ComplaintsforClackamas Pediatric Clinic

• Initial Complaint

  11/03/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  8/3/2023 I received a phone call from the provider and was not notified that I would be charged for it. I did not request the phone call nor make an appointment for the phone call. I contacted behavioral health administration to dispute the charge and the administrator named *****, who did not give her last name, denied my request. I should not be charged for a service that I did not request. ******* phone number is *********************. Clackamas Pediatrics submitted a charge of $180 to my health insurance and they notified me that I am responsible for $104. This is an abuse of medical billing. I want the charge removed.

  Business response

  11/14/2023

  We have completed a review of the complaint filed.  We reviewed the documentation associated with the bill.  Due to our practice model of being an integrated medical home, we can offer behavioral health services in addition to medical services. This allows us to help those who need additional support without having to send them for care outside our offices, which can be delayed due to wait times.

  
  The outreach in question was at the request of a physician after discussion with the customer per visit note. The behavioral health documentation states the provider informed the customer the visit may incur charges should the call exceed 15min. The call was documented as 25min in length which is supported by a report from our phone system.

  
  A statement was sent to the customer on 10/25/23. We were contacted by the customer on 10/26/23 via a portal message. It was received by our medical billing team who responded stating the behavioral health supervisor handles invoice disputes for that department and she would forward the information to her.  The supervisor reached out to mom on October 31st to discuss the dispute but was unable to connect.  A voice message was left stating we were unable to remove the charge due to the supporting documentation, but we would be able to offer a reduction of the charge and to please call to discuss further. We received no further communication from the customer until the complaint was received in the mail from the BBB on 11/13/2023.

  Customer response

  11/28/2023

   
  Complaint: 20820820
  
  I am rejecting this response because: I did not request the behavior health call and I was not advised that I would be charged for it. I did not accept their offer to reduce the charge. I want it remove from my account. My kids have been patients there for 15 years. If you do not remove this charge, we will find another clinic for our medical needs. 
  
  Sincerely,
  
  **********************************************

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