ComplaintsforOrthoCarolina

• Initial Complaint

  06/12/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Dates of transactions were 3/20/24-4/12/24 and 4/24/24. Every time I went to the doctor, the receptionist stated todays visit will be $250. I would pay $250 for each visit. Which should of cleared each visit. I noticed they started debiting my debit card recently. I found out that my office visit actual price was $225 on 3/20and $194 on 4/12 and $130 on 4/24.My insurance paid for office visit on 3/20/24. They claimed my visit on 4/12 only $30 was applied to him. But I paid $250 for that specific visit as directed by the receptionist. Nothing was applied to my doctor on 4/24. So why are they telling patients each visit is $250 and not applying it to that specific doctor. Why tell the patient the bill is more than what it actually is.They do whatever they want to do with your money without telling the patient what they did with your money and still send you a bill. That should be illegal. Unorthodox customer service.They even broke my ribs while I was in the hospital and would not admit it. I had to go to urgent care for help. I shouldve sued them. They charged me for that too. Ortho Carolina is the worst and a rip off. They need to place my money specifically on the date of service I paid for. What is left over is up to me where it goes to.

  Business response

  06/14/2024

  The account support manager reviewed ******************** billing concerns with the patient.  **************** is a self-pay patient and OrthoCarolina's policy is to collect $250.00 at every office visit.  The patient is billed for the outstanding balance. If the balance is less than $250.00, the payment is applied to any outstanding charges. The charges on her account were correctly billed. 

  **************** should call the *************** at ************.  

   

• Initial Complaint

  05/20/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I visited Orthocarolina at the ***************** location and got a cortisone shot in my foot. I was billed $200 as they filed it as an "Office Surgery." My out of pocket is $70 and the medicine itself is $7. I was then billed another $70 for an office visit. This place is a ripoff and does not truly care about patients

  Business response

  06/07/2024

  Thank you for sharing ***************************** concerns with me.  I reviewed the charges from the patients bill from the date of service, 4/18/2024.    ************ had not met her deductible and she was billed $83.33.  ************ was billed for an office charge, injection, and the injection drug.  The fee for the injection was for the provider to place the injection in the correct tendon location.  The patient was treated for left plantar fasciitis and consented to an injection in her left heel.  

   

  If ************ has additional concerns, she may reach out to the *************** at ************.  OrthoCarolina is closing the BBB review for ************.

   

  Thank you,

   

  *********************, CPC

  Privacy Manager

  ************** (Phone)

• Initial Complaint

  01/25/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  In Fall 2021 my son was seen by OrthoCarolina in ***********. At the time of service I submitted both insurance cards reflecting my son has two insurances (one primary and the other a secondary). In 2023, I was contacted stating I had to pay for the full visit of 2021 due to the fact that only one insurance was billed and that insurance company finally denied due to the factor the secondary was not billed. Never once over the course of two years was I contacted and OrthoCarolina admitted they did not contact me until 2023. I was told also by OrthoCarolina billing office that the time frame to dispute or rebill has passed and I now have to pay the bill in full. The bill is now with the collection company. My son has been seen numerous times prior to the 2021 visit and after in which both insurances were billed. Now they are declining in seeing him demanding I pay the bill in full. OrthoCarolina clearly made a mistake and want me to pay for their mistake.

  Customer response

  01/25/2024

  My son name is *******************************. Guarantor number/account number: *********    Amount $460

  I have spoken to many representatives in the billing office of OrthoCarolina. I even spoken to managers and everyone has told me the same thing which is even though my son has two insurances I have to pay the bill for 2021. There are numerous notes on his account with ********************** that can validate my claim.

  Business response

  01/29/2024

  DOS 08/06/21- The account support manager spoke with ******** explained she never presented the Tricare card (primary insurance card) at the visit.  The manager explained that ******** did not present the Tricare or ******** card at her son's visit. The OrthoCarolina *************** verified eligibility.  ******** paid the visit in 2021 and then recouped the funds in 2023. The account support manager suggested the charges from 8/6/2021 be changed to the self-pay rate, reducing the billing balance from $460.00 to $319.00.  ******** to setup a payment plan with the new balance of $319.00.

  The insurance information was corrected in the patient's account for the 1/25/2024 office visit.  The Tricare and ******** insurance information were updated to the patient's account.  

   

   

   

  Customer response

  01/31/2024

   
  I am rejecting this response because I spoke to *********************** of OrthoCarolina on January 26, **** and my exact response to **************** is that on the date of service which is in question I personally gave the check in PSC my son's military ID card showing he has Tricare and his Healthy ************* card. The factor which she states they were not scanned in I have no control of the check in person scanning in the cards. However, I know I personally handed the PSC/Check in person both items and explained Tricare needed to be billed first then Healthy Blue. During the conversation, **************** stated on my son's visit and previous visit on different dates his insurance for Tricare and ******** has been pulled and verified which means Orthocarolina has and is aware my son has two insurances. On the phone call also with **************** I sent to her direct email another copy of my son's military ID card. Therefore, her dispute stating  "******** did not present the Tricare or ******** card at her son's visit" is false. I would like the cameras in the waiting room and above check in to be pulled if that is in question from that date. And I will not set up payment arrangements due to the fact that per this phone call and previous calls with OrthoCarolina billing office representatives and managers have all stated eligibility was pulled and verified which means OrthoCarolina is aware and has always been aware he has two insurances. Even previous visits and current visits both insurances were billed and has paid. Therefore, 8/6/2021, both insurances should have and needs to be billed!
  
  

  Business response

  02/02/2024

  This is a final review from OrthoCarolina!  

  The patient's mother did not present the insurance cards at the appointment.  ******** denied the charges in 2021.  The charges from 2021 are not billable to the insurance carrier because they are past the timely filing deadline. 

  The charges from 2021 were changed to a self-pay rate to the lower the fees.  A payment plan may be set up with no interest for up to 12 months. The patient is responsible for the outstanding balance. 

   

   

   

• Initial Complaint

  07/03/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I am disputing $194 for a virtual appointment on May 18, 2020. I initially disputed this bill with Orthocarolina and was told several times they were looking into it. Shortly thereafter, I got letters and calls from a collection agency. I again disputed the charge (see my attached email). I never heard back after that email was sent.I then called earlier this year to make an appointment with a different doctor at Orthocarolina. I was told I could not make an appointment till I paid my outstanding bill...a ********** had assumed had been written off.I would like my balance to be zeroed out so that in the future I am able to go to Orthocarolina to see other doctors.

  Business response

  07/05/2023

  The billing supervisor reached out to ************** and reviewed the billing charges from 5/18/2020.  The billing charges were paid from 5/18/2020 but the charges were not paid for date of service 4/8/2020.  ************** is responsible for the office charges from 4/8/2020. She was offered the opportunity to pay her bill, but she declined. 

   

• Initial Complaint

  06/13/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had hand surgery back in November of 2021 with OrthoCarolina. My surgery costs reached the limit of my insurance's out of pocket maximum. However, every time I went in for physical therapy, Ortho carolina still charged me a $60 co-pay. The visits were paid in full by my insurance, so Ortho Carolina double dipped and they owe me $360.When I called the billing department, they claimed my copay was being applied to a pending charge which my insurance was disputing. I logged into my account recently and it seems that dispute was resolved, but Ortho Carolina has not reimbursed me for my co-payments.

  Business response

  06/19/2023

  The patient was contacted by the OrthoCarolina and advised to speak directly with *****, the Account Support Manager. Her contact number is ************.  

• Initial Complaint

  05/01/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Orthocarolina has billed numerous times for therapy procedures which were not done on particular visits. (1st occurrence was last November). After many calls and messages via their portal as well as changes documented by the actual therapist which treated me to verify the info I have given, there are still remaining discrepancies in my bills for the attached insurance EOB's. I have sent 5 messages regarding these and they will not respond as requested. They forced me to pay an incorrect charge back in March before allowing a treatment visit. Their attitude @ the Park rd. location is demeaning to patients and give incorrect info as they do not understand the issue. Their failure to send proper paperwork to my insurance company resulted in delay in treatment as well as billing inaccuracies. They also have posted some of my payments made to wrong treatment dates despite my specific request as to which date the payment is for. I have included just the recent dates which have wrong amounts but have numerous other ***** of messages sent...

  Business response

  05/05/2023

  ****************** billing concerns have been thoroughly investigated by the Account Support Manager of OrthoCarolina multiple times.  The manager has made compromises with his physical therapy charges and submitted corrective claims to the insurance company.  ****************** charges are correctly billed, and any additional questions may be directed to *****, the manager, at ************. 

  Customer response

  05/08/2023

   
  I am rejecting this response because:
    I requested ***** the billing manager to call me last week, waiting for a response. Orthocarolina has still not corrected some of their inaccurate bills to my insurance company from last Feb. They continue to make errors.... Just las week, payments I made on April 26th for specific service dates were applied to some of the wrong dates without my permission. This has occurred 4 times. I messaged them via my patient portal twice about this. Waiting for response and corrections.....

  Business response

  05/10/2023

  The account support manager has reviewed the patient's account and the requested dates of service.  The patient's balance was reviewed and corrected.  The account support manager is closing the review of the patient's complaints. 

   

   

  Customer response

  05/14/2023

   
  I am rejecting this response because:

   

  Better Business Bureau:
  
  Orthocarolina continues to apply payment I made designated for a specific visit to the wrong date of service. I have wasted more time sending another detailed message to billing via my patient portal and left a  voice mail for the account manager.

  Once they take the time to insure this correction is made, I will end complaint.

  
  

  Business response

  05/18/2023

  Please reach out directly to ***** during business hours from 8:00 to 5:00, Monday through Friday. This case has been closed by OrthoCarolina. 

   

• Initial Complaint

  04/27/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Im being refused medical treatment because of a dispute that I filed with the BBB and Orthcarolina 2 years ago on a Dr. ****** and his staff. I refused to pay fees because of unjustified treatment and now my doctor is sending me to them for physical therapy and ** denied due to bad debt. When talking to ***** in billing she claims I owe $107.24 and then said $35 for physical therapy and a $60 charge. Party was very rude and condescending and only amount I owe is $107.24. I received an apology from Dr. ****** on behalf of his staff but did not want to continue treatment with him and was referred to another surgeon for my knee replacement surgery in 2022. I left a message by voicemail for *********************** office manager for accounting but no response.

  Business response

  04/28/2023

  The account support manager of OrthoCarolina spoke with ******************** and explained she has a legacy balance of $110.00 for a June MRI during 2021. Additionally, there is a current balance of $107.24 that is due.  ******************** does not want to pay the balance at this time. 

• Initial Complaint

  12/05/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I have attached all emails received ****** 18th, the day the issue was resolved. We remade a payment plan with autopay with OrthoCarolina. I made the payments for the month of November over the phone after we set up the plan. My card was charged. I was told the next payment would be December 18th, and it would be higher. I was told it would withdraw from the card we attached. My HSA card attached has more than enough money to cover the monthly costs. I received a random email that my payment plan was canceled and sent to collections. I received no warning and no explanation. I received no real explanation through their portal. I attached the following proof. I also called the number and received no response on what they would do. They said they would call back. I never received a call. I made this months payment with them, so theres no reason it should be thrown to collections. Whatever error they ran across is on them, not the paying patient.

  Business response

  12/06/2022

  ******************** account concerns were reviewed and addressed by the business office manager.  Her account was corrected and is no longer in collections.  **************** notified that a clerical error was made on her account, and it has been corrected. 

  Customer response

  12/06/2022

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

• Initial Complaint

  11/08/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I was given injection to wrong area for the pain although I was clearly pointing to the place where the acute pain was happening the sad part is - I mention this during followup visit and doctor dicussed with me what went wrong and other details but the wierd thing is there is no mention of this on doctors note I didn't want to pay the bills until this sorted out , subsequently I opened a claim on thier portal and thier billing **** said sending for review I recived no answer and what so ever despite many followup's from my side and now I see they sent this bill to the collections which is unethical and unprofessional I believe (attached screenshot of proof that I have been waiting long time for thier answer)also another thing , I have been going through physiotherapy sessions and all of a sudden my appointments got cancelled without any information to me even before cancel or after the cancel which kept in dark and my scheduled time off from work got impacted severly .

  Business response

  11/14/2022

  Our OrthoCarolina provider previously responded to the patient's concern through the patient portal and informed him that the spinal injection was given in the correct location. The patient's spinal injection was given in his spinal protrusion in the L5-S1 location.   The patient's MRI on 2/5/2022 also confirmed the spinal protrusion in the L5-S1 area.  The patient was unable to schedule an appointment with our provider due to the balance on his account. The patient was informed that our policy states that balances must be paid prior to scheduling additional appointments. 

   

   

• Initial Complaint

  11/08/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Date of Service: 8/9/2022 Issue: Orthocarolina and its billing staff are negligent in its failure to provide Aetna the requested modifiers and quantities for Aetna claim # ERWZ14TJ1. Aetna Reference # ************. Patient Name: ************************* (dob: 01/18/2005) had ACL surgery on 8/9/2022 with **************************. A *** machine was issued on 8/9 and returned on 8/23. Orthocarolina has been requested NUMEROUS times by both AETNA and by me, as the patients father and guarantor, to supply the necessary CPT codes, modifiers, dates of use, and per diem rates to AETNA so that the claim can be processed. However, they have not sent the info to AETNA.Per my last conversation with "Armani" in billing, this should have been done over 2 weeks ago, but it has still not been submitted to AETNA. OrthoCarolina, continues to show an outstanding balance of $720 for the *** machine use and is willfully negligent as it is aware of its own error, yet is still trying to collect the $720 from me as the guarntor. AETNA INSTRUCTED ME NOT TO PAY THE CLAIM as they have not received the requested information from Orthocarolina.If this matter cannot be resolved, I will contact our family attorney to file suit and seek treble damages in tort as well as punitive damages. The amount of billing disputes on the BBB website alone will serve as fantastic evidence to prove the ongoing negligent behavior of the Orthocarolina billing department.**********, upon numerous DOCUMENTED requests to speak with a supervisor, my requests are repeatedly denied claiming that they are "in a meeting." Perhaps they will rethink this tactic when they have to explain to ********************** and the *** as to why they are being named as DEFENDANTS in a billing lawsuit due to the willfull negligence of the billing staff and supervisors.Resolution sought: Orthocarolina shall immediatley submit to AETNA the requested modifiers, and units, and cost; OR THEY WRITE OFF THE AMOUNT OF $720 from my account.

  Business response

  11/11/2022

  The patient's father was contacted, and an apology was given for the difficulty that he experienced with the OrthoCarolina business office.  The claim for 8/9/2022 has been corrected and resent to Aetna with the correct policy number.  The privacy manager will reach out to the patient's father in one week for follow up on this account.  

*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. ↩