Complaints

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• Initial Complaint

  Date:06/30/2025

  Type:Billing 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 have been a patient of Dr. ***** at Adventist HealthCare since 2022, where she has served as my primary gynecologist for annual womens health exams. In December 2024, I attended my regular yearly exam. The evaluation performed was consistent with those conducted in previous years. As part of the visit, Dr. ***** recommended a follow-up vaginal ultrasound.Upon receiving the bill, I noticed that two different exam codes had been submitted on the same day for what was essentially the same evaluation Ive received over the past 2 years. I subsequently contacted both Adventist HealthCare and Aetna for clarification. I was informed that I am required to pay a $55 co-payment, as two separate exams had been billed on the same ****** a physician myself, I understand that this discrepancy likely originates from the billing practices of the institution rather than from Dr. ***** personally. However, I believe I should have been informed at the time of scheduling that additional charges could apply. Had I been made aware, I would have had the opportunity to reconsider or reschedule the appointment accordingly. Despite my written inquiry as attached below, I haven't recieved any response other than another reminder for the bill

  Business Response

  Date: 07/02/2025

  The Annual Well-Woman billing practices that are followed by all Advantia practices are posted on our website at the following location and available within our offices: ********************************************************************************
  
  As noted within, in instances when a separate problem is identified during an wellness exam visit, we are required to submit separate claims based on what is documented in the medical record of the service provided. This means two services may be billed -- the annual wellness exam and a problem-focused office visit. The same is true if significant time is spent on counseling during an annual wellness exam visit. If two services were billed, it is because one of these situations applied.
  
  For compliance purposes, we bill without regard to patients individual insurance coverage and in accordance with nationally recognized standards. Unless an error has been made, we are not able to alter charges or diagnoses in order for rendered services to be covered or paid by a patients insurance plan as doing so would be considered fraudulent billing.
  
  Out of respect for patient privacy, we cannot include any personally identifiable information in our response. If you would like to discuss this further, we invite you to call our office at **************. We apologize for any miscommunication that may have occurred.

  Customer Answer

  Date: 07/06/2025

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: 23537454
  
  I am rejecting this response because: I'm not sure as a physician how a manual exam can assess endometrial thickness without a transvaginal ultrasound, which would result in two separate service charges.
  
  
  Regards,
  
  **** *****, MD
  
  
  
  
  
  
  
  
  

  Business Response

  Date: 07/10/2025

  Dear Dr. **************** previously stated, we are not able to discuss the specifics of your care in this forum out of respect for patient privacy.
  
  We have reviewed your information and can confirm that the billing was done correctly, and in a manner that is consistent with both our stated policy and nationally recognized standards. We are not able to alter charges or diagnoses, as doing so would be considered fraudulent billing.
  
  While we understand that you do not wish to have further contact with us, we are happy to discuss this matter in greater detail with you over the phone. 
  
  As our services were provided and billed correctly, you are responsible for those charges, and we will continue to correspond with you about that matter until it is resolved.
  
  Warm regards,
  
  Ob-Gyn Associates of Advantia