Complaints

This profile includes complaints for Southwest Health's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Southwest Health

  1400 Eastside Rd Platteville, WI 53818-9800

• 

  Southwest Health

  207 E Skelly St Cuba City, WI 53807

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:11/24/2023

  Type:Sales and Advertising Issues
  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 schedule physical check up and went to Southwest Hospital in ***********, ** without any pre-condition in Nov 2022 ******************* *************, ***********, ** *****). I received a bill from Hospital in Jan 2023 regarding my lab work for 470$, with the fact that my insurance only pay 84.57$ of it and I should cover the rest which is $385.43. I went to Southwest Hospital in Jan 2023 and showed them the bill and they apologized and mentioned they had similar problems with United Healthcare (which is my insurance) with other insured as well and they will work with them to solve the issue. In Jan 2023, I actually called my insurance and asked my insurance whats going on and why they are not paying for it. They mentioned the hospital you went for physical check-up they coded your lab work as diagnostic and this is not a typical lab work for check-up. If you went there without any pre-condition why they even ran such tests? Interesting enough, the results of all of my labs came back normal as expected. I called Southwest Hospital and complained about it and they mentioned do not worry about your bill, we will work with your insurance and fix it. Recently, I received the same bill from Southwest Hospital that I owed them $385.43.

  Business Response

  Date: 12/13/2023

  I have reviewed the account, had the coding reviewed for accuracy and reviewed the accuracy of how our facility sent the claim to the insurance company.  Based on the reviews completed, the true dispute is between the patient and his insurance company.  The diagnosis codes used were both screening codes.  The first was "encounter for general adult medical examination without abnormal findings" and the second was "encounter for screening for lipoid disorders."  Neither of these diagnosis codes should be considered "medical" as the patients' insurance is indicating.  Our facility did request the claim be sent back and reprocessed twice, each time the insurances' decision and the result had the same outcome.  ********************* has indicated to us that the tests performed are subject to the patient's deductible.  

  Based on the information received multiple times from the insurance company, we did send the patient a statement for what his insurance company has deemed patient responsibility.  They are applying $385.43 towards his deductible.  

  Customer Answer

  Date: 12/14/2023

  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.
  
  Even though I agree with their statement, I can tell that hospital failed on their side. I went to hospital for physical check up without any precondition or symptom. I actually see both Doctor and Hospital failed in on their side. First of all, why Doctor prescribed blood tests for physical checkup that is not covered by my insurance. When I contacted my insurance they mentioned two of these blood test are not for normal check up. Second, Hospital had my insurance info. The minimum they could do was contacting my insurance and check it will be any cost for patient or insurance cover it all. As a patient you go for normal check up, you do not expect to pay anything as you have insurance. Plus, all results came back normal as expected and nothing was abnormal. Unfortunately, I feel I did extra blood test that was not needed because of Dr and Hospital & I ended up with 400$ bill that I have to pay for because they did not do their jobs.  
  
  Regards,
  
  ***********************

• Initial Complaint

  Date:06/12/2023

  Type:Billing Issues
  Status:

  UnansweredMore 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 eye exam in Jan of 23. Received explanation of benefits from insurance stating I owed $55 and they covered the rest. SWHC sent me a bill for $585 stating insurance was denied. I contacted my insurance they stated it was covered except $55. I tried calling the business office numerous times with no answer and left voicemail for them to return my call, they *****. I faxed the explanation of benefits and messages from insurance stating it was covered by them.SWHC did nothing and continues to send me hills for $585 and send me automated voicemails however wont actually have a physical person call me. And to top all of this off the eye DR ***** even give me the right prescription, she gave me the same exact prescription for both eyes which isnt accurate. I had to go somewhere else and get an accurate eye exam as I was getting headaches from the incorrect prescription. I will never go to this clinic/hospital again, what a nightmare.