Complaints

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• Initial Complaint

  Date:04/23/2025

  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.

  Business charged me the normal copay amount, rendered their services, sent me on my way with no further issue. Later was sent a bill believing that my insurance had covered the visit for $290.00. I was not made aware in any way shape or form that I would be receiving additional charges for this appointment prior to receiving said bill in the mail.

  Business Response

  Date: 05/19/2025

  On May 19th, 2025 MOD Dermatology received notice that patient ****** ******** had filed a complaint against the practice in regards to a bill received for $290 after his appointment on February 12, 2025. 

  On February 12, 2025 patient was seen in our office at ***** ******* *** Omaha, NE 68130 by *** **** ******* ***. At check in patient his specialist copay of $35.00. Prior to treatment patient was asked to fill out a consent form for treatment stating "I understand that I am being treated at MOD Dermatology. MOD Dermatology will submit this claim to my insurance company, however I understand that this condition may be a plan exclusion and if my insurance plan does exclude this coverage, I will be responsible for the full cost of the office visit, labs or any other charges incurred." Patient agreed to sign this consent, and signed it on February 12, 2025 at 1:21 pm.

  Patient was treated in office, and upon completion of treatment a claim was submitted to patient's insurance company (**** ***** **** ******) for $475.00 on 2/12/25. On 2/18/25 the insurance company sent notice that the claim will not be covered under the insurance, stating "This service/equipment/drug is not covered under the patient’s current benefit plan." As a result of the insurance not covering the office visit, the billing manager reduced the patient's fee from $475.00 to $325.00 as a courtesy. $325.00 is our standard self pay cash price for an office visit. On 2/20/25 patient was mailed a bill for $290. This amount is the difference between the $325 charged amount and the $35.00 patient had already paid. Patient was sent a second statement on 3/24/25 as the balance was not paid at the time of our 30 day billing cycle. Our financial policy states that patients are responsible for paying balances in full within 30 days of receipt of statement. Patient paid the $290.00 in full on 4/23/25. 

  On 5/19/25 Executive Administrative Assistant Haylee Frisbie reached out to patient via phone call, and explained all of the above to the patient. Patient verbalized he understood the situation, and Haylee emailed patient a copy of the consent patient had signed prior to treatment. This situation has been resolved. 

   

  Customer Answer

  Date: 05/19/2025

  
  
  Complaint: ********
  
  
  
  I am rejecting this response because:
  
  
  
  Sincerely,

  While I accept that MOD is not going to budge on this issue, pricing still needs to be upfront and transparent when working on a case which they should know may not receive coverage from insurance given they do this everyday, rather than just hiding behind generic disclaimer wording that then gets followed up with by a 10x bill. I am not interested in pursuing this further, or continued treatment with MOD, but hope MOD will change how it communicates it's pricing in the future so other people are not so blindsided as I was.

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

  Business Response

  Date: 05/21/2025

  Thank you for sharing your feedback. We understand your frustration and are sorry to hear about your experience. While we do strive to be clear in our communication and include necessary disclaimers, it's clear that in this case, the process did not meet your expectations, and for that, we apologize.

  We appreciate your suggestion regarding greater upfront transparency, especially in situations where insurance coverage may be uncertain. Your comments will be shared with the appropriate team, as we are always working to improve how we communicate and serve our patients. Please know that you are always welcome to contact our office ahead of time and ask for an estimate of services, or welcome to contact your insurance company to inquire about your coverage and estimates. Every treatment has a different contracted rate, and every insurance company has their own contract; for this reason we do not provide a price list as it would simply be impossible to list every condition, treatment, or contracted rate for every single insurance company. We do however strive to make our billing process as transparent as possible which is why we have a financial policy stating anything not covered by insurance is patient responsibility, and why we have additional disclaimers about frequently denied services. We would encourage any patient who has questions about why a claim has been denied to reach out to their insurance company directly. We understand some insurance prices may be unexpected, which is why we provided the courtesy of reducing the amount owed. 
  

  We respect your decision not to pursue further treatment with MOD, but sincerely thank you for bringing your concerns to our attention.