We use cookies to give users the best content and online experience. By clicking “Accept All Cookies”, you agree to allow us to use all cookies. Visit our Privacy Policy to learn more.

Manage Cookies
Resources for Businesses My BBB
Share
Business Profile

Orthopedic Surgeon

Orthopedic Associates of SW Ohio, Inc.

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Orthopedic Surgeon.

Complaints

This profile includes complaints for Orthopedic Associates of SW Ohio, Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see

Find a Location

Orthopedic Associates of SW Ohio, Inc. has 8 locations, listed below.

*This company may be headquartered in or have additional locations in another country. Please click on the country abbreviation in the search box below to change to a different country location.

    Please enter a valid location.

    Customer Complaints Summary

    • 2 total complaints in the last 3 years.
    • 0 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.

    Sort by

    Complaint status

    Complaint type

    • Initial Complaint

      Date:02/01/2024

      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.
      I had ACL surgery on May 9, 2022. The Thrusday before the surgery, I was asked to go into the office and have the knee brace that I needed for surgery to be sized. Fifteen months later, August 2023, I was sent a bill for the first time for this brace. I had met my deductible for the year prior to the surgery.After many phone calls and conversations with my health insurance (United Health Care) it was decided that the charge was paid for in part of the "GLOBAL AGREEMENT" that the insurance company and the provider have. The agreement says that the brace is included int he price that they have agreed upon. The provider refuses to accept this. After many months of me trying to resolve the matter with the Orthopedic Associates of Southwest Ohio, they are unwilling to discuss the bill. They have sent my bill to collections. The insurance company is now filing a fraudulent charge against them.

      Business Response

      Date: 02/05/2024

      Thank you for forwarding this complaint for our review.  

      We have spoken to this patient and her insurance on several occasions trying to help to get this matter resolved for her.  This patient received a durable medical equipment item which was prescribed by her physician in May of 2022.  At the time of receipt, the patient was informed that she would be responsible for any necessary deductible, copay or co-insurance liability.  Additionally, should her insurance deny this as non-covered and/or not medically necessary, she would also be liable for the brace.  The patient had the opportunity to refuse the brace from our office and we would provide her with a script that she could take to another supplier or to obtain the brace from our office.  At that time, the patient chose to accept the brace from our office and signed the waiver advising that should her insurance deny, she would be responsible.

      We billed the patients insurance carrier and they denied coverage of the brace stating that she had received a same or similar brace in the last 3 years and her benefit plan only covers 1 brace every 3 years.  We attempted to submit reconsiderations and appeals on behalf of the patient to try to explain the medical necessity for the specific brace that the patient received and were unsuccessful in overturning the denial from the patients insurance carrier.  Once we exhausted all available options on our end in appealing to her insurance, we did ultimately turn the bill over to patient liability.  

      We sent the patient 5 statements for this charge and spoke to her on 7 different occasions prior to sending her account to our external collection agency.  The patient was explained all of the work we did to try to get her insurance to overturn the denial and she was explained why she was being billed for the non-covered item.  Additionally, once her account turned to collections, her insurance also contacted our office questioning why the patient was being billed and we advised them that we had the waiver on file as well.  The patients insurance is pulling copies of the documentation that we sent in proving that we have the signed waiver, once they have that confirmation, they will also be advising the patient that she is being billed appropriately for this item.  

      I have attached a blank copy of the exact document that the patient signed for the durable medical equipment she received which shows the waiver acknowledgement and the option to refuse.  I am attaching a blank copy as the instructions for rebuttal state not to include anything that has the patients actual information on it.  Should you need a copy of the actual signed waiver from the patient, we would be happy to supply that as well.

      We as a practice strive to help our patients in getting their medical bills paid whenever we can.  We prefer not to bill the patients if at all possible.  Unfortunately, there are times when the insurance company will not cover items even after we supply them with proof of the medical necessity due to their internal policies and/or benefit restrictions.

      Please let me know if there is anything additional that you need from our office to complete this review.

      Thank you,

    • Initial Complaint

      Date:12/26/2023

      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.
      the Billing Department at Yankee (including the VA manager) continues to bill ALL OF MY VA CARE TO CIGNA. THis is Veterans authorized surgical care for my service connected disabilities and is preapproved and paid in full by the VA. I have spoke in person and on the phone with the front desk, the 'manager' who slammed the phone down on me, and the 'VA' claims person over the past months and NOW EVERYTHING IS BEING BILLED To private insurance. I've talked to Cigna and it's not them, it's OASWO. It almost seems malicious, but is most certainly a compromise of my personal health information protected by U.S. Government.

      Customer Answer

      Date: 12/27/2023

      Please CANCEL or withdraw  Complaint *********.  After further investigation I believe this may have been a technological integration error.

    Orthopedic Associates of SW Ohio, Inc. is NOT a BBB Accredited Business.

    To become accredited, a business must agree to BBB Standards for Trust and pass BBB's vetting process.

    Why choose a BBB Accredited Business?

    BBB Business Profiles may not be reproduced for sales or promotional purposes.

    BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.

    When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.

    BBB Business Profiles generally cover a three-year reporting period, except for customer reviews. Customer reviews posted prior to July 5, 2024, will no longer be published when they reach three years from their submission date. Customer reviews posted on/after July 5, 2024, will be published indefinitely unless otherwise voluntarily retracted by the user who submitted the content, or BBB no longer believes the review is authentic. BBB Business Profiles are subject to change at any time. If you choose to do business with this company, please let them know that you checked their record with BBB.

    As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation. BBB charges a fee for BBB Accreditation. This fee supports BBB's efforts to fulfill its mission of advancing marketplace trust.