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Business Profile

Hospital

SSM Health St. Louis

This 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

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    Customer Complaints Summary

    • 123 total complaints in the last 3 years.
    • 33 complaints closed in the last 12 months.

    If you've experienced an issue

    Submit a Complaint

    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.

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    Complaint status

    Complaint type

    • Initial Complaint

      Date:11/28/2023

      Type:Product Issues
      Status:
      Answered
      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:
      Answered
      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 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:
      Answered
      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.

      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,

      **********************************

      ervisor 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

    • Initial Complaint

      Date:11/22/2023

      Type:Billing Issues
      Status:
      Answered
      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

    • Initial Complaint

      Date:11/14/2023

      Type:Billing Issues
      Status:
      Answered
      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 7/06/23 I visited ************* regarding nasal congestion. There is no signage of any Emergency Room at any time. No indication of emergency charges. No prices discussed. SSMHealth charged $550.00 for a 15min visit claiming it was an emergency room.I disputed the debt and offered $180.00 to resolve the remainder of the balance. SSMHealth accepted my offer and continues to attempt collection.I think SSMHealth is committing fraud by not holding itself out as an emergency room but charging emergency room prices.l

      Business Response

      Date: 11/15/2023

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

      The consumer states he was billed charges for Emergency Room level service when services were provided in an *********** setting. 

      Hospitals bill using revenue codes that indicate to the insurance carriers where the services was provided. These codes are universal. Revenue code 0456 indicates an *********** and revenue code 0450 indicates a hospital Emergency Room.

      This claim was billed with revenue code 0456 which indicates an *********** level of service. The allowed amount on the claim is $413.00 which was applied to the unmet deductible. One payment of $180 is seen posted leaving a balance of $233. Billing is correct for the services provided. The balance is correct per the members benefits for *********** services. 

      SSM does not accept the payment of $180 as a settlement. The remaining balance continues to be patient responsibility.

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

    • Initial Complaint

      Date:11/09/2023

      Type:Billing Issues
      Status:
      Resolved
      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 calling to let you know SSM finally looked at their records and saw they should be billing Medicaid.  They billed them for the costs instead of me.  I am satisfied with that, and I consider this complaint closed.k. My ******** should have covered this bill. I would like for them to put this bill through my insurance and I would like financial assistance.

      Business Response

      Date: 02/07/2024

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

      The consumer states SSM Health refuses to acknowledge his coverage when he has insurance coverage through ******** ********, 

      SSM Health billed a claim for services provided on 8/29/23 to the patients *********** plan. Both the hospital and providers professional claims are paid by ******** at 100% with no patient responsibility. The patient has a $0.00 balance with SSM Health. 

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

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

    • Initial Complaint

      Date:11/08/2023

      Type:Billing Issues
      Status:
      Answered
      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.

      Complaint: 20842794

      I am rejecting this response because:

      I do not feel this is a fair response. I'm sure you incurred cost but it was not my fault that the procedure failed.  I was given the wrong instructions by your own department.  ********* failed me and should be held accountable. I feel my insurance was incorrectly billed as if the procedure went fine.  You should re-examine your position.



      Sincerely,  

      ***********************

      Business Response

      Date: 11/10/2023

      November 10, 2023

      **************************
      ***********************
      ************************************

      Dear ****************,

      Account Number: ***********
      Date of service: November 1, 2023

      SSM Health has received your concern regarding the charges at SSM Health- St.Marys St. Louis *****************************


      A review on your account was completed for auditing purposes.
       
      Documentation supports patient presented to SSM Health St.Marys St. Louis ***************************** It is unfortunate that the planned procedure could not be completed due to unforeseen medical issues. However, SSM did incur costs and use hospital resources in undergoing the procedure in good faith. It is appropriate for your insurance to be billed for the services provided. Final reports are in medical record. Patient may go to any SSM ********************** facility and obtain a copy of his medical records for his review and personal records.

      If you have questions regarding your medical treatment, please contact your healthcare provider directly.  If you have questions regarding your medical benefits, please contact your insurance carrier directly.

      Billed charges are correct for the services rendered to the patient, coding is correct according to the physician's orders and documentation of procedure and tests. SSM follows CMS (Centers of ***************** Services) who set the billing guidelines for these services.

      SSM Health offers several options for repayment. Financial assistance is available for those patients who find their hospital bills create a financial hardship.Please contact customer service at **************, Monday-Friday.

      We apologize for the inconvenience that this might have caused you. We appreciate the opportunity to address.


      Sincerely,

      ************  Corporate Patient ************************** Operations- SSM

      Business Response

      Date: 11/30/2023

      Thank you for providing SSM Health 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:11/06/2023

      Type:Product Issues
      Status:
      Unanswered
      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 Jan 2022 after being admitted for a couple of days ********************** had to send me to ******* for a test they couldn't perform. They sent me to the only place they could find a bed for me due to covid. My insurance does not cover the ssm ******* hospital that they sent me to and received huge bill. I have called monroe numerous times, sent info on my chart and even stopped into billing informing them if they will write a letter to my insurance informing them it w.as only bed available due to covid all would be paid. Not happening. Can you help?

    • Initial Complaint

      Date:10/13/2023

      Type:Billing Issues
      Status:
      Answered
      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 vs BCBSDAVID ****** (Dad) SSM Account *********** DOB 8/20/239/25/23 Between 12/12/22 through 2/21/23 Dad received 34 Hyperbaric Oxygen Therapy Treatments at SSM Health. The procedure was necessary to stop the bleeding in Dads bladder. The bleeding was the result of ***** sustained during prostate cancer treatment in 2019. Several attempts were made to cauterize We began to notice that we were receiving past due notices on billing. Identified ******** had paid and adjusted amount owed. BCBS Denied Claims based on incorrect Diagnostic Code.Please review the attached for attempts to work between BCBS and SSM Billing.

      Business Response

      Date: 11/15/2023

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

      The complainant states the denial from BCBS is the result of an incorrect diagnosis codes bille for the service Hyperbaric Oxygen Treatment.

      All claims were billed to ******** as the primary payer and those claims were paid without denial, with cost share applied per the members benefits. All claims were billed to BCBS as the secondary payer. Per the Explanation of Benefits (EOB) received from BCBS, the service Hyperbaric Oxygen Treatment is not a covered benefit under the plan. 

      The charges are correct for the services provided. The balance is correct per the members benefits for this service. Coding is correct and cannot be revised. 

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

       

    • Initial Complaint

      Date:10/12/2023

      Type:Billing Issues
      Status:
      Resolved
      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.

      Hello, 

      I am following up as it has now been a week and I have not gotten a response from the business *** health, I was wondering if they have responded as of yet or if someone could reach back out to them and request a response. 

      Thank you. 

      handle issues like this, spoke to **************** who adv. she sees the notes and understands what occurred, advice to me is that yes they made the mistake and when the sup. reviewed my account back in Aug. they should have caught the mistake and assisted me with understanding and fixing the issue. She told me to pay the collections *** I responded with I am not taking a derogatory **** on my credit report, because of a SSM mistake. ******* then stated she would email the issue over to SSM directors for atten, I also req. a billing specialist sup. To which she stated she doesnt know when either party will call.I spoke with billing specialist Deasisha today 10/12 as no one from SSM has called she could not find ******** notes in the sys. about the action she took. Stated she would put the same request in, she adv. I did not receive any action from my phone call with ******* because my account was already with collections & $0.00 accounts get skipped when it comes to sup. call backs.

      Business Response

      Date: 11/21/2023

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

      As of 11/15/2023 the consumers balance with the physicians billing at SSM Health is recalled from bad debt collections with no negative remarks. The consumer gave authorization to have his balance place with the Commerce Line of Credit. Currently there is a hold on the account that will remain in place until the the account is funded and shows a $0.00 balance. 

      We apologize for the inconvenience this has cause out patient, and for the delay in responding to this complaint. 

      Sincerely, 

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

      Customer Answer

      Date: 11/27/2023

      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,

      *******************************

    SSM Health St. Louis is NOT a BBB Accredited Business.

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