Complaint Category: None of the Above - Credit, Billing or Collection Complaint Issue
Complaint: They failed to get Medicare and my secondary insurance to pay for all the services and are trying to make me pay when Medicare says I do not owe it. I have Medicare as primary medical insurance and AARP/United Healthcare as my secondary. United Healthcare pays everything that Medicare does not. I am 100% covered.
For an outpatient procedure on 7/17/13 Medicare denied some charges. I received a bill for those charges in the amount of $602.36 with a statement date of 09-16-13. I called the billing at OHH and they told me I had to call Medicare. I called Medicare. Medicare told me the OHH had not provided sufficient documentation for the number of units used on some items. They said the OHH needed to call the Medicare Provider Line and provide the documentation. I called the OHH billing and told them. They said they would take care of it.
I then received another bill from OHH date for the service on 7/17/13 for the amount of $75.30 with statement date of 10/16/13. I called OHH billing again and told them I did not owe anything. I was told the billing would be put on hold until they got it fixed.
I received another bill for service on 7/17/13 for $75.30 with a statement date of 10/16/13. I sent them a letter stating I did not owe anything and would not pay anything. I enclosed a copy of the Medicare statement showing the $602.36 for 7/17/13 was denied and that I did not have to pay it. The Medicare statement showed I could be billed for $755.83. I also enclosed a copy of my benefits from United Healthcare showing they had paid $755.83. I told them not to send me another bill.
On November 18th I got a phone call from the OHH billing again saying I owed $75.30. I told them again I would not pay it and that I had sent them the documentation. Then the woman said well maybe I had had services too close together. All he bills show a service date of 7/17/13. I kept telling them I did not owe and would not pay, but the woman kept trying to get me to pay. I can furnish the Medicare and United Healthcare documentation, if needed. I am being harassed by the OHH billing. I told them I would be submitting a complaint with the BBB. The woman even tried to get me to pay after she was told that. I told the woman I needed a detailed copy of all the billing and she said she would send it. That got her off the phone. But, I do not need it as I have already provided them with sufficient documentation showing they were paid and they already had copies from Medicare and United Healthcare.
Business Response Dear Mr. *****:
This is in response to your complaint filed with the BBB. On behalf of Oklahoma Heart Hospital Physicians (OHHP), I would like to apologize for the frustration you have experienced with the Business Office and your concerns were not taken care or addressed in a timely manner.
After your initial call, we provided Medicare with the required documentation to reprocess for the additional units. Unfortunately, the status of your account was not moved from patient responsibility back to insurance pending. This resulted in the additional statements and phone calls to you. Medicare responded to our appeal and made additional payment on 12/03/2013. We have filed the corrected response from Medicare with your secondary insurance AARP United Healthcare. We are currently still waiting on additional payment from them.
I am truly sorry for the errors and the inconvenience this has caused you. We never want to hear of distrust or dissatisfaction from our patient's especially when the situation could have been avoided. Please feel free to contact me directly at (XXX) XXX-XXXX if I can be of further assistance.
Complaint: Services given without my knowledge. And Billing system a major mess. Product_Or_Service: Heart Operation Account_Number: XX-XXXXXX
Business' Initial Response Contact Name and Title: ******* *********** Contact Phone: XXXXXXXXXX Contact Email: *************@okheart.com In response to Mr. ******'s complaint, per review of his account the only physician's he would not have had contact with would have been the reading physicians. Mr. ****** was inpatient at Oklahoma Heart Hospital, service received from the physicians are billed separately from the hospital. His claims were timely filed to his insurance carrier and multiple statements regarding patient responsibility were mailed to him.
The services provided by OHH Physicians LLC were provided and billed accordingly. Please feel free to contact me directly if I can be of further assistance at (XXX) XXX-XXXX.
Consumer's Final Response (The consumer indicated he/she DID NOT accept the response from the business.) There were a Total of three Dr. I did not meet. Their service Is questionable. Kansas Heart Hospital did not require the additional service on My first trip. Nor did they do as much physical damage to my body.
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*Oklahoma Heart Hospital Physicians LLC is in this range.
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