Complaints

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• Initial Complaint

  Date:04/01/2025

  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.

  I had a procedure done on January 31. I talked to the financial department and received a financial quote for the hospital cost and the anesthesiacost. I took money out of my 401(k) to cover that and the oral surgeons fee. I explained to them, I have not met my deductible that nothingwould be covered and I need to know the whole amount. The amount I was given was paid upfront. Then they came back and told me they had bill part of the insurance, which is not they told me in the beginning was going to happen. They said I would be treated as self-pay completely. Now they are sending me a for additional funds that I do not have and I do not think I owe them money because that should’ve been told to me in the beginningso that I could come up with the money now I have no more money to pay them and it’s not fair. They should’ve told me everything upfront and been honest with me. I tried to work it out with the hospital and asked them to take the billaway and they would not and they hung up on me.

  Business Response

  Date: 04/14/2025

  We are an anesthesia office. Our billing occurs after the
  procedure is done. There was no contact from our office with the patient until
  the patient received her statement and called our office. The patient had two
  separate procedures: one that was considered cosmetic, which was not covered by
  insurance, and one that was covered by insurance because it was medically
  necessary. The first time the patient contacted our office to make a complaint
  about the billed amount, our office staff attempted to explain that the $929.20
  was for the portion of the procedure that insurance covered and applied to her
  deductible. The patient did not accept that as an answer. Eventually, after
  being unsuccessful at getting through to the patient, our staff member told the
  patient to have a good day and disconnected the call. The patient called back
  and left a voicemail on the manager's line about the issue. At that point, the surgeon's office was contacted to confirm it was a split case (partially non-covered and partially
  covered by insurance). We also confirmed with our medical coders that the case was
  coded and billed correctly.  
  The facility was contacted, and we spoke with one of the financial counselors. It was confirmed that one of the financial counselors told the patient the entire case was
  self-pay, and the patient was quoted an anesthesia self-pay price of $865, which ended up
  being $265 more than what it should have been after we coded and posted the
  charge. We refunded the patient that overage on February 13th. Then,
  we received the EOB on the portion that was billed to insurance on February 20th,
  and BCBS assigned $929.20 to the patient’s deductible. It is illegal to adjust the
  deductible off, which is why she was billed $929.20. When we spoke with a financial counselor at the facility, it was stated that the notes of the procedure were changed at some point from being a split case to self-pay. The financial counselor agreed that it was a mistake on their end.
  The patient stated to our employee that she didn't feel like she should be
  responsible for the $929.20 deductible because the financial counselor she spoke with told her
  it was all self-pay.
  After speaking with the administrator of the anesthesia
  department, we will follow how the hospital billed and reverse the charge to the
  insurance. This will remove the deductible being owed to us so that insurance
  can apply to it elsewhere. The patient will have a $0 balance on our end.

  Customer Answer

  Date: 04/15/2025

   
  
  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID 2******** and find that this resolution is satisfactory to me.
  
  
  
  
  Sincerely,
  
  
  
  ***** ******