ComplaintsforUniversity of Kansas Medical Center

• Initial Complaint

  12/11/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  October 6 I had a doctor's appointment. On my discharge instruction paperwork, I was told to go for a pelvic ultrasound and abdominal ultrasound. There was nothing listed about a third ultrasound. I went to have the two ultrasounds done on October 27, and when I arrived, they told me the doctor also wanted a third transvaginal ultrasound that had not been listed on my paperwork. I was not given any kind of estimated out of pocket cost prior to these ultrasounds by the doctor or billing or any other hospital representative or any indication that the cost would be more than a typical doctor's office visit. I could not have even checked with insurance myself for the third transvaginal ultrasound, since I didn't even know about it until I got there. When I was leaving the ultrasound office, I asked if I needed to pay anything and was told simply "no". Later, I received a bill for $3,943.18 for these ultrasounds. My complaint is that I did not give informed consent for these ultrasounds, as I was never informed of the significant financial risk of having them done or given any reason to believe the out of pocket cost would be more than a typical doctor's office visit. A bill of this size is a significant financial setback for me in my current situation. I could not appropriately decide if the risk of these procedures outweighed the benefits without being made aware of that risk. I am basing my complaint on the same ethical principles behind the surprise billing laws currently in place to prevent unexpected costs for emergency out of network care and the laws requiring good faith estimates to be given to self pay patients. If there was a significant financial risk of these procedures, I should have been given a real time estimation of benefits and out of pocket costs as part of the informed consent process prior to the exam. Here is an article from a Missouri medical journal that supports my complaint: *****************************************************

  Business response

  12/13/2023

  *** ******* reached out to the Patient Relations team on 11/30/23 to express her displeasure with billing and the amount owed for the ordered ultrasounds. A response letter was sent to her on 12/11/23 and reads as follows below. The ultrasounds ordered were indicated for evaluation of the reported symptoms:

  Dear *** ********
  I am writing you in response to the concerns you have regarding the billing of x-rays performed on October 27, 2023, and a bill for seeing the OB/GYN doctor at The University of Kansas Health System on October 6, 2023. We take all patients concerns seriously and yours is no exception. Your feedback and concerns have already been shared with my manager, J**** ************ members of our health care team, *** ******, and your electronic medical records were reviewed.
  
  The Ultrasound reports were normal, was informed if continued to have pain, would need to see a PCP for further testing. You did decline hormonal therapy at this time. Our doctors do not know the price of procedures that were ordered for you, which were an abdominal ultrasound, a transvaginal and pelvic ultrasound, and the cost of your doctor appointment are all managed through billing.
  
  Your insurance paid $2, 599.82, the balance left was $3, 943.18 for the patient to pay. The clinic has offer to get you started with a PCP to better manage your concerns. We do have financial advisors to help patient better understand their bill and assistance in making a payment plan. That number is *************
  
  Our determination was that appropriate care was provided. I am terribly sorry you have experienced changes in your health. If you have further concerns, wish to share additional information, or have questions, you may contact me at the phone number listed below. Thanks for bringing your concerns to our attention. Your feedback is important to our ongoing efforts to provide the best care and service to our patients.
  
  
  

  Business response

  01/04/2024

  Thank you for reaching out again. The attached letter was mailed to *** ******* on 1/2/24, and I imagine there was a delay in getting the mail to her home. My hope is that our patient will be pleased with the thorough review, response and balance adjustment based upon our findings. Happy to help in any other way requested.

  ******* ******* Director of Patient Experience

  Customer response

  01/08/2024

  
  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. While I still maintain that ethical principles would require the business to alert the consumer to the cost of the procedure as part of informed consent, I understand that the current Kansas laws unfortunately do not require this for those with insurance. I appreciate the business reviewing my complaint more closely and adjusting the bill for the third ultrasound. 
  Thank-you.
  Sincerely,
  
  ******* *******

• Initial Complaint

  07/27/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I received care from the University of Kansas Health System (KU Med) Emergency Room on January 9-10, 2022. After working with both primary (**** ***** **** ****** ** ****** ***** and secondary (K&K Insurance), I resolved this claim with KU Med in approximately late August/early September 2022 as I had met my $1,000 deductible through K&K Insurance. At this time, in approximately September, I received a small refund check for about $40 for the amount that I had paid KU Med exceeding that $1,000 deductible. In May 2023, I began receiving new statements from KU Med stating that I owed $3,289.04, which were sent every 2 weeks. I have called KU Med about this resolved bill multiple times this year in May, June, and July. In both May and June, I was advised by KU Med representatives that this bill was set to be written off. Additionally, in June 2023, I was advised that I would stop receiving billing notices. I continued to receive both emails and phone calls. Also in June 2023, I sent a message to the billing department through MyChart. Two and a half weeks later, I received a response directly contradicting what I had been previously told, stating that management declined to adjust the amount since they do not take contractual adjustments for out of network plans for secondary insurance. I was not aware of this response until I called on July 26, 2023. I am working with K&K to solve the billing discrepancy, but I am deeply frustrated by KU Med's lack of transparency in billing and mixed messaging. I am further concerned about KU Med sending this bill to collections prior to resolution with K&K. If I had been advised of their policy when I first began receiving statements again in May, I would have reached out to K&K much sooner. My interactions with KU Med's billing department are exemplary of why many Americans do not seek necessary treatment for medical conditions--they fear an expensive, opaque billing process that will haunt them long after receiving care.

  Business response

  07/27/2023

  Upon receiving this complaint, our Patient Accounting Manager reached out to the patient and had the opportunity to speak with her. She has adjusted off the patient's balance, as that is what should have happened because of the lack of timeliness to bill the patient. We are pleased that the patient is pleased with our response and our identification of opportunities to improve in the future. 

  What we learned was that her primary insurance left her a large balance and then her secondary did not pick up the total balance that remained.  Our patient did her due diligence of contacting us when she received the first few statements in early 2022.  Her secondary had not received the claim.  It appears we had issues getting the claim over to them.  They eventually processed it in August, 2022 but then it was with follow up until May 2023.  The follow up team noted in May they were going to adjust the balance off, but that did not occur. When one of our reps got a phone call once the patient was again billed, she adjusted the balance off, but our manager denied the adjustment because of the lack of notes from the rep. 

  No one brought any of this to our manager's attention, including the person that answered the patient's MyChart question last week.  Additionally, the original rep never went back in to follow up after she was notified more information was needed to resubmit the adjustment.  Unfortunately, there were multiple missteps in this case, but we have worked to recitfy with a solution suitable to the patient. 
  
  

   

  
  

  Customer response

  07/28/2023

  ** ******* ****** ** ******** **** ***** ********* **** ********** ** *** ********** *********  ** *** ***** *** *** ****** ** ****** ******* **** ****** ******** ******* * **** ******** *** ******** **** ** *** ******** ** ********* ** ********* ** ********* *** find that this resolution is satisfactory to me.
  
  Regards,
  ******* *******

• Initial Complaint

  04/23/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  This office is attempting to collect the negotiated amount that the office of ** *** agreed not to collect from me in the amount of **** plus dollars. My deductible had been met as of 12/27/2022 also. They will not accept the attempt that I sent them to prove that they negotiated this amount and agreed not to ask me for this amount as payment. They will not answer any of my messages and my insurance was to send this information for them but they will not confirm this has been received either. I was told it would be reviewed by a **** * over a month ago. I have messaged multiple times this week and want this taken care of as I am getting calls from them asking me to pay and that my account is over due. My bill needs adjusted to the $346 that I actually owe. I have never been asked to pay the negotiated amount from any medical office before so this feels like insurance fraud. I am appalled by the lack of attention to this and want it resolved immediately. Very tacky of an office that refused to work with a patient who loved over three hours away in the beginning to attempt to collect more than they should be.

  Business response

  04/27/2023

  The Director of Revenue Cycle has reviewed the patient's account.  It appears the codes that were sent on the remittance advice shows an amount that should have been adjusted as a contractual adjustment.  It is not coded as a contractual adjustment in Epic, but should be. When that adjustment is posted, it would leave a balance of $346.52 owed by the patient.  We will have that adjustment posted and this will resolve to the amount requested by the patient.
  
  
  

  Customer response

  05/01/2023

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  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.
  Regards,
  ***** *****

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