ComplaintsforSouthwest Endoscopy & Surgicenter LLC

• Initial Complaint

  08/02/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I visited Southwest Endoscopy in December 2022 and overpaid for my visit. They let me know i would be issued a refund if they over charged me. I got my EOB from my insurance company outlining what my monetary responsibility was and it was close to $300 less than what I had already paid. I have been reaching out over and over requesting my refund and have received no call back since March when I was told a check would be mailed to me. I still haven't received my refund check and they will not return my calls after leaving a voicemail 1-2 times a month since march.

  

  Business response

  12/14/2023

  I have lots of notes on this account.

  There was an issue with her *************** denying the claim due to not having an authorization on file.

  There was an authorization, so the claim had to be sent back to Cigna, which it was.

  After checking on the claim our billing department found it was misrouted in Cignas system. Two more phone calls to Cigna and it was still misrouted in the system.

  A final adjudication to the claim was received on 6/12/2023.

  A check was mailed out to her on 8/23/2023 check # **** which was cashed on 9/14/2023.

   

  Also, here are notes of phone call records:

   

  3/31/2023: DOS 12/09/22 RETURN VM TO PT AT ************ REGARDING A REFUND, PER COMMENTS THE CLAIM IS UNDERPAID , HAD TO LEAVE A VM

  5/16/2023: DOS 12/09/22 RETURN VM TO PT AT ************ REGARDING A REFUND, PER COMMENTS THE CLAIM IS UNDERPAID AND IS STILL ON APPEAL. LEFT A VM.

  6/20/2023: DOS 12/09/22 REC'D CALL FROM THE PT AT ************ IN REGARDS TO HER REFUND IN THE AMOUNT OF $ ******, PER REVIEW THE PT POSTED ON 06/12/23, SENT AN EMAIL TO THE COLLECTOR ASKING ABOUT THE REFUND REQUEST.

  8/3/2023: DOS 12/9/2022- RTND CALL TO PT @ ************ BUT NO ANSWER SO HAD TO L/M FOR A RTN CALL. SHE IS VERY UPSET THAT SHE HASNT RCVD HER REFUND FOR ****** YET. EMAILED MNGMT TO PLS ****** UP THE PATIENT REFUND REQUEST AND SUBMIT FOR 2ND LEVEL APPROVAL.

   

  I am not sure when this complaint came in so I cant attest to when someone would have looked at it to respond.

  Hopefully, this is sufficient evidence that we have reached out to her and resolved this as quickly as we could based on her insurance.

   

  Thank you,

  ****

  *******************, MBA

  Administrator 

  Southwest Endoscopy & SurgiCenter

• Initial Complaint

  05/10/2023

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  On 2/27/23 I had a colonoscopy. I was required to pay $1179 prior to the procedure, telling me it was my responsibility even though the facility in in network with my insurance. SW Endoscopy filed a claim with my insurer, who paid the entire $1179 on 3/16/23. I contacted SW Endoscopy to get my payment refunded, and their billing office in ***** said that there was an outstanding claim for $202.53, and it was their policy to hold on to my duplicate payment until the outstanding claim was resolved. My insurance knows nothing about any outstanding claim, pending or otherwise. They have held my payment hostage for 3 months now, with no end in sight.

  

  Business response

  05/10/2023

  The refund is being sent out. The reason it wasn't sent out as of yet is because the patients insurance company processed a previous claim incorrectly and we have been waiting for the insurance company to correct this issue to see if there is any patient financial responsibility. However, we will just send a bill if necessary.

   

  Best regards,

  *****

• Initial Complaint

  05/03/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I had a colonoscopy scheduled for 4/24/23, and the day before the appointment, I received a text stating that I would owe $1,200 for the procedure after insurance. I called them back and left a voicemail requesting more information, since I was under the impression my insurance would cover it. Of course they never returned my call. I went ahead and paid the $1,200 on my Care credit card, but later found out after the fact that my insurance indeed paid in full the total amount billed by Southwest endoscopy. So they actually charged me double. Upon reading ****** reviews on this company I found out that this happens very frequently to other patients. The ones who realize that they've been double billed have to jump through hoops and wait weeks to get a refund, however how many patients are there who don't realize that their insurance paid the bill? so they've paid it in full as well?? Double profits for SouthWest Endoscopy... This is blatant fraud. Plain and simple.I did finally get a voicemail from "****" as I was typing up this complaint ironically. However on his message he stated that my payment hasn't posted yet, and to allow two weeks for a refund. This is unacceptable, as the charges have posted. I have spoken to Care credit today before filing this complaint, and confirmed that the payment had posted. I want my refund Immediately.

  

  Business response

  05/15/2023

  This has been refunded. 

  Customer response

  05/15/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
  
  Regards,
  
  *********************
  
   
  

• Initial Complaint

  12/28/2021

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I paid $1400 before my procedure, but SWE didnt report it to my insurance. This $1400 would have made me meet my insurance deductible and prevented additional charges for other medical procedures. I've left voicemails, we've spoken to them and they'd "email an itemized statement". Nothing gets done. Billing says talk to the front office. The front office does nothing. I need them to submit the $1400 payment correctly to my insurance.

  

  Business response

  12/29/2021

  Hello,

  Our billing department spoke with the patient and let him know his claim is in process and gave him a direct call back number so he can reach someone quickly if he has any further questions. We dont have a claim number yet but the call ref# is ************.  The account is notated with all of the information. 

  Please let me know if you need anything else.

   

  Best regards,

   

  *********************

  Administrator

• Initial Complaint

  08/09/2021

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  On April 16, 2021 I had a colonoscopy at Southwest endoscopy and surgery center. On April 13, 2021 I paid $543.64 from my health savings account to cover my out of pocket deductible for the procedure. My benefits company is now saying I owe the $543.64 back to them because the insurance was never billed. When I call the billing department they say they are unable to help me because there is no insurance paperwork. I have called multiple times to resolve the issue. I can only leave messages a live person never answers the phone. My ********* billing person *** has also sent emails to southwest endoscopy on my behalf. I have not received any communication back from them. It has now been 5 months and the issue has not been resolved. I have bills from the dr and anesthesiologist showing the procedure was done that day and those bills are paid. I need help in getting the surgery center to contact me to resolve the payment

  

  Business response

  08/23/2021

  Hello,

  I apologize for the frustration this patient encountered. The account was billed through insurance and processed. We have started the refund process to the *** account. Please let me know if there is anything further I can do to assist. 

   

  Thanks,

  *********************

  Administrator

• Initial Complaint

  05/08/2021

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I had a procedure scheduled and the doctor utilizes Southwest Endoscopy. My procedure was on 2/8/21. On 2/4/21, the office called and advised I had to pay $543.16 after checking my health insurance. I indicated I had already met my deductible and this seemed high. Additionally, I advised that I would prefer they **** my insurance first. They indicated I needed to make the payment or my procedures could not be performed. I made the payment. Approximately a month later, I received an explanation of benefits from my health insurance who paid the claim and indicated my out of pocket expense was $71.91. I have been going back and forth since March for a refund. I was told I would be receiving one and then when I followed up, was told insurance paid incorrectly. I called Aetna who confirmed claim was processed correctly. I have called, with no return calls. I called the main office who said they would message billing department. Still no contact. This is ridiculous. Just want the refund

  

  Business response

  10/05/2021

  This has been responded to previously, the patient was called and refunded on 8/20/2021. Is there something I am missing?

  Customer response

  10/06/2021

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and confirm resolution has been reached. 
  
  Regards,
  
  *****************************
  
   
  

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