Complaints
Customer Complaints Summary
- 3 total complaints in the last 3 years.
- 0 complaints closed in the last 12 months.
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Initial Complaint
Date:04/12/2024
Type: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 had a procedure done at the Soin Medical Center back in 12/2022 and billed for in 1/2023. I applied for financial assistance on the myChart in 5/2023 after not being able to make the payments. I sat in wait to hear back on the outcome and never heard anything. I continued to receive statements and I sent messages through the myChart app asking for a followup and never got response. Will attach screenshot proof. This was in 7/2023 and 8/2023. I continued to monitor the myChart app for the update or any correspondence to come through about the status of the financial assistance. I never received any indication of it being denied. The system had generated some letters to me in 11/2023 that were generic with no info filled in. They gave no indication of denial. Will attach screenshot proof. At one point, my app then indicated I had no balance so I assumed the financial assistance covered the bill because I no longer received any correspondence. Fast forward to March 5, 2024, I received a letter in the mail indicating my debt was sold to a debt collector of which was never indicated to me. I called Kettering billing of which I was told they could not help me because I should have known when I seen no balance on the app that it was sent to a debt collector and they also sent me statements in November. Also that financial assistance will not cover a doctor bill. I had to CALL to figure that out. How am I supposed to know that financial assistance wasn't accepted by a simple statement that just tells me a balance and the app still says that financial assistance is under review? They are not willing to help me and Lisa (supervisor in billing) was not trying to understand the situation just for simple fact these were sent to collections months ago. Again, how was I supposed to know that? I had no indications of that to tell me that. Kettering Health... do better!
Business Response
Date: 04/15/2024
We apologize for the issues she is having. The bill in question is a physician bill. Soin does handle billing issues, but if the patient calls ************, they can discuss her concerns.
Thank You,
******* ******, Patient Relations Representative
Initial Complaint
Date:06/21/2023
Type: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 March 28th I was involved in a bad car accident and I totaled my neighbors vehicle. CareSource is my main Insurance and paid for all the services. After that Progressive, which is NOT my Auto Insurance, (I do not have Auto Insurance, I have an SR22 from Gainsco.) sent Soin a $5000 check to cover the same related services. When I spoke with Soin, an agent by the name of Donise stated she is going to refund CareSource their monies and take the monies from Insurance instead. This is wrong as I have an abundance of expenses from that accident, most importantly replacing my Neighbors vehicle (who DOES have Progressive) that the $5000 Progressive Payment could go toward. They have refused to not process Progressive and are refunding CareSource. After looking at at the bill and payment for CareSource I understand why - SOIN is taking the Insurance money because it is more even though the claim was already processed through CareSource.Business Response
Date: 07/10/2023
I have contacted our billing department to see how this can be resolved. I have also inquired as to how to resolve the physician billing. Those bills are from a separate group, and I will see who to contact to have that resolved.
Thank You,
Customer Answer
Date: 07/20/2023
Hello, I did not understand that I was supposed to give a response to the Hospital, I thought the investigation was still ongoing. As of today, I still am very much unsatisfied with the Hospitals financial decisions. I do not want my case closed. Attached is information that shows $3,559.22 taken from "Special Services" Insurance which is Progressives payment. CareSource previous to them receiving that payment covered ALL of my services. I have other expenses from that accident & see it fit that the Hospital send that Progressive payment to me.Thank you in advance & take careCustomer Answer
Date: 07/20/2023
Also, how do I refute the statement Kettering verbally made that I gave them Progressive Insurance information and that's why they submitted the bills to them. I NEVER gave them Progressive Insurance Info. because I didn't know about this Insurance?!If you look at the date on the Progressive payments, they received their 1st bill on April 17th. The date of the incident was March 28th - I did not give the Hospital Progressives information.Business Response
Date: 08/11/2023
We apologize for the delay in responding. We have resent this information through billing seeking clarification on the payment received. Billing has indicated that it may take 5 business days to ensure that correct practices were followed in the processing of the claim. Thank you for your understanding as we work through the channels to ensure this has been handled appropriately.Customer Answer
Date: 08/14/2023
Complaint: ********
I am rejecting this response because my signature does NOT exist on any information submitted to Progressive from the Hospital authorizing $5000 be payed out. I DO NOT HAVE PROGRESSIVE AND WAS NOT AWARE of What insurance the Owner of the car had when the accident occurred so there's no way I gave The Hospital Progressive's information. I have my own SR22 insurance and I have CareSource Medicaid. That $5000 can assist the owner in getting another vehicle instead of paying bills that were already paid for by MY INSURANCE.
Sincerely,
****** ****Business Response
Date: 08/14/2023
This case remains open. We apologize for the delay in responding. We have resent this information through billing seeking clarification on the payment received. Billing has indicated that it may take 5 business days to ensure that correct practices were followed in the processing of the claim. Thank you for your understanding as we work through the channels to ensure this has been handled appropriately.Customer Answer
Date: 08/21/2023
Complaint: ********
I am rejecting this response because:The actions of this Hospital are not acceptable to me when they chose One Insurance over the other without me giving them that information
Sincerely,
****** ****Business Response
Date: 09/14/2023
September
14, 2023
Dear
*** ****
We hope this letter finds you well. Thank you for allowing us to address your
concerns shared from your visit to Soin Medical Center on March 28, 2023. At
Kettering Health, we are committed to providing high quality healthcare
services to our community. It is our goal to serve you safely and effectively
with respect, integrity, teamwork, and excellence. Therefore, our
responsibility is to assure you, your concerns have been investigated and
appropriate actions have taken place.
Your care concerns were shared with and
reviewed by the Patient Resolution Team and the Department of Financial
Services. These individuals are the most appropriate to review this matter and
take any warranted follow up actions.
Grievance
description and findings
You
were involved in a car accident on March 28, 2023, and Soin Medical Center
accepted payment from CareSource and Progressive (the car owners insurance
company). Upon investigation payment from CareSource was refunded and the payment
from Progressive was applied to the services rendered. You expressed that Soin
Medical Center should return the payment from Progressive to the car owner.
A
thorough investigation has been completed of your above concern. The findings
are that we are legally obligated to bill charges to
the patients auto insurance. When a patient has a government health plan and
there is another possible payor, we are required to notify Medicare or Medicaid
of a third-party payor.
Med pay covers any person in the vehicle at the time of the
accident regardless of if they are an authorized driver or on the insurance
plan. We apologize, but we are unable to refund the payment from Progressive as
indicated by law.
We truly hope the above information is
beneficial to you. On behalf of the
Kettering Health, please accept our most sincere apologies that we have failed
to meet your care expectations and for any stress and anxiety you may have
experienced. We appreciate you bringing your concerns to our attention and
allowing us the opportunity to address and improve upon the quality of care and
treatment we provide to our patients. Our investigation and follow-up process
is considered complete effective today September 14, 2023. I truly hope your recovery is going well and
wish you God’s blessing of improved health for the future.
Should
you have any further needs or concerns, please do not hesitate to contact me at
************.
Sincerely,
*** ******
*** ******* Patient Representative
Patient
Relations Department
Soin
Medical Center
Initial Complaint
Date:05/02/2023
Type: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 been trying since early Jan to get Dr. ******* (Beavercreek doctor of Kettering Health Network) & Soin Medical both of Kettering Health Network to correctly submit my Preventative Wellness claim of Dec 20, 2022.
Claim numbers for reading of scan (original & resubmit) ********** & **********
and actually preventative scan claim numbers resubmitted: **********, Credit claim to correct **********, and original **********.
This was part of my PReventative Wellness. I told the doctor that again and again. Yet they have submitted as something other than Preventative Wellness!!! Got it wrong again when they resubmitted.
The cost to me should be ZERO. The scan and the scan reading should have been coded as preventative care (wellness). I had NO issues. I told the doctor I wanted to get the scan as it was simply part of my preventative wellness that I wanted to get as my right and covered within my insurance plan's in-network preventative care (wellness).
Consequently, my insurance tells me they have to pay out what codes are provided. They did contact the doctor's office via letter but as mentioned, when resubmitted, it was resubmitted wrong again!
Hence, my insurance paid on those claims: $208 for the scan and for the scan reading - a total of $19.71 ($18.72 once and $0.79 additional with resubmittal).
The $208 and $19.71 was paid out of my Health Reimbursement acct (HRA) and is due back to me since the claim was coded as something other than preventative wellness.
I have gone round and round on this and see no other alternative than to come to the BBB.
they need to resubmit the total scan and scan reading correctly as preventative care (wellness) and repay my HRA account $227.71 immediately. With an ending result of a zero cost to me.Customer Answer
Date: 05/16/2023
Why is the Kettering Health Network not responded??? I recently again received an erroneous bill from the Kettering Network Radiologists which did the image analysis.I'm at my wits end with these health networks that continually use wrong codes. This seems to be no accountability for their continual errors.thanksBusiness Response
Date: 05/30/2023
I have attempted to contact the patient. Per record, the patient only consents to email, no phone numbers listed other than work. The number provided with complaint is a non-working number. I have also contacted billing to see why there was a balance. I emailed the patient to contact our office, as for the Imaging Center, this is the first complaint we have received.
Thank You,
******* ******
Patient Relations Representative
Customer Answer
Date: 05/31/2023
Complaint: ********
I am rejecting this response because as usual, a lack of phone number is your reason for not solving my complaint. REALLY? After all this time, you have yet to research and resolve the reason WHY there is ANY balance on the 2 diff parts (scan and the scan report) of this Preventative Wellness scan. ALSO, as mentioned in my original complaint, you also OWE ME MONEY BACK. Again, it was coded wrong. Why are you not resolving this? Preventative wellness is 100% covered by my insurance. Yet, because it was coded wrong, part of the costs were passed on to me and paid out of my Health Reimbursement Account or Personal Care Account.My insurance should have paid ZERO out of my Health Reimbursement Account but United Health Care (UHC) did because Kettering Health Network & Dr. *** ******* coded it wrong!!! DR ******* was told many times my visit to his office and subsequent referral for the scan was ALL PREVENTATIVE WELLNESS. UHC has contacted Dr. Bennett's office twice per my request to get this resolved. I have contacted your billing dept and the Kettering Radiologists billing and told both, this was preventative wellness and that BOTH, owe me money back. YET, like yourself, nothing happens and I continue to get bills and past due notices.
I have turned in complaints before on the Kettering Health Network for this SAME reason. Kettering Health Network needs remedial training in medical coding!!!
Does Kettering Health Network not want people to use their Preventative Wellness benefits from their insurance??? WHY is there such a problem with using this essential insurance benefit IF the patient can't get the full benefits they pay for with their health insurance????
This needs to be resolved IMMEDIATELY. I have been trying to get this fixed since Jan.
Sincerely,
****** *****Business Response
Date: 06/15/2023
Our billing department had issues obtaining the updated diagnosis from the ordering provider. They contacted Dr. ******* on 6/1/2023 stating they needed a diagnosis revision form. They received it on 6/5/2023, and billing was able to resubmit the claim with correct codes.
Nothing has been received from the insurance company as of 6/15/2023 on the status of the updated claim submission. Billing worked diligently to obtain the correct codes needed to submit the claim as preventative. Billing is aware that the patient is waiting to hear. We will email the patient on the listed email, unless notified otherwise when it is completed.
We apologize for the extended timeframe, but we are working with multiple departments to correct the issue.
Customer Answer
Date: 06/15/2023
Complaint: ********
I am rejecting this response because my issue is not completely resolved. As noted previously, there are 2 parts to this issue AND return of my funds.1. One of the claims (the Soin Med Ctr scan) has been resubmitted correctly (per phone conversation I had with them on 6-15-2023). However, there is the matter of returning my Health Reim Acct (HRA) or Personal Care Acct (PCA) funds which were originally paid out on the erroneous insurance codes. The amount are noted in the original complaint.
2. The analysis/reading of the scan has NOT been resubmitted per my insurance company. Insurnace company said nothing has been submitted since early April 2023 and it was wrong. As mentioned previously, this is also preventative wellness AND should be zero cost to me and my HRA funds returned. The claim numbers were provided in the original complaint. In addition, the amount owed back to me are noted in original complaint.
Sincerely,
****** *****Business Response
Date: 06/19/2023
Our billing group has contacted UHC to see the status of refund to your HSA. Radiology group reading the scan is working on re-billing claim. They said to allow up to 60 days for them to investigate, bill and hear from insurance company. They will follow up with me as needed.
Due to number of areas involved, these processes take time for review, requests and communication. We apologize for the delays.
Customer Answer
Date: 06/22/2023
Complaint: ********
I am rejecting this response for same reason as before. WHEN all claims are resolved and MY funds are returned, I will accept.Fixing of your errors are still in work and who knows if the Kettering Health Network Radiologists will turn in a corrected claim with the medical codes indicating Preventative Wellness this time.
Plus NO funds have been returned to my HRA/PCA from Kettering Health Network yet.
Don't you agree I need complete resolution?
Sincerely,
****** *****Customer Answer
Date: 07/26/2023
If anyone cares, What I said would happen has. I received a Debt collector letter today from Revco Solutions on med acct via Kettering Health Network for $32.90!!!!!!!what is most amazing is that KHN owes me money back. just gaulling.NOW, this will be impossible to get undone!!!. Like I said before, this I'm sure has been also reported on my credit!@!! Trying to get this kind of thing undone is nearly impossible and I should NOT have to deal with this.Kettering Health network is horrible like I said. I had another complaint in on them on another nearly same issue in 2021. I made the mistake of going back to that same doctor's office for preventative again.What do you suggest now??????? This should have never been closed because I knew they would drop the ball.Business Response
Date: 08/11/2023
Good afternoon,
This remains an open case for Patient Relations. We apologize that this has not been corrected in a timely manner. We continue to work with several departments for a resolution. Patient relations has sent correspondence on your behalf to patient resolution to see if anything can be done to expedite the correction. Please allow for 5 business days for patient resolution to respond to our request. Thank you, Patient Relations.
Customer Answer
Date: 08/14/2023
Complaint: ********
I am rejecting this response because Soin did not provide any answer or resolution other than still working it. I don't understand why Kettering Health Network can't do correcting medical coding and billings. and if I accept, the case will be closed once again.
Sincerely,
****** *****Business Response
Date: 09/22/2023
Good afternoon, *** *****,
September 22, 2023
I do apologize that this claim
is not resolved to date. I have included the correspondence from our Patient
Resolution team. “We called UHC spoke w/ ***** CR# ****. Rep stated that she is
going to request the initial payment of $208 made from the PT's HSA be refunded
as the corrected claim has been processed and paid by UHC, and not coming from
the PT's HSA. She said it can take up to forty-five business days for a
decision, and up to a year for the funds to be refunded into the patient’s
account.” The Rep confirms the PT owes nothing for this DOS.
Soin Medical Center has received
the correct billing codes and has processed them and has completed the necessary
work to correct the issue. Currently the extended wait time is on behalf of
your insurance company to provide the refund to your account.
I want to apologize again
for the processing of the initial claim with incorrect coding. We are required
to bill with the codes submitted by the ordering provider. Once the billing department
received the updated codes for service, they worked to reprocess the claim.
Thank you for allowing us the opportunity to correct the claim and I hope that
you receive your refund from United Healthcare in a timely manner.
Blessings,
*** ******
Safety Manager for Soin Medical Center.Customer Answer
Date: 10/11/2023
sorry, I have been extremely busy. this goes on and on!!!!!I downloaded the status of my claims from the Insurance. The $208 still shows paid on my insurance claims so I need to call my insurance company on status. What they say could be true.BUT AGAIN, STILL, there is the SCAN ANALYSIS that once again, they HAVE ADDRESSED since last April. Didn't they say they were going to work on that in prior response. YES they did!!!! However, when I reviewed my claims yesterday, NOTHING has been reprocessed since April so they have dropped the ball again. How many times do I have to say it. Its the approx $20 that was paid to Kettering Health Network for that scan analysis. I have said it time and time again, Its in my original complaint. This was always 2 issues about the same medical appointment (the scan). GEEZZZZZZ.I made this ALL very clear from the beginning. I don't understand and am appalled by the incompetency. This is why I had to come to the BBB because I could NOT get them to understand on my own. But even thru the BBB, I can't get this fixed. It will be a year in December that I have tried to get one medical appointment issue corrected!!!!!Again, I've been so busy and it takes time to once again review claims and make an correct response.Business Response
Date: 10/16/2023
Soin contacted UHC and spoke with ***** CR#**** who stated she will request initial $208 be made from the patients HAS be refunded. Per ****** it would take up to 45 days to make a decision and up to a year for the funds to be refunded. The bill for the Scan Analysis is from Kettering Network Radiologists. This group bills separately from Kettering Health. Per Kettering Network Radiologists, there is a zero balance, with the bill being paid from UHC in February 2023. Since we do not handle billing for this group, *** ***** needs to contact them at ************. They are the facility handling the bill for the Scan Analysis.
Again, we apologize for the processing of the initial claims, we billed according to codes provided to us. Thank you for allowing us to help resolve this issue.*******
Patient Relations
Customer Answer
Date: 10/18/2023
Complaint: ********
I am rejecting this response because my complaint was against Kettering Health Network from the beginning which includes both places, Soin and the scan analysis. I had to have said this and kept bringing it up 4 times clearly restating time and time again!!! As I've said for the 5th time, funds were paid out of my PCA/HRA for the scan analysis!!Now its claimed that's someone else problem how many months later?
Kettering Health Network has some major training of employee issues. Just look at the other billing complaints on the BBB.
I don't know what else to say. I'm really tired of revisiting and restating what I've said from the initial complaint.
Sincerely,
****** *****
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