories. I need them to submit the claim to TriCare as has been requested numerous times.
  
  
  
  Sincerely,
  
  **********************************

• Initial Complaint

  Date:11/22/2023

  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.

  SSM refuses to acknowledge my payments of their bills. As shown in the attached file, a payment of $304.21 was made 5/10/2023 with **** credit card ending 2679. This payment has not been credited to my account, and I continue to receive nasty letters from credit collectors.

  Business Response

  Date: 11/24/2023

  This correspondence serves as SSM Health's response to Complaint # ********

  SSM Health bills hospital and professional charges separately.  The payment indicated as missing in the complaint was received and posted to the consumers professional account on 5/9/23. The outstanding remaining balance is due on a hospital account. 

  Thank you for allowing us the opportunity to respond to this complaint. 

  ************** SSM Health ***************** Services