Complaints

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:01/30/2023

  Type:Billing Issues
  Status:

  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.

  The date of service is 1/24/2022. At the advice of my primary care physician, I scheduled an appointment with Ulster Gastroenterology for a routine colonoscopy. I met with the doctor on or about November for a pre-procedure consultation and after, the colonoscopy was scheduled. Preauthorization for the procedure was sought out from my insurance, ***************** Blue Shield, by Ulster Gastroenterology's office/scheduling/billing staff. The insurance approved the procedure, and the date was set for December. A scheduling conflict on my end caused the appointment to be pushed out to January 24, 2022. Between the initial consultation and the scheduled procedure, Ulster Gastroenterology's office/scheduling/billing staff did not contact me to inform me that the anesthesia services would be provided by an out-of-network provider, nor did they have me sign a consent agreeing to out-of-network anesthesia services. At no time would I have agreed to any out-of-network medical services because I have adequate health insurance and I cannot afford to pay for out-of-network medical services. I would have canceled my appointment with Ulster Gastroenterology and looked for an in-network provider had I been properly informed. On the date of service, I was still not made aware by Ulster Gastroenterology or the anesthesiologist that the services he would be providing were not covered under my health insurance. Because care was not provided by both Ulster Gastroenterology and *****************, PLLC in good faith, I am now faced with a medical bill of $465.70 that I am unable to pay. Ulster Gastroenterology is fully responsible to cover the outstanding $465.70 because they did not disclose before medical services were administered that the health insurance was not going to cover the entire procedure. This information must be disclosed to the patient so an informed decision can be made about care. I have visited UG twice and called once for a resolution and no help has been provided.

  Business Response

  Date: 01/31/2023

      Attached are the forms ******************************* had completed and signed.  The last two pages the patient was given to take home, read, complete and sign.  The other signed page was given to ***** to sign the day of procedure by the anesthesiologist. 
      I do have an email out to Dr ******************** who was the doctor who administered the anesthesia for ***** that day.  *********** is also the owner of Greentree anesthesia.
      As soon as I receive a response from ************ I will have more answers in regards to the balance due.  If you have any questions please feel free to contact me.
  
  Thank you,

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

  Office Manager

  Ulster Gastroenterology, PLLC

  Customer Answer

  Date: 01/31/2023

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

   

  At no time was I told verbally or otherwise that the anesthesiologist's services would be out-of-network. The Assignment of Benefits is vague and does not expressly state the care being administered would come from an out-of-network provider. This is something that must be disclosed to the patient when scheduling services and before any procedure is performed. The patient has the right and should be afforded the opportunity to seek a provider that is in-network and will accept their insurance. I have adequate health insurance, which was contacted by office staff for prior authorization, and this procedure should have been fully covered. 

   

   

   

  In order for the BBB to appropriately process your response, you MUST answer the question above.

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

  Business Response

  Date: 02/01/2023

  I have spoken to ********************** Dr ******************* and he informed me that he will write the balance off.  This situation should have been handled directly with ****************** and it would not have taken so long to resolve.

  Customer Answer

  Date: 02/01/2023

  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 and the matter has been resolved. Thank you.
  
  Sincerely,
  
  *******************************