ComplaintsforGastro Health, LLC

• Initial Complaint

  05/14/2024

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I had a procedure done 2/9/2024. On 2/5/2024 I was instructed to pay before the procedure $268.76. My EOB from my insurance company ************ stated that I owed only $21.25. I have called numerous times for months about receiving my refund, receiving false promises that my request has been expedited. It is now more than 90 days since the procedure and every call I make, I am told that the refund was approved 3/26/2024 and I should receive the refund shortly.

  Business response

  05/16/2024

  As you see in the attached accounting logs, this refund check was originally processed on 3/22/2024 and mailed. We checked with our accounting department and confirmed the check was never cashed. We will reissue the refund check tomorrow and send it to the patient via overnight mail for tracking.

  Customer response

  05/20/2024

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

• Initial Complaint

  04/10/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  Gastro Health of ********** billed me for services never rendered. After speaking to my insurance representative, they billed me for an in person visit , and a tele-visit with ****************************** on 1-9-24, and I never saw or even met *************. ************* called me by phone a week later to apologize for not being able to evaluate me in person.I was evaluated by her Nurse Practitioner, who appeared confused about my complaints, never called in my prescriptions to my pharmacy, and I got really sick due to their medical negligence.They are now threatening collections for my out of pocket cost of $112.00, after my insurance paid them over $300,00.

  Customer response

  05/15/2024

  ***See The Attachment From The Consumer***

• Initial Complaint

  03/24/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  Date of the transaction: 2/14/24 Amount owed: $300 ($300 was already billed through insurance- so total=$600)The business committed to providing me results to feel better & it didnt help. The doctor reached straight to medicine and didnt know what I had. All he asked me was if I had the symptoms listed on the medicine and I said some and then he showed me another medicine and asked the same thing and I said some. He told me one of the pills was for Gastritis and the other for IBS. He said try both and see which one helps. I told him I didnt want to reach for medication since my issues could stem from foods (hence, I did my research before going and it said to follow FODMAP diet). When I told him I wanted to go the natural way and actually find the root cause of the problem, he told me come back in one month, after taking the sample of medicine and he would know what I had. I told him how would he be able to tell and he said by seeing which ***** worked. I was asking probing questions of what if the medicine didnt work and he said then well do blood work. I asked if we could have started with blood work and he said no. He did not care to find out what was actually wrong, but just wanted to see by trial and error of medicine and then charged me $600 when I was the one who actually did all the research. I even read that you could do an endoscopy to find out what I had since Ive had issues my whole life and stomach cancer runs in my family. He told me no, that it wasnt necessary. I found it super unprofessional that he just reached straight to medicine without doing tests or digging in to find out what I have. This was at Gastro Health in ************* with Doctor ****************************

• Initial Complaint

  02/08/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Since my April 2023 colonoscopy, through numerous texts, calls, and emails to both GastroHealth (**) billing and a ** benefits administrator, attempts to correct the anesthesiologist claim have failed. ** submitted claims for TWO anesthesiologists. On the anesthesiologist #1 claim, insurer remarked E50 We reduced your claim. This is either due to certain codes billed, or because weve paid another provider for part of this service. and R01 You do not have to pay this. This service is denied. Per standard coding guidelines, it is not billed appropriately. Payment for this is included in the payment to the hospital. On the anesthesiologist #2 claim, insurer remarked E50 We reduced your claim. This is either due to certain codes billed, or because weve paid another provider for part of this service. I connected with **s Lead Authorization and Benefits Coordinator, who made numerous requests to the ** billing ***** to correct the claims, including giving them the correct coding, but to no avail. Theyve ignored the requests.*** received over 25 bills, over email and regular mail, ranging from $2,610 to $5,508, and although a billing rep told me to Please disregard any bills and will not be forwarded to collections, it was recently forwarded to collections.I only ask that ** correct the anesthesiologist claim per the insurers agreement and that **s bill reflects what the insurer considers my share.This has been a nightmare. Though I'm very pleased with my gastroenterologist, I won't be returning to him nor any other doctor associated with Gastro Health, LLC.

  Business response

  02/09/2024

  ******** law requires that Certified Registered Nurse Anesthetists be supervised by an MD Anesthesiologist. In accordance with that law, we have to submit separate claims for each provider. The reimbursement for those services gets split between the two so that a patient is not responsible for more than they would be if only ************** provider billed. One of the claims charges were sent to collections in error as we were pending a resubmission to insurance. That balance is being removed from collections. Nothing was reported to any credit bureau so there is no impact on the patient's credit score as a result. After we resubmitted the claims with updated coding, the patient's insurance still applied a deductible share of costs on a remittance dated 2/2/2024. As a courtesy, we will adjust the charges on one of the anesthesia providers claims and only bill the patient for the amount her insurance deemed her responsibility after corrected codes were submitted for the second.

  Customer response

  02/13/2024

   
  Complaint: 21267216
  
  I am rejecting this response because:

  1) Re: After we resubmitted the claims with updated coding, the patients insurance still applied a deductible share of costs on a remittance dated 2/2/2024. As of 2/13, insurer does not show that coding on these claims has been corrected, as error code E50 still shows. The deductible amount shown is still based on this incorrect code. The *** will be available on 2/17, and if coding was indeed corrected, the *** should show this. I will check again when the *** is available.

  2) Re: As a courtesy, we will adjust the charges on one of the anesthesia providers claims  As I understand, this refers to the claim that was denied because it was not submitted on time. Gastro Health (**) may consider this a courtesy, but the insurer clearly states on my claim that You dont owe this amount. The provider didnt send us the claim within the required time limit.[U9]
  
  3) Re: and only bill the patient for the amount her insurance deemed her responsibility after corrected codes were submitted for the second.  As I understand, this again refers to the claim above where the *** will be available on 2/17. If codes were submitted correctly, it should show no errors, with my correct deductible.
  
  4) On 2/12 I received yet another e-bill from ** for $319.20, which was the deductible from the claim showing a coding problem. However, the claim that was denied is also shown on the bill as pending charges. This claim has been denied, I owe nothing on it, and it should not even appear on the bill.
  
  I will not be satisfied until the ** bill reflects my insurers correctly coded deductible, with nothing pending, and I see evidence that the claim has been removed from collections.
  
  Sincerely,
  
  ***************

• Initial Complaint

  01/31/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I had a colonoscopy done by ********************************************* on October 2,2023. This was a screening/preventive care. This ( the procedure and the general anesthesia) was covered 100% by my health plan Anthem BCBS ( i attached the explanatiion of preventive care coverage and the report of my colonoscopy from ****************) The Gastro Health billing department submit a wrong code saying it was " diagnostic". As a result the billed me $502.50 for the anesthesia. I did not find out until after I paid them $502.50 and I contacted Anthem BCBS, they said I should not be billed since this was a screening/preventive procedure. I conbtacted the Gastro Health billing department and requested them to resubmit the claim and reimburse me $502.50 because they made a mistake but they refused to do and even asked me to contact my insurance to get the right code for them. This is their job not my job and my insurance would not provide me the code for them. I would like BBB to help me in this matter to get my money back.I really appreciate your assistance.

  Customer response

  02/01/2024

  Receipt of the payment of $502.50 to gastro health 

  Business response

  02/16/2024

  The physician corrected their medical record, which then allowed us to submit a new claim to the patient's insurance with updated coding. The patient's insurance recently adjudicated the corrected claim and paid them at 100%. The patient does not have any balance due currently.  

  Customer response

  02/17/2024

   
  Complaint: 21229409
  
  I am rejecting this response because: I expect they reimburse tme the $502.50 i paid them for the anesthesia which was covered 100% with the colonoscopy. They have not reimbursed me yet.
  
  Sincerely,
  
  *********************

  Business response

  02/20/2024

  The anesthesia claim was not paid on the latest remittance from the insurance. We will submit another corrected claim for that charge to have it reversed. Once we receive payment from the insurance for the anesthesia claim, we will issue the patient refund.

  Customer response

  03/11/2024

  Hi BBB:

  Anthem just sent me an email telling the claim for anesthesia was reprocessed on February 26,2024 in the amount of $500. Up to today  March 11, I still have not received the  reimbursement . Please see the attached of the copy of the claim anthem sent me above. Thank you for all your help. 
  ******

  Business response

  03/20/2024

  A refund for $502.50 has been approved and will be issued in the next 10 business days.

• Initial Complaint

  01/24/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On March 20, 2023, I had a colonoscopy at GHE Fremont Endoscopy Center in *******, **. Since I am uninsured and self-paid, I paid at the time of the procedure. I was told by employees of this company (both in advance and at the time I paid) that this would be payment in full, a package price offered to all self-paid patients. (Receipt transaction no. **********). Since then, I have been receiving multiple invoices from Gastro Health demanding an additional $512. The bills mention a provider adjustment (I have no provider) and that I paid $260 (I actually paid $1,760). I have written to the address on the invoices multiple times explaining their error and proving copies of my payment receipt. The invoices kept coming so I also sent a letter to their local office explaining everything again. The result: another invoice arrived in the mail. (Marked patient account no. *******, bill ID no **************, dated Dec 9, 2023.) It still demands $512.

  Business response

  02/08/2024

  The statement sent was in error due to a system glitch as the patient did pay the balance in full as stated. The patient's account has been updated in our main system to reflect a zero balance and our statement system will be updated via file transmission within one to two business days. We apologize for the oversight.

  Customer response

  02/12/2024

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

• Initial Complaint

  01/19/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  A check was accidently sent to this company. I'm not a patient with them. I talked to several billing **** reps and they have validated that I'm not in their system and my account number is not associated with them as well. They've claimed they would follow up and no one has. The ********* blatantly told me that I was not going to get a refund because I'm not in their system. Well they shouldn't have cashed a check with someone who is not in their system. The check that they cashed with my name and address and account #****** was visible on this check so it should not have been cashed. Check #********** with the date of 9/13/23. I provided them with all this information and they still refuse to refund my money. They have not provided any direct service so they took money that was not owed to them and now is refusing to return it.

  Business response

  01/19/2024

  **************** emailed our main office today and provided a copy of his cancelled check. That allowed us to locate this payment and we will be issuing the refund. We apologize if previous attempts to resolve this at one of our other offices was not properly handled.

  Customer response

  01/31/2024

  I was told I would receive a refund and have not received anything at this time. So this issue has not been resolved.

• Initial Complaint

  12/26/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Unanswered

  More info

  Dealing with this business has been horrible. It's unbelievable how much lying and indifference can be institutionalized within one company with all the employees in cahootz, specifically the billing department. How does anyone including the doctors associated with this business sleep at night? The PA that saw me at GastroHealth recommended that I get a screening for colonoscopy. I agreed to having it without knowing this is a predatory scamming business. After the colonoscopy, I get 2 undisclosed bills from two anesthesiologists for $250 each and one for the colonoscopy $751.92. I immediately reached out to my insurance company and attempted to link the representative with someone at gastro health billing. We were told that our inquiry will take ***** days to be reviewed. I appealed to the doctor who requested from the billing department to recode the procedure from Diagnostic to Screening, and have a copy of the request from Gastro Health's Lead Authorization and Benefits Coordinator. Nevertheless, I have had nothing but run arounds with customer service and their billing review team. I keep calling, and I asked many times to speak to a supervisor and they avoid me at all costs, they go out to lunch and put me on hold for hours. I get told I'll get a call back by a supervisor and never do. I request to wait to speak with a supervisor and after 45 minutes of being on hold, they hang up. My bill has been in coding review since June 2023. They will not let me speak to the billing department "back office" and say that I have to wait ***** days for a review every time I call. I've been told that at least 7 times. Each time nothing happens, the bill just comes back to me VIA a threat of being sent to collections company. This is the most horrid place I've ever dealt with. I don't know how this can be considered a health care facility as patients are not prioritized. All the doctors should leave this place immediately if they have any self-respect or reputation.

• Initial Complaint

  12/13/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I visited Gastro Health-********* **************************************************************** for information regarding a procedure that is recommended for men over 50 years old (colonoscopy). I was given brochures and instructions on how to prepare for the procedure but I didnt make an appointment at that time because of my busy work schedule. I called in to get insurance coverage information because I lost my job. Shortly after, I received a message that I missed an appointment which I never made. I tried calling to explain that there was a misunderstanding and that I never made an appointment. I keep getting billed $70 for a co payment and I never received any services. They continued to call me frequently and no one would listen to me or address my issue or even attempt to resolve it. I now have health insurance with a new company but I dont feel comfortable calling Gastro Health-Hollywood to follow up on the procedure because of their constant harassment. I just received notification that they have me in collections now for $70. They are trying to destroy my credit rating for services that I didnt get. Please help me resolve this issue. I dont owe them anything. Whoever that lady was who put in a appointment did it without my consent and she is responsible for this whole mess. I cant believe that she caused me so much mental stress for services that I didnt receive or even benefit from in anyway. In no way are they saving lives but instead hurting people like me. Thank you for your help!

  Business response

  01/02/2024

  As the patient stated, he visited one of our facilities for a consultation regarding a potential colonoscopy. That consultation was a billable service and was submitted to the patient's insurance as such. The $70.00 billed to the patient is the office visit copay that his insurance, BCBS, applied as the patient's responsibility. The patient has access to his explanation of benefits from BCBS to validate that fact. This balance is not for a procedure that was not scheduled or for a service that was not provided. As a courtesy, we will remove the patient's balance from collections and follow back up with BCBS to determine why they applied the copay. If they still apply a balance due after those efforts, we will rebill the patient for any balance BCBS states he owes. Nothing has been reported by Gastro Health to any credit bureau so there has been no negative impact to the patient's credit due to this.

• Initial Complaint

  11/22/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Two medical procedures were conducted at Gastro Health an ultrasound on May 26th, 2023, and a colonoscopy on July 12th, 2023. Gastro Health collected upfront payments of $250 and $335, respectively. Following the receipt of the Explanation of Benefits (EOB) from my insurance, it was revealed that only one copayment of $191.58 was applicable to the first procedure.Accordingly, Gastro Health is obligated to refund the excess amount collected. I initiated contact with them on August 14th, and while they acknowledged the error, promised a refund, and assured me a check was on the way, as of now, I have not received any reimbursement. Despite making multiple follow-up calls, the situation remains unresolved.I have spoken with various representatives and escalated the matter to a manager, yet there has been no tangible progress or response to date. This prolonged delay is causing significant inconvenience. I kindly request your urgent intervention to expedite the refund process and ensure the reimbursement of the overpaid amount.

  Customer response

  12/01/2023

  Please do you have any update on this? I dont even see it as a complaint in the website . Really need help here 

  thanks very much 

   

  Business response

  12/18/2023

  We issued a refund check to this patient on September 8th, 2023. The patient's daughter sent an email to our main office last week and we provided her proof of the previous check being issued. We found that the previous check had not been cashed so we are voiding that check and re-issuing a new one.

*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. ↩