Business Profile

Hospital

SSM Health

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Complaints

This profile includes complaints for SSM Health's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

90 total complaints in the last 3 years.
34 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. 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.

Initial Complaint
Date:02/07/2024
Type:Delivery Issues
Status:
ResolvedMore 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.
We received a bill from SSM health for services that were not received on the date listed. Requested a detailed billing statement, but again received a bill with no details for services. **************** cannot explain the charges. On the service visit date listed on the bill, any services would have been provided by ******* care. There were no visits to SSM Health on the date listed on the bill or days prior.
Business Response
Date: 02/09/2024
This correspondence serves as SSM Health's response to Complaint # ********.
The consumer states no services were received on the date in questions and calls to SSM Health customer services failed to explain the charge.
The charge is for physician certification to determine if a patient is eligible for home health and hospice services. A patient is not present, but this is a billable service. The charges in questions are now being billed to the patient's hospice coverage. The consumer can disregard the statement received.
Thank you for allowing us the opportunity to respond to this complaint.

************** SSM Health ***************** Serivces

Customer Answer
Date: 02/09/2024
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
Date:02/05/2024
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 received 6 weeks of iron infusions per my doctor's referral due to iron deficient anemia. Over the course of the treatments I was told that everything would be able to go into a payment plan without collection issues. During the summer of 2023 the issues of payment plans began. Each call to customer service I made a request to combine my bills and have a payment plan. The employees told me not to pay my bills, which then *** decided to look into that, and then refunded the bill, which was a random bill from earlier in the year. Once that was taken care of I asked for a payment plan with commerce as they have done for many years now. I made nearly 5 calls over the summer just to apply for this financial assistance they provide. Each time I called they took my information to "apply for commerce bank credit" and stated the previous representative never actually put in the application on my behalf. On one specific call the representative requested my social security number and it turns out they too never actually applied on my behalf for commerce either. A month later I get rejection letter from ******** and ********** for credit cards I myself never applied for. All I could think was SSM. So I called and explained it to them. They said they would look into it but gave me no help. About a month later my family members received letters about data breaches and stolen private info from the company SSM uses for billing. I believe that confirms their employee stole my info and they never helped me regardless. At this point I want them to wipe my bill clear and I'll never return to their facilities again.
Business Response
Date: 02/19/2024
This correspondence serves as SSM Healths response to Complaint # ********

SSM Health ***************** Serivces offers patients the option of an extended payment plan through our Health Serivces Financing (HSF) Program with ************** The Commerce (HSF) Line of Credit can only be used for balances at SSM Health. An account cannot be opened, and the funds sent to the patient or guarantor. There are safeguards in place due to no credit check. Commerce requires two forms of identification, the guarantor SSN and address for the last two years. It is standard process to ask the guarantor requesting the *** to verify these two forms of identification.

Information regarding the *********** breach was sent to every individual whose information was present in the impacted servers. If that individual believes they were potentially impacted, they are urged to call IDX at ************. Navvis or IDX will follow up with them after Navvis reviews the information to confirm if they were impacted. There is no connection between the data breach and the Commerce ***. The consumer is urged to contact ****** and discuss their concerns.

Thank you for allowing us the opportunity to respond to this complaint.

************** SSM Health ***************** Services
Initial Complaint
Date:01/22/2024
Type:Service or Repair 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.
Billing.
1- They are billing for visits before hearing back from insurance. This causes overpayments and other issues. The way they communicate these overpayments is not clear. I don’t even recall them communicating them in the first place. When I call billing for help, they are not even able to understand what I actually owe right now and where that number came from. I don’t know how I can figure out as a consumer what I owe if the hospital itself can’t tell me for sure because their billing system is so “messed up” (their words.

2- this is the worst part. The part that affects people’s credit! They “manufacture” statements from the past that never were sent out. For example, I checked my daughter’s account this morning online and it showed a zero dollar outstanding balance. I checked it this afternoon and I owed 7.48, which would be fine, except they showed this amount as past due since October. They also claim to have been sending statements since then requesting it. I get my statements emailed. I have no record of those. I was nearly sent to collections over this amount. I am certain her account was paid this morning, and then showed as 4 months past due hours later. This amount was also all messed up due to an overpayment because they insisted I owed a copay for a preventative visit (which was covered 100%). I paid it, insurance said I shouldn’t have, and they applied it toward another visit without letting me know so that I can track things. Even when it was all said and done, the person helping me admitted that the numbers don’t add up or make sense. Of course, I still had to pay that amount to avoid it affecting my credit, even though it doesn’t make sense.

I’ve requested paper copies of my bills for 2023 to try and sort things out. I doubt I will be able to as the employee helping me couldn’t make it “add up” either.
Business Response
Date: 02/06/2024
This correspondence serves as SSM Health's response to Complaint # ********.
The consumer states SSM Health is billing for services rendered prior to billing insurance. She states she is receiving statements via email not through the mail and has no record of these statements being sent. She also requested a summary of all payments made to SSM Health for the year 2023.
SSM Health sends paperless statements through My Chart, which is the default setting for billing. All My Chart user have the option to disable paperless billing and received paper statements. Notifications are sent via email and text according to the preferences chosen by the guarantor. Paperless billing is now disabled for the guarantor.
All statements include the date(s) of service, the provider of service, a description of the service (office visit, etc.), the charge(s) and the outstanding balance. Also included is the insurance payment (if applicable) and any patient payments received. This information is included so the guarantor can review and compare to the EOB from the insurance carrier. The visit can easily be referenced if information is needed prior to making a payment.
A statement with all previous years (2023) payments was mailed to the guarantor on 1/22/24 at her request.
Thank you for allowing us to respond to this complaint.
***** P. SSM Health Patient Financial Services
Initial Complaint
Date:01/21/2024
Type:Order Issues
Status:
ResolvedMore 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.
The monroe clinic SSM of ** continues to double bill people.. send accounts to collections BEFORE sending to the correct insurance.. and continues to make people pay on their account even though they havnt billed the correct insurance
Business Response
Date: 01/22/2024
This correspondence serves as SSM Healths response to the complaint.
The consumer does not specify a patient, date of service or specific service billed. We will need a more specific complaint before we are able to respond.
Thank you,
************** SSM Health ***************** Services
Customer Answer
Date: 02/08/2024
The business has resolved this issue for me.
Initial Complaint
Date:01/11/2024
Type:Product Issues
Status:
ResolvedMore 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.
September 2022 had gallbladder removed as outpatient at SSM health in ******. Pre paid my part of surgery bill my provider which was in network Aetna********* paid there part. SSM health was in dispute with *****. SSM health no longer take Aetna in there network as of December 2022. Everything was paid then in October 2023 I received a bill 13 months later for over 300 dollars. I prepaid before surgery like they ask and received a discount. I paid over 500 dollars for my part. Aetna ********* paid there's and they were still in network at that time. I did a 3 way call with my provider,SSM health,and I as soon I received bill. No explanation for bill change. Filed dispute with SSM health/ address given / their associate. They been communicating through SSM health my chart also . No resolve as how they send a bill 13 months later with no explanation. .
Business Response
Date: 01/15/2024
This correspondence serves as SSM Healths response to Complaint # ********.

The consumer states she pre-paid and received a discount for services, then received a statement thirteen months later with no explanation.

SSM Health offers patients an estimate of liability prior to service with the opportunity to receive a discount if the estimate is pre-paid.The estimate is based on the members benefits at time of service and is only an estimate. The actual patient responsibility is not known until the claim processes with the members insurance. In this instance, the estimated liability was less than the actual liability assigned by the insurance carrier and a statement billed to the patient. The balance billed constitutes a valid debt.

In a gesture of good customer relations, the remaining balance of $289.69 is waived due to the delay in sending a statement to the consumer in a timely manner.

Thank you for allowing us the opportunity to respond to this complaint.

************** SSM Health ***************** Services
Customer Answer
Date: 01/18/2024
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.
I also contacted SSM health via my chart and by phone to pay the bill after answers to questions after you contacted them and got an immediate response. Accepted there answers and apology for billing 13 months later. Clarify I want to pay bill in full after response through you.They will not take. Thanks so much for your help this has been very stressful.
Sincerely,

*********************
Initial Complaint
Date:01/04/2024
Type:Sales and Advertising 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.
We had a lab bill that was coded incorrectly and sent to our insurance for *ayment. Afterwards we were sent a bill requiring we *ay full amount. We contacted them after coding had been corrected by our *hysician and asked to have it resubmitted. The hos*ital billing wrote a letter saying it had been recoded and would be resubmitted and a*ologized for the billing error. We then found out it had been sent to collections. After re*eated calls they failed to resubmit it to our insurance com*any with corrected coding. Billing was again contacted and they reassured me it would be taken care of as our insurance covered 100% of labs for well visits. It again was never resubmitted to our insurance com*any as UMR had no claim received from SSM. The re*eated *hone calls are *laced on hold for long *eriods. It you request a call back, they do not call back. The billing at SSM Healthcare is extremely difficult to reach or get any billing issues resolved as they fail to answer, res*ond, or com*lete their jobs when called.
Business Response
Date: 01/04/2024
<*>This corres*ondence serves as SSM Health's res*onse to com*laint # ********.&nbs*;<*>SSM Health acknowledges a revision to the coding was com*leted but no corrected claim was ever filed to the *atient's insurance carrier for reconsideration and reimbursement. Due to the age of the account, it is likely a claim filed at this time would be denied. A onetime courtesy adjustment will be *osted to the account and a review for *atient refund will be com*leted. Refunds are *rocessed only after all outstanding account balances are satisfied.&nbs*;<*>We a*ologize for the inconvenience this has caused. Thank you for allowing the o**ortunity to address this com*laint.&nbs*;<*>***** *. SSM Health *atient Financial Services
Customer Answer
Date: 01/04/2024
Com*laint: ********

I am rejecting this res*onse because: We will wait for the determination by the insurance com*any. If too much time has la*sed we want full credit for this amount. We continually contacted SSM Health billing and they failed to submit the claim to our insurance com*any as asked. We were continually told they would take care of it along with letter stating that they would do so. We want our account credited for the total amount of 776.05, which is the balance of the claim they failed to remit to our insurance. Our insurance would have *aid it at 100% if they had done their job res*onsibly.

Sincerely,

***** ********
Business Response
Date: 01/05/2024
<*>Second Res*onse from SSH Health -<*>The consumer has been refunded the full amount of their *ayment ($776.05 *osted 1/5/2024 back to the credit card used for original *ayment) as requested and would never receive a refund for more than that amount.&nbs*;<*>***** *.&nbs*; SSM Health *atient Financial Services
Customer Answer
Date: 01/05/2024
Com*laint: ********

I am rejecting this res*onse because: I was wanting the refund credited to ****** ******** SSM Health My Chart account, not our credit card. I would *refer to have it show on the *atient Don ********’s St. Mary’s Hos*ital account, thereby having a record of credit being a**lied. Can this be done?&nbs*;

Sincerely,

***** ********
Initial Complaint
Date:12/28/2023
Type:Service or Repair 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.
This is a repeating problem that has happened 3 times in the last year and after this last time I refuse 2 go here. I called the VA in Madison because I am a disabled army veteran, to talk to a nurse because I hurt my back. The nurse told me 2 go 2 the ER at SSM. They treated me in a few seconds and with a dismissive attitude. Again I got a vibe that this was because we are a mixed race couple and my husband who is a disabled army veteran 2 was with me. They then sent my prescription 2 a place that was closed so we called and asked where else it could be sent and they said all the CVS pharmacies closed at 7pm. They sent it 2 another pharmacy and we drove 2 that place and in the parking lot I called the VA 2 see if this pharmacy could be covered. While my husband saw a CVS across the street and looked it up and found out it closes at 8pm so he called SSM back. The 1st lady told him they couldn't transfer it again or it would be blocked the 2nd lady told him they wouldn't be able 2 fill it in the half hour remaining. The VA wouldn't cover the place it was sent at Walgreens so we drove 45 minutes to the Madison VA 2 be seen in the ER again so that I could have my medications...pain and muscle relaxers 2 make it thru the nite...the staff at SSM were rude, dismissive and did not seem to care...they said I could come back again 2 their ER when the medications they gave me wore off throughout the nite but otherwise couldn't help me! As I said this same thing happened 2 other times with getting medications...the time before the doctor kept putting in the incorrect prescriptions!...and it took 1 week to get the medications!...I called 2 make a complaint and the head nurse pretty much said that none of what we said was accurate and they did nothing wrong!..how does a person get a prescription in the middle of the nite if all the pharmacies are closed? They should have an all nite after hours pharmacy like the VA hospital does! And I was treated like I didn't matter!!
Business Response
Date: 01/03/2024
Thank you for providing
SSM Health St. Mary’s Hospital – Janesville with the concerns you received
regarding our organization. SSM Health takes all customer concerns very
seriously. Upon receipt of this notification, we began to review all
aspects of the concern and followed-up on any potential opportunities for
improvement necessary as part of our complaint and grievance process. We
have worked to resolve the concerns with the customer directly but are unable
to share any details with the BBB regarding our review and response due to
patient privacy laws.
Initial Complaint
Date:12/19/2023
Type:Service or Repair 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.
Paid hospital directly to get out of collections because they would not give us the correct UB04 form to submit to medishare. Then once medishare did pay on 10/9/2023 for the hospital visit on 3/27/2023 for the birth of our son they are refusing to refund overpayment at all and will not discuss it. The billing department continues to avoid answering any questions on the matter and will not give us any details. We have contacted no fewer than 10 times to try and resolve this with no resolve.
Business Response
Date: 01/02/2024
This correspondence serves as SSM Health's response to Complaint # ********.

SSM Health acknowledges the account was sent up with the incorrect insurance plan at registration. SSM Health did received payment from the in-network insurance carrier and from the consumer.
SSM Health apologizes for the inconvenience this has caused.

A refund of the consumer payment, less the amount assigned as patient liability by insurance has been refunded as of 12/22/23. Please allow 10-14 days for this refund to process and mail.
Thank you for allowing us the opportunity to respond to this complaint.

***** P. SSM Health Patient Financial Services
Initial Complaint
Date:12/19/2023
Type:Service or Repair Issues
Status:
ResolvedMore 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.
********* SSM health Group is giving the ******** Wellness Visit more than once a year and the rules are, you are allowed a Wellness Visit once a year. In my case they gave me the Wellness Visit six months apart and my insurance paid for the first visit but refused to pay for the second visit. Now SSM is threating me with a collection agency to collect on this second visit which is out of the guidelines of the Wellness Visit Program. They claim I owe them $272.00 and I'm appealing to you to look into this complaint. This sounds like another scam going down..
Business Response
Date: 01/02/2024
This correspondence serves as SSM Healt's response to Complaint # ********.
SSM Health has reviewed the complaint and acknowledges the ******** Annual Wellness exam was scheduled outside the guidelines for a wellness exam. A courtesy adjustment of $272.00 has been posted to the account and the consumer will no longer be held responsible for this amount.
Thank you for allowing us the opportunity to respond to this complaint.
************** SSM Health ***************** Services
Customer Answer
Date: 01/02/2024
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.
I have been told this before and they said they are turning me over to a collection agency. I would like to be sent a letter saying that I am free and clear of this debt. I would like clarification that they are going to do this.

Sincerely,

***************************
Initial Complaint
Date:12/14/2023
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.
To whom it may concern,
On 8/19/2023 I went to SSM Health Urgent Care at **** ****** ****, ** *******, ** 63304. For clarity, this location is a medical health building and NOT a hos*ital.
It was a Saturday and I thought I needed a *rescri*tion for an antibiotic. I received the *rescri*tion.
My benefit with ***** Medicare Advantage is that I *ay a $35 co*ay for an urgent care visit. I *aid that 8/19/2023 at the Urgent Care office.
SSM billed the visit to ***** Medicace Advantage under two codes: Code ***** - "Hos*ital out*atient clinic visit" for $183 and Code 99213 - "Office out*atient visit" for $160. (based on my call to *****)
SSM sent me a statement on 8/30/2023 stating:
Emergency Room – Urgent Care $183
*rofessional Fees – General Classification $160
*lease note that this is the source of my *roblem. It is obvious that SSM is either unknowingly or deliberately miscoding an urgent care visit to receive **nies in excess of agreements between the insured, the insurer and SSM!
***** adjusted the $183 to $116.07 and said I owe this because SSM coded it “Hos*ital out*atient clinic visit” inter*reting it as Emergency Room visit, as SSM wrongly described it on my bill. But it was NOT an emergency room visit! SSM credited my $35 office co*ay and then billed me the difference of $81.07 (less 10% for *rom*t *ayment). ***** ex*lained that I had no benefit for “hos*ital out*atient” services.
***** adjusted the $160 to $55.43 and *aid that to SSM.
The bottom line is that I should only owe $35 for a visit to urgent care. SSM is coding this wrongly, leading the insurance com*any to wrongly understand the nature of the services rendered, and thus wrongly inflating revenues, or wrongly creating **re cost to the *atient.
I have discovered on a neighborhood internet site that many others have com*lained about this very same *roblem.
Business Response
Date: 12/21/2023
<*>This corres*ondence serves as SSM Health's res*onse to Com*laint # ********.&nbs*;<*>SSM Health Urgent Care located on ****** **** o*erates as an out*atient de*artment of SSM Health St. Jose*h Hos*ital. The Urgent Care bills a technical com*onent (facility) and a *rofessional com*onent (*rovider) for services at this location. Hos*ital services are billed using universal billing codes that indicate to the insurance carrier where the services are *rovided. Revenue Code 0456 indicates an Urgent Care location. Revenue Code indicate the *rofessional com*onent.

The charges are correctly coded and billed for location and services *rovided. Any questions regarding the members benefits should be directed to the insurance carrier.<*>Thank you for allowing us the o**ortunity to res*ond to this com*laint.&nbs*;<*>***** *. SSM Health *atient Financial Serivces&nbs*;

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