Complaints
This profile includes complaints for Cleveland Clinic Foundation's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 252 total complaints in the last 3 years.
- 84 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe 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:10/03/2023
Type: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.
I have called the billing department of Cleveland Clinic 9 times since July of 2022 requesting a refund for the amount I paid over the copayment for the procedure. Each time I called the agent I spoke with told me I should receive a refund. Several of them apparently didn’t forward my claim to the proper department. The last 3 calls I was told that the claim would be sent to the department that issues refunds. I still have not received any refund.
I
Business Response
Date: 10/13/2023
Dear
Sandra,
This
letter is in response to the billing complaint filed by ****** ***** to the
Better Business Bureau on 10/3/23. I would like to first offer my sincere
apologies for any frustration this may have caused Mr. *****.
The
root cause of the complaint was that Mr. ***** states he has called the
Cleveland Clinic many times requesting a refund for an overpayment. A thorough
investigation has been completed and upon review, a refund check in the amount
$2,603.79 has been sent to Mr. ***** as of 10/4/23.
Thank
you for allowing us the opportunity to address Mr. *****’s concerns. If we can
be of any further assistance, please feel free to contact me directly at
************.
Respectfully,
Rachel
******,
Financial Ombudsman
Revenue Cycle Management, CCHS
Cc: ****** *****Customer Answer
Date: 10/16/2023
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
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.
Regards,
****** *****Initial Complaint
Date:09/23/2023
Type: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.
On May 27, 2023, I utilized the ER at Cleveland Clinic. I have a $450 copay per my plan. When CC billed the visit, they billed the doctor charges separately and my insurance company assigned the responsibility to me in the amount of $188.92. I called my insurance company and explained that I have only a $450 copay for emergency room visits and should not have been responsible for the doctor charges. After they reviewed this, they agreed. They sent me a new explanation of benefits showing I am responsible for $0.00 and they paid Cleveland Clinic. The new EOB AND a copy of the check showing the claim was paid by ****** has been provided to them, but they will not remove this charge from my account. I have made several phone calls and even asked for it to be escalated. I have received two calls from the escalation request, but still the charge remains. I am told this can take months to resolve! This is ridiculous. They make sure you know that you have four billing cycles to get an account paid or they will turn it over to collections. but they are in no hurry to resolve issues! They have all they need to correct my account. The incompetence of the Cleveland Clinic billing department is astounding. They seem unwilling to take the steps necessary to get my account accurate. One can only hope the care team doesn’t mirror the apathy shown by the billing team. If you go to CC for care, watch your billing statements and double check EVERYTHING. In my family, we have had two encounters with CC and both instances where a complete mess.Business Response
Date: 10/06/2023
Dear ******,
This letter is
in response to the billing complaint filed by ****** ***********, to the Better
Business Bureau on 9/25/2023. I would first like to offer my sincere apology
for any frustration this may have caused Ms. ***********.
A thorough
investigation has been completed on Ms. ***********’s account. I reviewed the
account in conjunction with the medical records associated with the services
rendered from May 27, 2023 to May 28, 2023 below are my findings:
May 27, 2023 to May 28, 2023 Professional services (Reference # ***********): The Cleveland Clinic has removed the $188.92 from patient responsibility while our Cash Control Department locates the insurance payment and applies it to the account correctly. Please allow time for this process to be completed.
I apologize for
any frustration this may have caused Ms. *********** and thank you for allowing
us the opportunity to address her concerns. If I can be of any further
assistance, please feel free to contact me directly at ************.
Respectfully,
Brendan *******,
Financial
Ombudsman
Revenue
Cycle Management, CCHS
Cc: ******
***********Customer Answer
Date: 10/06/2023
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
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.
Regards,
****** ***********Initial Complaint
Date:07/28/2023
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.
Every time I call for any reason or any location, I always have to wait at least 20 minutes for anyone to pick up the phone. then it takes 15 minutes to make an appointment for a simple PCP visit. on the phone with them waiting over 2 hours of my calling, i get angry. I calm myself down and try again. All day. no one knew what to do so they would transfer me up to 5 times and i would still end up with orthopedics. I am so tired of your mistakes. my doctor appts and billing are comical. all i wanted to do is schedule urology test. instead i spent most of my day frustrated and angry.
finally got the number for urology. It was a fax number. AAAAAGGGGGGG!Business Response
Date: 08/16/2023
Business reached out to complainant twice by phone, (once on August 1, 2023 and once on August 2, 2023), and once by mail, (on August 3, 2023), with no response from complainant until August 15, 2023. Business will reach out to complainant again.Initial Complaint
Date:06/28/2023
Type: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 COLE EYE INSITUTE DOES NOT HAVE ENOUGH VALET WORKERS. THE WAIT TIME FOR YOUR CAR IS REDICULOUSBusiness Response
Date: 07/03/2023
I talked with the person who filed the complaint and got the date, time and make of the car that was valet. We took that information and looked at the cameras. From the time that the patient paid for his car until it arrived to him was 11 mins. We apologized for the wait time and sent him some parking validations for the next time he visits the Clinic.Customer Answer
Date: 07/03/2023
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
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.
Regards,
**** *********Initial Complaint
Date:04/20/2023
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 had an appt with Dr. ****** on February 27 for an RLE consultation, which is free, stated on your website.
************************************************************************************************
I have received a large bill for this consultation. I am being told that this was a keratoconus evaluation and RLE consultations are not free. I believe there was miscommunication regarding the appt. When I first arrived, the medical assistant (?) was confused and told us RLE consultations are not done on main campus, only Westlake office. She then checked and said they actually did have the necessary equipment to complete it. Dr ****** was very helpful and competent and helped me reach a decision regarding RLE. However, it would seem this was not noted as an RLE consultation in her notes and therefore we have been billed. I have reached out to her office numerous times and to billing without getting this resolved. Many messages have been sent to Jen, her secretary, with no attempt by Jen to follow up with me. Very unprofessional. I have had a few RLE consultations done, due to wanting a few opinions due to this eye condition that I may or may not have, and we have had zero issues like this. Billing has essentially said they've done all that they could. Where does this leave us, with an appointment that was supposed to be complimentary? There are many places to go to receive this kind of consultation without the headache of a massive bill. This is an error on Cleveland Clinic's side. We told staff we were here for an RLE consultation. At no time were we told this was no longer an RLE appointment and we would be billed.
PT Account # ************Business Response
Date: 04/27/2023
Dear ******,
This letter is in response to the billing complaint filed by **** ****** to the Ohio Better Business Bureau on 4/20/23. The complaint was sent to the Financial Ombudsman department to review and respond back to you.
I would first like to offer my sincere apology for any frustration this may have caused Mr. ******. The root cause of his complaint is he believes RLE Consultation is free. A thorough investigation has been completed into **** ******’s account. As part of the investigation, the account was sent to our coding department, where an audit on the charges was performed. It was determined that the charges on the account for date of service, February 27, 2023, are correct and there were no financial errors. The patient came in with a known medical condition and that he has KCN(Keratoconus). This is not considered a free Lasik screening.
However, if Mr. ****** would like to contact me, I would be willing to offer him the $150.00 self-pay healthy routine eye exam.
Thank you for allowing us the opportunity to address Mr. ******’s concerns. If we can be of any further assistance, please feel free to contact me directly at ************.
Respectfully,
Brendan *******,
Financial Ombudsman
Revenue Cycle Management, CCHS
Cc: **** ******Initial Complaint
Date:03/21/2023
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.
In August I scheduled some yearly well visits for my kids.
My oldest had the appointment in late August. It was billed as a well visit and was 100% covered by our insurance.
My youngest had the appointment September 15th. She had been sick with an ear infection the week before her appointment, so I took her to a walk-in clinic and she got some antibiotics. She was better by the next day. Then at the well check the doctor checked her height, weight, milestones, I requested her vaccination records & health form for school, etc. The doctor checked the chart, said, "Oh, I see she was seen last week for an ear infection. How is she doing?" I said she was fine & that was the end of the visit.
Weeks later I get a bill for my youngest's visit. Her pediatrician coded the visit as a "follow-up visit" to her walk-in visit for her ear infection, not as a well check. This follow up wasn't covered by our insurance. Additionally, the well check had been scheduled (then rescheduled as we were on a waitlist to get in sooner) in August, way before we were ever dealing with an ear infection! How could I schedule a follow up for something I didn't know existed yet?
I called the office & was told that because my youngest went to the walk-in clinic, the doctor had to bill the visit as a follow up. Her pediatrician refused to change the coding. I've talked to the front desk, billing department, customer service, & my insurance. All say there is nothing they can do because the doctor only mentioned the ear infection in her notes. She didn't include all the development questions, vitals, request for school forms, or anything else we spoke about.
I had been under the impression that we were at a well visit, as that is what I scheduled, and no one informed me that they were changing the nature of the visit. Now I worry about taking my kids to the doctor when they are sick, because I don't understand how walk-in visits might interfere with future scheduled visits.Business Response
Date: 04/03/2023
Dear *******
This letter is
in response to the billing complaint filed by Mrs. ********* ***** to the Ohio
Better Business Bureau on 3/21/23.
A thorough
investigation has been completed on Mrs. *****’s daughter, ******’s account.
Per my review, it was determined that per the medical record, the type of visit
that took place on 9/15/22, was clarified with the family during the visit because
the family declined the Well Care child visit since they had one on 1/25/22. They
opted to wait to have the well care child visit in January 2023. The family agreed
with doing a follow up from the Urgent Care visit with Dr. ******** on 9/15/22.
The diagnosis coding is correct as billed since this visit was not related to a
well check and documentation in the medical record supports the follow up for
ear pain. The COVID vaccination was given, but billed separately, which is also
accurate. However, the CPT code used was for an Established Patient visit, but was
not correct because ****** was a new patient being seen by Dr. ********. The
CPT code was updated from Established Patient to New Patient visit type and a
corrected claim will be sent to ****** overnight.
Thank you for
allowing us the opportunity to address Mrs. *****’s concerns. If we can be of
any further assistance regarding this matter, please feel free to contact me
directly at *************
Best Regards,
Tiffany Bracken
Financial
Ombudsman
Revenue Cycle
Management, CCHSCustomer Answer
Date: 04/03/2023
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
********* *****
Contrary to what is mentioned in this response, I was not notified that the visit would not be a well visit. No one explained that to me at any point prior or at the appointment. I did not decline a well check as we were eligible for one.Yes, my daughter had a well visit in January 2022 through ****** **********, but that was in ******** and we had since moved to Ohio, my husband had a new employer, and we were on a new insurance plan starting July 2022. Therefore, we were eligible for another well visit for 2022 under our new insurance plan. My older daughter had also had her well visit in ******** in January of 2022 under our old insurance and her August visit at Cleveland Clinic was coded as a well visit and was completely covered by our insurance with no issue.
(My husband had another job change and we got another new insurance November 1, 2022, which is why we were eligible again for a well visit in January 2023.) The purpose of that doctor visit on September 15, 2022 was not to check on ******'s ear infection, as I no longer had any concerns about it. She was back to normal, had gone back to school, and was feeling fine as she took her antibiotics. The only reason I scheduled and kept the visit on September 15, 2022 was for a well check/physical to get ******'s school forms filled out so she could continue to attend school for the 2022-2023 school year. (The school would only temporarily accept our ******** vaccine and wellness forms until 9/30/22.) I only needed her forms filled out and since ****** was a new patient, I was told that she had to have a well check before the doctor could fill out her forms, which made sense.
My older daughter's visit was a well visit and was coded as such, but ******'s was not. The only difference in their appointments is that ****** had gone to the walk-in clinic a few days prior, but I still fail to see how that makes her ineligible for a well visit. The insurance wasn't an issue since it was a new plan and I had contacted them prior to the appointments to ensure we were eligible for well checks and got the all-clear. The issue is that the doctor apparently coded the visit as a follow-up, but I don't know her reasoning for this. I didn't want or need a follow-up and literally only needed a physical to get ******'s school forms filled out.
My concern is that I will never feel comfortable taking my children to the walk-in clinic when they are sick because it may cause billing issues with future appointments. I don't know what else I could have done in this situation - force my daughter to suffer through an ear infection until after her well check? Or cancel the well check and then she would get unenrolled from school? I feel like I was left with impossible choices where there really should have been no issue. ****** was sick, I took her in to get antibiotics, then she had a well check for her school forms - why can't both of these be true?
Business Response
Date: 05/09/2023
Response received by BBB Staff via email
Hello *******
The new issue relating to care in the rebuttal has been forwarded to the Medical Ombudsmen’s office for them to review and respond back to the patient’s mother.
ThanksInitial Complaint
Date:03/13/2023
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.
The genetics department at the Cleveland Clinic is completely mismanaged. I had a referral placed in December regarding an evaluation for potential connective tissue disorders. This was flagged as a concern by doctors from neurology, podiatry, orthopedics, and primary care, all of whom have a lot of experience. The ************ number, which is cited as the correct number to call, is rarely ever answered. Option 1, 2, and 3 all go to voicemail. The first voicemail I left was regarding getting an appointment to be seen as my providers were waiting for the information to guide them in future decisions. I was told by **** *. that I would be contacted within 30 days about my referral via. MyChart. I waited about 45 days before sending multiple emails to [email protected] and left multiple voice messages using all three phone options. I was never able to get through and never heard anything.
While at the main campus for a few tests, I went to the R building to see if I could speak with someone. The front desk staff were friendly but said no one from genetics that is an admin or front-line staff was there. I also went to the T building where the website claims genetics is. That area's sign says "Medical Genetics" when in fact it is a Brain Study. First of all, the sign should be updated. Or, there should be a sign by the door saying genetics has moved--a lady I ran into said just in September that is where it was located. The person in the room didn't even know where genetics was. I was told it is in the crile building. That wasn't true. Only after I sent a hostile and aggressive email to Dr. ****** *** and her assistant, did I finally get a call from a medical director the next day who finally made my appointment. She said they are severely understaffed. I got a call from a geneticist the next day who told me she has been scheduling her own patients and the staff have been complaining and nothing has been done. She encouraged me to escalate this forward to seek change.Business Response
Date: 04/05/2023
The Cleveland Clinic has
completed a review of your concerns on April 5, 2023. The patient’s medical
records were reviewed and the concerns were shared with the Administration and
********* ********** *** *** ****** *** ************ ******* ****** and the
Hospital’s Executive Administration. The department leadership has shared they
have followed up with the appropriate staff and leadership to resolve these
concerns and are working to make the appropriate changes and updates.Initial Complaint
Date:03/08/2023
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.
Visited opthmologist on Jan 11, 2023. Routine vision test was done in addition to other things. I have been billed for the vision test. I called Customer Service to tell them I have vision insurance through ******* and was told she couldn't take the information over the phone. CS said she would send me a form to fill out. That was a month ago and I have not received it. Only receive a bill.Business Response
Date: 03/10/2023
Dear Ms. *****,
This letter is in
response to the billing complaint filed by Ms. ********* to the Ohio Better Business
Bureau on 03/08/2023 regarding not receiving the itemized statement for vision
services completed at Cleveland Clinic.
A thorough
investigation has been completed on Ms. *********’s account. Per my review, it
was found that an itemized statement was requested and generated for the
patient, Ms. *********, on 02/25/2023. I have mailed the itemized statement to
the patient.
Her Medicare policy does not cover refraction exams. They are
considered a vision benefit and not a medical benefit. A refraction exam helps the
physician determine if the patient need prescription or contact lenses, or if
there has been a change in their current prescription. It also helps the
physician diagnose the presence of eye disease and is associated with routine
annual vision checks.
Thank you for
allowing us the opportunity to address Ms. *********’s concerns. If I can be of
any further assistance, please feel free to contact me directly at
216-636-8029.
Respectfully,
Emily P*****
Financial
Ombudsman
Revenue Cycle
Management, CCHSCustomer Answer
Date: 03/10/2023
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
Regards,
***** *********
I wanted Cleveland Clinic to submit the vision test charges to my ******* Vision Insurance which will reimburse them for a prescription vision exam. Why cant this be done?
Business Response
Date: 03/16/2023
Dear Ms. *****,
This letter is in
response to the rebuttal filed by Ms. ********* to the Ohio Better Business on
March 13th, 2023. We appreciate Ms. *********’s efforts to resolve
this matter. Please be advised that the vision charges have been billed
correctly by the Cleveland Clinic.
An
additional review has been completed based on Ms. *********’s concern regarding
having her vision insurance billed. Unfortunately,
this location cannot bill VSP insurance as it is not a contracted provider for
any vision insurance so the patient must submit it on her own, hence why the itemized statement was provided
to the patient to be submitted to ******* insurance. Please be advised, the
vision charges have been billed correctly by the Cleveland Clinic.
Thank you for
bringing these concerns to our attention. Please note, this is our final review
on the above concern, any further questions related to their benefits and how
claims are processed, should be directed to the patient’s vision insurance.
Respectfully,
Emily P*****
Financial
Ombudsman
Revenue Cycle
Management, CCHS
Cc: *********,
*****Customer Answer
Date: 03/16/2023
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
I have not received an itemized statement. When I receive an itemized statement I will submit to my vision insurance. The details on My Chart are not an itemized statement suitable for submission to insurance.It's amazing how Cleveland Clinic treats senior citizens.
Regards,
***** *********
Business Response
Date: 03/24/2023
Dear Ms. *****,
This letter is in
response to the rebuttal filed by Ms. ********* to the Ohio Better Business on
March 20th 2023. We appreciate Ms. *********’s efforts to resolve
this matter. Please be advised that the vision charges have been billed
correctly by the Cleveland Clinic.
The
review has been completed based on Ms. *********’s concern regarding having her
vision insurance billed. Per the initial response an itemized
statement was requested and sent via USPS to the patient on March 10th 2023. We ask that the patient allows up to 10 business days to receive the
itemized statement. In addition, I will send the claim forms for the date of
service 01/11/2023 as well. As mentioned, these claim forms will be sent via
USPS and please allow up to 10 business days to receive.
Thank you for
bringing these concerns to our attention. Please note, this is our final review
on the above concern, any further questions related to their benefits and how
claims are processed, should be directed to the patient’s vision insurance.
Respectfully,
Emily P*****
Financial
Ombudsman
Revenue Cycle
Management, CCHS
Cc: *********,
*****Initial Complaint
Date:02/22/2023
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.
Prior to a scheduled outpatient surgery (Dr *****, ENT), I was called by a Cleveland Clinic appointment setter to schedule pre-op blood work and a visit to my PCP office (Dr ********, Nephrology). Both the labs and the physician visit were required by my ENT prior to the surgery. The lab bill I received from 10/27/2022 is for $200. I was told by ******* **** that the bill was processed as “Outpatient Hospital Visit” for lab/pathology/non-surgical procedure. My in-network copay is therefore $200. Had I gone to Quest for the same pre-op blood work my co-pay would have been $25. I was told by Cleveland Clinic billing on 2/22/2023 that no courtesy adjustment could be made because I signed a “Patient Responsibility” form at the time of service. I am appealing this $200 bill for several reasons: 1. Cleveland Clinic specifically directed me to use their lab. I wasn’t given a choice by Cleveland Clinic. 2. The blood work was time sensitive. I needed the labs done that day (followed by my PCP appt) in order to complete pre-surgery protocol. 3. Had I not signed that routine “responsibility” document I would not have gotten these necessary lab services. And without the lab work, I couldn’t have had my surgery. That form is not really “optional.”
I am requesting a courtesy adjustment on this bill. $200 is unreasonable under these circumstances. Cleveland Clinic CALLED ME to schedule these labs and specifically DIRECTED ME to do them at the hospital. Had I known my copay would be $200, I would have gone to Quest and paid $25 for the very same services.Business Response
Date: 03/16/2023
Dear ****** *****,
This
letter is in response to the billing complaint filed by, ****** ****** to the
Ohio Better Business Bureau on March 9, 2023. This complaint was received in the Financial Ombudsman office to
review and respond back to you.
I would first like to
offer my sincere apology for any frustration this may have caused Mr. ******. I
have undertaken a full review of the concerns mentioned and I am satisfied that
all issues raised have been researched and addressed appropriately.
The root cause of the
complaint is to have the balances of $200, which were processed towards the
patient’s copay adjusted. Unfortunately, their request was denied based on my
review, which is documented below
As
part of the investigation, a call was made to ****** ****** System to ensure
these charges were correctly billed to Mr. ******. According to the billing representative
Jacara, the services provided aligned with the provider’s order and were
correctly billed to both Mr. ****** and ** ****. We do understand that these
charges can be a large financial burden, however ****** ****** does offer
payment plan options through MyCare as well as Financial Assistance for those
who qualify.
I
wanted to take a moment to address the concerns Mr. ****** has expressed
regarding the pricing of our outpatient hospital services. I understand that Mr.
****** feels our prices are set too high and wanted to provide her with some
additional information that may help to clarify the situation.
First
and foremost, please be advised that all insurances companies are well aware of
the difference between our institution and community setting hospitals. If contracted, they
have negotiated in advance with the Cleveland Clinic to make contractual
adjustments to our prices on our patient’s behalf. Insurance companies receive
our claims and adjusts those prices to amounts insurance accepts as usual, customary
and reasonable fees – Mr. ****** has already received that adjustment. The
price assessed is the price the Cleveland Clinic routinely charges for this
service and is the price everyone at the Cleveland Clinic is assessed for this
service.
It
is important to note that when it comes to how these claims are billed to
insurance, the procedure codes should be accurate and line up with what service
Mr. ****** had. The procedure code in the outpatient hospital services group is
for the laboratory service.
While
I understand that Mr. ****** may still feel our prices are high, I hope that
this information helps to provide some context for how our pricing structure
works. I
apologize for any inconvenience this may have caused and thank you for bringing
these concerns to our attention. If we can be of any
further assistance, don't hesitate to contact me directly at ************.
Respectfully,
Ruth H*****
Financial Ombudsman
Revenue Cycle ManagementInitial Complaint
Date:01/29/2023
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.
Me and my wife(******** ****) both scheduled a physical check at Cleveland Clinic last year, she is my dependant under my company's insurance. We did the blood test on 09/30/2022 and ******** **** did it on 09/19/2022. Later, I visited the doctor to complete the physical check on 11/03/2022 and ******** **** completed it on 12/21/2022. We both have the same insurance program and the same test, and physical checks out and issues come with the billing for these services:
***** Ku's Blood test billing: $228
******** ****'s Blood test billing: $54
***** **'s Physical check billing: $33
******** ****'s Physical check billing: $0
first, the physical shall be fully covered and I still got charged; second, the charge amount is different under the same insurance and same service.
I tried to contact both the insurance company and the Cleveland Clinic and none of them could resolve these issues.
One issue is that Cleveland clinic considers Vitamin D as a standard test while insurance doesn't not. We weren't informed of this additional charge and tested and were surprised by the bill. Another issue is why the same physical check blood test requests will bill different amounts for me and my wife. The last issue is why I get billing for my physical visit. I tried to ask Cleveland clinic but they insist their charges are correct and said their charging codes were right.
However, neither the blood test charge code nor physical checkout codes are procedure correctly because we got changed differently for the same service, this all depends on Cleveland clinic's random choice of the billing code and I am not the only victim. They have been doing this for years.
The amount is not large and I am willing to pay. However, these unethical and unreasonable changes must be alarmed and noticed. No one wants to go physical check out and got surprised billing from CCF and They must be corrected.Business Response
Date: 02/07/2023
Dear ****** *****,
This letter is in response to the billing
complaint filed by, ***** ** on behalf of his wife, ******** **** and himself
to the Ohio Better Business Bureau on January 30, 2022. This complaint was received in
the Financial Ombudsman office for review on behalf of the Cleveland Clinic.
I would first like to offer my sincere apology for any frustration
this may have caused both Mr. ** and Mrs. ****. I have undertaken a full review
of the concerns mentioned and I am satisfied that all issues raised have been
researched and addressed appropriately. The root of the complaint is to review the services provided on
09/30/2022, 09/19/2022, 11/03/2022, and 12/21/2022
and ensure the services are properly billed.
Upon further review, I can confirm both the office visits
and labs are coded, billed and processed correctly, and match the documentation
in the medical records. Please note that the labs provided to both patients
were not the same. The cost of the services provided ******** **** was higher
due to the nature and extent of the services rendered. As part of the review, a
courtesy call was made to United Healthcare and per the representative, Heather
reference number: 9221 the claim processed correctly according to both ***** ** and ******** **** plan benefits.
Furthermore, the scope of services included in a wellness
exam may vary based on the individual circumstances, but generally, it does not
include services beyond the review of current health and preventative
screenings. A wellness visit includes the following:
• A review
of your current health and medical history.
• Counseling
about ways to improve your health.
• A
physician exam tailored to your preventative care needs.
• Immunizations
and screening tests, if needed (this would be billed separately)
A
wellness visit does not include the following:
• Treatment
or consultation for a specific medical condition.
• Recommendations
for treating a symptom is not considered part of a well-care visit.
• Medication
refills for current medical conditions.
• Disease
care/management.
I
apologize for any inconvenience this may have caused and thank you for bringing
your concerns to our attention. If we can be of any
further assistance, don't hesitate to contact me directly at 216-442-1506.
Respectfully,
Ruth
******
Financial
Ombudsman
Revenue
Cycle ManagementCustomer Answer
Date: 02/07/2023
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.We weren't aware neither notified any additional tests needed for the regular examination; this is unexpected cost for us. Neither of us have any physical issue by the last check so I am wondering what metrics CCF used to include these additional services or just charge all patients for physical check out with these additional services.
Also, another question is my physical check with doctor ****** * ******* on Nov 3rd. CCF claimed it as a preventive care but it's not for my UNH. Who's responsibility for this? Shall a patient being charged randomly by different code recognitions by different organizations? How should a patient knows if CCF's preventive code is identical with UNH? How would a patient know the different definition of physical checkout between two institutions? Shouldn't CCF review these information with UNH together before they contracted? This is not a patient's responsibility to pay these unpredictability bills. It's their responsibility to clarify these code matches and inform patient ahead any additional services.
Regards,
***** **
Business Response
Date: 02/13/2023
Dear ****** *****,
This letter is in response to the rebuttal filed by ***** ** on behalf
of his spouse, ******** **** and himself to the Ohio Better Business Bureau on
February 8, 2023.
We appreciate your efforts to resolve this matter. Please be advised
that the charges are billed correctly per the provider documentation and no
further corrections will be made. I understand that it can be confusing to
understand what is covered and not covered under your insurance plan benefits.
However, it is ultimately the responsibility of the patient to familiarize
themselves with their insurance coverage.
During the wellness exam, the doctor provided the appropriate care and
ordered the necessary labs within the guidelines. If additional labs were
ordered due to medical concerns outside of those guidelines, it is important to
note that these services were billed and coded correctly.
I would like to emphasize that the charges owed for these services are
the responsibility of the patient, as stated in your insurance policy. We have
a responsibility to accurately document and bill for the services provided.
Thank you for bringing
your concerns to our attention. Please
note, this is our final review on the above concern, any further questions
related to your benefits or how these claims were processed, should be directed
back to your insurance company
Respectfully,
Ruth ******
Financial Ombudsman
Revenue Cycle Management
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