Complaints

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:07/15/2025

  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 reached out to this office via email with serious concerns, hoping for a written response for documentation purposes. Despite multiple requests, they continued calling and leaving voicemails instead. Under HIPAA, patients have the right to request communications in their preferred format. This office disregarded that right, which I found disrespectful and unprofessional.For accountability, Ive reported my concerns to my insurance provider, the ***********************************************, the ********************/Nursing, and the Department of Health.I ultimately transferred my care due to the following:1.Billing Practices:Patients are forced to enroll in autopay and keep a card on fileeven with in-network insurance. I wasnt informed until I was at my appointment. They also charged my card without providing an itemized bill, despite my request. I was told to call and ask, but thats impractical if youre charged before you can inquire. Theres no notice or amount given ahead of time. I was also charged for procedures I wasnt informed oflike a vascular duplex scanwhich was not explained, consented to, or appropriate for checking fetal viability at 7 weeks pregnant.2.Inaccurate Medical Documentation:My chart falsely states I reported vaginal bleeding. I did not. As an Rh-negative patient, this would have required Rhogamwhich was never offered. This inaccuracy raises concerns about either negligence or falsification.3.Improper Billing CPT Code 93976:They billed for a limited vascular duplex scan I never consented to or received. No spectral Doppler, velocity measurements, or diagnostic criteria were met. The study was not documented in the chart, nor were results reviewed with me. My fetal viability ultrasound was performed transvaginally, which further shows no vascular duplex scan was performed as they would have done at least part of it abdominally. This appears to be an unsupported charge.

  Business Response

  Date: 07/17/2025

  The patient and her spouse reached out to the office multiple times through email. The emails addressed multiple concerns both clinical and financial related. We called and left a message on the patientsvoicemail asking if we could address her concerns either in person or over the phone.  We would be happy to schedule a time that was convenient for her.  After her concerns were discussed we would document the conversation so we both would have it in writing for documentation purposes. The next response received was that she was reporting her concerns to her insurance, the *********************************************** and the ****************************.
  1.Billing Practices:
  Our Obstetrical Payment Policy is that we require a credit, debit, FSA or HSA card to be kept securely on file to process any patient responsibility balances after the health insurance has processed the claim. The account is set up for autopay, balances up to $500 automatically process using the card on file. We only charge the card after the insurance has processed the claims to patient responsibility.
  As an in-network participating provider with this patients insurance we are under no obligation to send an itemized statement prior to collecting payment. Any balance due to co-pay,co-insurance or deductible amount may be collected at time of service or when the claims process to the patients responsibility.  Explanation of benefits from insurances give an explanation of how claims are processed and their responsibility for payment.
  2. Inaccurate Medical Documentation:
  A template was used with chief complaints for her visit.  The chief complaint in dispute, while written in the office note, was not billed or part of the decision-making process or her care received.  Subsequently the complaint in question has been removed from the chief complaint section.  
  3. Improper Billing CPT Code 93976
  The medical chart is documented:
  The appropriate codes were billed for the services the patient received. The limited color doppler is commonly used in OB/GYN ultrasound when a mass is seen. The patient is not consulted when done because it is part of the exam and although billed with a separate CPT code is very much an integral step in reaching the correct diagnosis to ensure the best outcome for the patient.   All the appropriate measurements and criteria was met to bill the insurance this CPT code.
  

  Customer Answer

  Date: 07/17/2025

   
  Complaint: 23599427
  
  I do not accept the business's response as a resolution to my complaint because: [You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]
  
  Sincerely,
  
  ****** ***********

  Customer Answer

  Date: 07/17/2025

  I didnt realize I was able to type a response. Here is my response:

   

  Thank you for the response. Unfortunately, this reply does not resolve my concerns and actually confirms several of the issues I raised.

  1. My communication preferences were ignored. I asked them for a written response and explanation and was denied. 
  

  2. Yes there was false info in my medical record which they then DELETED instead of creating an addendum that is time stamped- this is against HIPAA 

  3. Yes they actually are required to give itemized statements to patients per law. I am shook that they are continuing to deny that that law doesnt exist despite my citing it officially. 
  

  4. They are actually wrong regarding the billing. The use of color Doppler DOES NOT allow for billing of a ***** Vascular Duplex Scan. Im unsure why they are continuing to defend this - I can literally show the rules from the *** and the billing code regulation agencies that in order to bill for a vascular duplex scan, SPECTRAL DOPPLER MUST BE USED- not just color Doppler. In addition, there needs to be an interpretation of such a study from the provider that addresses waveform and velocity measurements. 
  

  Im not sure if this is ignorance to the law and the regulations, or if they think that saying wrong stuff over and over will suddenly make it true. 

  
  
  

  Customer Answer

  Date: 07/17/2025

  I would like to revise my requests from the business:

  MOA-
  
  
  Thank you for writing out your explanation of the vascular duplex scan on the BBB website. 
  
  
  I now understand your offices position that you believe use of color Doppler to verify fetal cardiac activity or to see if a structure is vascular counts as license to bill for a duplex vascular study. Unfortunately this is conflicting with the information I found from the American Medical Associations CPT Manual, the **** the **** the ***** and the SMFM. 
  
  
  As you mentioned that there is proper documentation for this scan to be billed, can you please send me (by email if Im able to approve that here, or postal mail is fine too):
  
  
  The B-mode imaging + spectral Doppler results, ie: 
  
  
  Velocity measurements
  Waveform tracings
  Directional flow assessment
  
  
  As well as the clinical interpretation of blood flow and vessels and the documented medical necessity/reason for performing the vascular duplex scan- or refer me to the area in my medical record in MyChart that explains this as maybe Im missing it. 
  
  
  As for the itemized bill thing-
  
  
  Providers are legally required to provide an itemized bill upon a patients request, within 30 days, under the ***** Right of Access. This requirement applies regardless of insurance network status its a patient right, not a contractual detail.
  
  
  Requiring a credit card on file is permitted, but charging a patient without giving them the opportunity to review an itemized bill, especially after theyve explicitly requested one, raises concerns under both state consumer protection laws and *** regulations, which prohibit unfair and deceptive billing practices.
  
  
  Im not sure who I am speaking with regarding these issues but they seem to be lacking the proper knowledge about the legalities. 
  
  
  In any case, I look forward to receiving the results from the vascular duplex scan. 
  
  
  ****** ***********
  

  Business Response

  Date: 07/23/2025

  We have properly documented and billed your insurance with the correct CPT codes.  The images and report reflect all the proper information.  A request for medical records and ultrasound images can be made at our website. 
  
  As an in-network participating provider with your insurance we are under no obligation to send an itemized statement prior to collecting payment.  Any balance due to co-pay, co-insurance or deductible amount may be collected at the time of service or when the claims process to the patents responsibility.  We process all requests for an itemization of a bill upon request.  We follow HIPAA guidelines.
  
  We disclosed our obstetrical payment policy on our obstetrical pamphlet that you received prior to your appointment, and it was discussed with you in person.   We reviewed how outstanding patient balances will be processed to your credit card on file after the insurance has processed your claim to patient responsibility. You have access to review that itemization several ways; your explanation of benefits from your health insurance company, on-line bill statement, or you can request a copy of that itemization from our office.  You agreed to our payment policy and gave our office a credit card to put securely on file.  If you did not agree with our payment policy,you could have decided to receive care at another medical office. 
  

  Customer Answer

  Date: 07/24/2025

   
  Complaint: 23599427
  
  I do not accept the business's response as a resolution to my complaint because: 

  Im going to set aside the issue of the itemized bill for now, as it doesnt seem to be productive to focus on that aspect at this point. However- saying get care somewhere else if you dont like our policies is really stupid to say given the situation. Why? Well, I went for this ultrasound on May 27th BEFORE agreeing to those policies, maam. When I walked in on May 27th I signed NOTHING regarding any policies. In question is a visit from 5/27. I was not notified of these policies on May 27th, so when I walked in for the appointment I had absolutely no idea what I was getting myself into. None of this info was presented to me until a full month later, at my next visit on 6/30. So moot point lol. Once the policies were told to me, I finished the appointments I already had on the books because at that point I was already 12 weeks and about to get an ultrasound, and then I changed providers.
  

  In effort to perform continuity of care, providers must give prenatal patients 30 days to find a new provider. Since, I have found a new office that does NOT have these policies. 
  
  Anyways- What is being said on BBB is very different than what is being said via email. Theyre presenting things in a very different way here. Via email, they admitted that the only proof they have is of color Doppler images. As Ive said numerous times, spectral Doppler is needed for a *****. Color Doppler usage alone is already included in the other scan I was billed for- CPT code *****, which Im not disputing.
  

  A vascular duplex study, or *****, is for examining the vascular supply of the organs, not just noting the presence of blood flow. In their email to me, they blatantly confirmed that they were confirming blood flow to the corpus luteum and because of that, they charged for a *****. 
  

  So they can say whatever they want but my complaints have already passed legal review with the **** and is being investigated by the **** fraud team, after I had a full interview showing all the facts and faxing every email, medical record, etc. They would NOT waste their time doing all these investigations after the interview and after my presenting my proof, if they didnt think it was worth it. 
  

  This office keeps saying they can send all the records - forgetting I ALREADY HAVE THEM! Its all online- I have everything. Every clinic note and every ultrasound report. The only thing I dont have, PER THEIR OWN EMAIL, are the COLOR DOPPLER IMAGES. Those color Doppler images are NOT RELEVANT TO THIS ISSUE. 

  I can keep saying this until Im blue in the face. Ive sent them all the rules from the *** and the ****- all the regulatory agencies - and they still refuse to admit that this is incorrect billing. They skid right past the facts I present and never directly address them. Classic! 
  

  No worries. Eventually the proper agencies will give them a slap on the wrist and my insurance company with ask for a clawback. Just takes some time. 
  

  I tried really hard to present the facts professionally and transparently and all Ive gotten in return is evasion and zero direct responses to what Ive presented. Theyre backed against a wall lol and its funny to watch them squirm.

  Good luck!! 

  Sincerely,
  
  ****** ***********

  Customer Answer

  Date: 07/24/2025

  Just to re-cap:

  
  
  1. I did not consent to and was not informed about the payment/autopay policies at the time of the May 27th visit in question. 
  
  2. The policies were introduced much later, on June 30th, so applying them retroactively to the May 27th visit is not applicable.

  
  3. I honored my existing appointments after being informed of these policies, showing good faith AND responsibility to the health of my pregnancy/baby.

  
  4. I then chose to change providers once I was made aware of such policies. 
  

  5. The charge for the ***** is unfounded based on the provider offices own admission that it was charged because of color Doppler use on the corpus luteum.
  

  6. To charge for a ***** more than that must be done- you need to also use spectral Doppler, you must have provider interpretation of the study, you must have the actual waveform and velocity measurements.

  7. I asked for proof of the spectral Doppler usage, I asked for the waveform measurements, I asked for the velocity measurements, and I asked for the providers interpretation of the study. Their response was that they have the color Doppler images. Thats it. Color Doppler images are not sufficient enough to charge for a *****. Period. 
  

  Side Note: Health offices are required under both state and federal law to provider an itemized bill within 30 days of a patient requesting one:

  Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule requires covered entities to provide patients access to their medical records and billing information upon request. While HIPAA doesnt specify a strict timeline for itemized bills, it mandates timely access to health information and accounting of disclosures (45 CFR 164.524).
  
  
  State Law (*************):
  In ************* (where we are), the ************* Administrative Rules, He-P ******* (b) states that health care providers must provide patients with a written itemized bill within 30 days of a request.

  - Sophia 

   

   

   

  Customer Answer

  Date: 07/24/2025

  Apologies, I misquoted the ** law pertaining to itemized bills. 
  

  Heres the law:

  New Hampshire Revised Statutes ?151:12-a Itemized Bills
  
  Any provider of medical services who is to receive payment from a third party shall provide the person receiving such services with an itemized statement within 30 days of such service. The statement shall contain a list of services rendered, the dates on which such services were rendered and the costs of those services  

   

  So Im genuinely confused as to their stance that they dont have to follow this law. Unless they can prove that they are exempt, I have to insist that this is a law that applies to their facility. 

  Customer Answer

  Date: 07/24/2025

  
  The charge in question is called a vascular duplex scan: 
  
  Duplex = Two components:
  
  Color Doppler visualizes blood flow direction and presence (color overlay on the grayscale image).
  
  Spectral Doppler measures and displays velocity waveforms over time (shows how fast and in what pattern blood is flowing).
  
  Duplex = dual modes:
  Its not just turning on a Doppler setting it must include both color flow AND spectral waveforms to qualify as a true duplex Doppler study under CPT *****, according to the ****************************, who actually comes up with all these CPT codes and what is required for each. 
  

  Without both, and without documentation of measured velocities and interpreted flow patterns, billing ***** is incorrect and constitutes upcoding. 
  
  There are rules and standards when it comes to medical billing. This office seems to think theyre not only exempt from state law, but also *** regulations. 
  

  _________________

  I was told via email that they only have the color doppler images as attached in my other message above. 
  

  I asked specifically for the spectral doppler measurements, which are not photos. It would be actual numerical data that should be in the ultrasound report. They entirely ignored me. They didnt address this request at all. 
  

  They continue to say on the BBB that they have all the necessary documentation. And we can send it to you. Then when I ask for it crickets. They just come back with we can send the color doppler images and I keep saying- those arent relevant but thanks..please send the waveform and velocity measurements. Then they came back with the color doppler images need to be downloaded into a disc blah blah.. and again, totally skip over the other things I asked for. 
  

  its so confusing why they wont just admit they coded this wrong and move on.