ComplaintsforZoom Care

• Initial Complaint

  02/13/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I visited Zoom Care clinics for 5 urgent care visits in January 2023 at the ***********, ********, and Beaumont location in the Portland area. 3 urgent care visits, one for labs, and one for an ultrasound. During these urgent care visits, I was told that my health care insurance was in network and that my ** pay was sufficient. If there was any more payment required, I was supposed to be notified via mail and the online patient portal. During that time frame, I checked the online patient portal and looked for my medical bills to populate, but nothing populated. I never received any notification of billing in the mail either. I was assured that if anything was owed it would be in the patient portal. Today 2/12/24, I get notified that I have a **urt order attempting to be delivered to my old address by a **llection agency. The **llection agency, Quick Collect, informed me that I did in fact owe and the total is $1,164.98. I in turned **ntacted Zoom Care where I spoke with the patient advocate specialist named ***** who informed me that the patient portal was experiencing "technical difficulties" and "was not reflecting balances owed by patients." She told me that Zoom Care did not need to notify patients that the billing portal was not working and that the bills were already sent to **llections and nothing **uld be done. She told me Zoom care attempted to mail invoices and it was my fault that I never received any bills via mail. I now over $1,100 and Zoom Care is taking no responsibility for their failure to inform their patients that their online billing system was not working. Had I been informed, I **uld have paid as they were due but I was not given the opportunity by their **nscious and blatant lack of **mmunication.

  Customer response

  02/14/2024

  The fact that I was not notified within 120 days of the billing service shows that Zoom Care violated the No Surprises Act. I was told that I was in network and subsequently charged for out of network pricing. 

  Business response

  02/21/2024

  Dear *******,

  Thank you for bringing your concerns regarding billing discrepancies to our attention. We have conducted a thorough investigation into the matter and appreciate your patience throughout this process. Here is a detailed explanation based on our findings:

  Our records indicate that you visited several of our ZoomCare clinics for services on various dates in January and March of 2023. For each of these visits, we diligently attempted to notify you of any outstanding balances through mailed billing statements. These statements were sent to you on the following dates:

  - Date of Service (DOS) 01/30/23
  Statement (Stmt) #1 mailed 4/25/23 for $218.08
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  - DOS 3/20/23
  Stmt #1 mailed 4/25/23 for $218.08
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  - DOS 3/22/23
  Stmt #1 mailed 4/25/23 for $229.68
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  - DOS 03/24/23 (x2 visits)
  Stmt #1 mailed 4/25/23 for $149.44
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  Stmt #1 mailed 4/25/23 for $232.38
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  

  Additionally, we attempted to reach out to you via phone call on September 12, 2023, with a voicemail left requesting a return call. Unfortunately, we did not receive a response from you despite our attempts to reach out.

  We understand the challenges you faced with accessing billing information through our online patient portal and apologize for any inconvenience caused. Our team is here to assist you, and we encourage proactive communication if you encounter any difficulties or have questions about your billing matters.

  It's important to note that your insurer typically sends Explanation of Benefits (EOB) for each processed claim, which should have included information about any outstanding balances, in addition to our attempts. Moving forward, Quick Collect will be managing the collection process. We advise you to communicate directly with them to resolve the outstanding balance, as we have exhausted our options on our end.

  We understand your frustration and regret any inconvenience caused. Please feel free to contact us if you require further assistance or clarification at ************.

  Best regards,

  Sage

  ZoomCare Patient Relations

  Customer response

  02/21/2024

   
  Complaint: 21285009
  
  I am rejecting this response because I was charged and billed successfully for the amount of $226.00 with the card on file on 2/16/23 with no issues. Your billing services state that "If actual charges or payments are different than your estimate, you will be notified, and your card will be charged." The card on file was working for it to be charged on 2/16/23 and I received no notices that there were any outstanding charges. There was no attempt made by Zoom Care to charge the card on file as your billing service states and therefore, I am not responsible for Zoom Care's inability to bill successfully and follow through on their billing instructions. If my card was charged which was successfully billed in February as dictated by the billing department standards and practices prior to April, May or June, there would have been no need for mailed statements that were unsuccessfully delivered. The bills should have been charged as it was on 2/16/23. I have not seen any printed receipts that I was contacted other than what Zoom care has stated and therefore do not believe that any letters were sent to the address on file as they were never received. If this continues, I will seek legal counsel on how to process this further as this is a failure on Zoom Care's billing part by not following through with their own stated billing practices and I am not responsible for their billing failures. 
  
  Sincerely,
  
  ***************************

  Customer response

  02/21/2024

  I have followed up and shown proof that Zoom Care's online billing service was working properly and I was subsequently notified of my adjusted medical bill. I also have shown proof that I received an email notifying me of billing adjustment for $226.00 and email proof that I successfully paid $226.00 as shown in the billing adjustment. Also in the email, it is clearly stated that "Zoom Care will bill the card on file within 24 hours." I will also follow up with making a complaint with CMS and DCBS as this is not Zoom Care's first time being reported and found guilty for fraudulent practices. 

  Customer response

  02/23/2024

  Zoom care not responding to the information provided shows that they willing did not bill the card on file. Zoom care failed to follow their billing promise as shown in the attached documents either. Choosing to not reply shows their avoidance in admitting guilt in resolving the problem and trying to place it on the patient. 

• Initial Complaint

  01/10/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  This company is a scam. I should have listened to my husband and my instincts and not continued to receive service here based upon convenience. On 09/26/2023, I was seen at ZoomCare Super as a referral after I was seen at the ******* location for horrible stomach pains that weren't getting better. The ******* location said they could not do anything for me, so I paid $91.36 to that clinic for a statement saying they couldn't help. Upon my arrival, the Super location told me it would cost me no more than $750 (uninsured rate) even though I had insurance (Providence Connect). At the end of my visit, they returned with a summary of my visit and services performed, with the total cost of my visit being $578.71. They stated they would just bill my insurance for this and I could go on my way since I was feeling horribly and the visit took a long time. Come to find out, ZoomCare billed my insurance provider multiple times, with disallowed amounts. Today, when I opened my mail, all of a sudden I had a "past due" invoice from ZoomCare dated 12/28/2023. I had not received ONE BILL since the date of my service on 09/26/2023 for any emergency-related services for that date. I called Providence and they said unfortunately, since the provider is out-of-network, they can bill for disallowed amounts and make the patient responsible even though you have a max out of pocket (I already reached the limit before this) and coinsurance. Providence said usually all providers bill under standard codes, but this was not the usual practice. How can you have insurance and want to use the insurance, but the cost to use the insurance is more than having no insurance for the same services? This does not add up. This is a way for Zoom to collect additional money and chalk it up to, well this is the contracted amount with insurance. No, no it's not. I would have insisted on paying the $578.71 on 09/26/2023, if I knew my bill's total would be twice that amount 3 months later.

• Initial Complaint

  12/23/2023

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  Zoomcare claims that "*ZoomCare does not currently accept *************************************** or the ****** Health Plan. We are unable to provide care if you are covered under any of these plans." (Zoomcare website, ************************ even specify on their app that this policy includes those who pay out of pocket. I cannot understand how this isn't illegal discrimination. Not being able to accept state coverage is one thing; refusing care to those with state coverage is completely another. To me, this is major discrimination. Zoomcare must be forced to explain why this policy is in place. And furthermore, the state should step in to legally prevent these kinds of exclusionary policies.

  Business response

  01/09/2024

  Dear ***,

  Thank you for reaching out and expressing your concerns regarding ZoomCare's insurance policies. We understand the importance of addressing such matters, and we appreciate the opportunity to provide clarification.

  At ZoomCare, compliance with healthcare regulations is of utmost priority, and we carefully evaluate the applicability of various insurance plans, including *************************************** and the ****** Health Plan. Currently, ********************** is not registered to accept ******** patients, which impacts our ability to provide care to individuals covered under these specific plans. Our policies are in alignment with the regulations imposed by ********, and they are rigorously enforced by the insurance board.

  We acknowledge the inconvenience this may cause, and we want to assure you that we are actively exploring the possibility of registering in the future to broaden our scope of service. Your feedback is invaluable to us, and it will be taken into consideration as we continue to refine our policies.

  It is essential to note that our policies are not intended to discriminate against any individual or group. Rather, they are based on compliance with the regulatory framework governing healthcare providers. We recognize the importance of transparency and will make efforts to better communicate the reasons behind our current policies.

  We appreciate your understanding and are committed to addressing concerns raised by our valued community members. If you have further questions or would like to discuss this matter in more detail, please feel free to contact us directly.

  Thank you for bringing this to our attention, and we look forward to the opportunity to serve you in the future.

  Take care,

  Sage

  ZoomCare Patient Relations

• Initial Complaint

  12/16/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Appointment for 3PM. Arrived 3:05PM. Arrived to empty lobby. After 3 minutes, I went looking for someone. Office Manager was hiding in the office, looked up at me, and said "you're too late now. I am on the phone." then looked away.A NP emerged and apologized for the office manager's conduct stating "there is nothing she can do."

  Business response

  01/04/2024

  Hi there,

  I hope this message finds you well. I want to express my sincere apologies for the negative experience you encountered during your recent visit to ZoomCare. We deeply regret any inconvenience caused by the delay in being seen.

  At ZoomCare, we take pride in our commitment to providing efficient and timely care, and we understand the importance of each patient's time. Our five-minute grace ****** is designed to keep our clinics running on schedule, and I'm truly sorry that this was not the experience you had.

  I want to assure you that we take your feedback very seriously. Your insights help us identify areas for improvement, and we certainly never like to miss an opportunity to be there when our patients need us. The experience you described does not align with the standards we set for our team, and I appreciate you bringing it to our attention.

  Please know that your feedback has been reported as necessary, and it will be used to weigh in on ongoing discussions about improvements to our organization. We are committed to ensuring that incidents like these are addressed and that our patients feel valued and respected during every interaction.

  If there's anything specific you'd like us to address or if you have additional details you'd like to share, please feel free to reach out to us directly at ****************************************** Your experience matters to us, and we are dedicated to providing Beyond Better care.

  Thank you for your understanding, and I appreciate the opportunity to address your concerns.

  Best regards,

  Sage

  ZoomCare Patient Relations

• Initial Complaint

  11/30/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unresolved

  More info

  On 11/07/2023 I took my daughter to Zoomcare to receive treatment for a respiratory illness. We submitted our insurance information (Regency BCBS) and were seen by the physicians assistant. At no point did the office inform us that it was an out of network service, and that we would be responsible for the full cost of services. When we attempted to return to the office a week later they seemed to finally realize that they didn't take our insurance, so we went elsewhere. They also stated that "something changed" in the course of the week, and they couldn't take our insurance now.The office has now fraudulenlty attempted to charge the service through our insurance company, even though they don't take Regence BCBS. Today we received notice from our insurance provider that the service is out-of-network that was supposedly delivered on 11/08 (the day following our visit), and that we owe $636. We would have simply gone to a different provider if we had been told that Zoomcare was out of network at the time of the original appointment. This is clearly a bait-and-switch insurance scam that the company is running. Any look at reviews of their offices on ****** or Yelp will yield several reviews from people who the same thing has happened to.This so called "medical provider" needs to be investigated.

  Business response

  12/08/2023

  To Whom It May ******************** you for reaching out to us.

  After carefully reviewing the patient's information and addressing their concerns, we have successfully resolved this matter with the patient's father, **********************

  To ensure everything is in order, we recommend that patients directly contact their insurance provider for confirmation before scheduling an appointment at ZoomCare. As a gesture of goodwill, our benefits team always strives to verify a patient's insurance coverage prior to their visit to ensure that we are considered in-network for their policy. According to ZoomCare's Terms & Conditions, which are agreed upon when scheduling an appointment:

  "You acknowledge and agree that you are responsible for knowing your insurance benefits and guidelines regarding what is and is not covered by your insurance and for paying ZoomCare for all services and products provided that are not covered by your insurance."

  Although our benefits team made efforts to verify the patient's insurance prior to their visit on 11/08/2023, it was discovered that the insurance information provided was inactive. This required updated insurance details from the patient, which they provided upon arrival for their visit. Unfortunately, during the verification process, the information received from the insurance company was inaccurate as it indicated an 'in-network' status for their policy. Once again, as per ZoomCare's Terms & Conditions:

  "Not all services provided at ZoomCare will be covered by your health insurance. As a courtesy, ZoomCare may, but is not required, ask your health insurer about coverage on your behalf, but ZoomCare cannot know and is not responsible for the accuracy or completeness of any information provided."

  ***** contacted ZoomCare's billing department to dispute the outstanding amount owed by the patient and was offered a customer service accommodation of $279.75 by our *************** Center supervisor. We apologize for any inconvenience caused by the aforementioned situation and hope to have the opportunity to serve the patient and their family again in the future.

  Sincerely,

  Sage

  ZoomCare Patient Relations

  Customer response

  12/12/2023

   
  Complaint: 20939127
  
  I am rejecting this response because:

  The information provided by the business is false. At no point have I been offered a reduced charge, as stated in the response. I have not received an updated invoice, or any other notice from Zoomcare of a reduction in charges related to this appointment.  The last communication we received from Zoomcare after submitting the records release paperwork was that the request would need to be escalated to a senior person in their billing department. No other communications have been received from the business.

  In addition, per their comments that it's the responsibility of the patient to know whether Zoomcare accepts their insurance, I am submitting screenshots of their own website that clearly lists both Regence and ********** Blue Shield as being accepted (our insurance is Regence BCBS). Furthermore, at no point during the original appointment were any charges discussed with the patient or their parent, either with regard to insurance, co-pays, or out of pocket expenses. The company did not perform the most basic due diligence in informing the patient of the associated charges for services.

  This is also a pattern of behavior that can be seen in hundreds of online reviews of their services and questionable billing practices, that are clearly predatory, and take advantage of sick patients in need of urgent medical care.

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

  Business response

  12/21/2023

  Hi there,

  I've attached the requested invoice reflecting the adjusted amount of $279.75 for the patient's visit on 11/08/23 to provide additional clarity. Our commitment is to ensure our patients have a clear understanding of each step in the process, and I apologize if this information was not initially provided. It is never our intention for our patients to feel they have been misguided or misinformed at any point in their healthcare journey.

  Concerning billing the insurance, I'd like to shed some light on how it works when a facility is considered out of network, especially given the complexity of insurance plans. While we do accept many Regence BCBS policies, it's crucial to note that acceptance doesn't guarantee coverage, and the specific policies covered may vary due to the diverse range and frequent changes in plans offered by insurance companies.
  The process hinges on the patient's specific policy with the insurance company:

  1. If the insurance policy includes coverage for out-of-network providers, the facility will bill the insurance. The insurance will then pay the amount for out-of-network services, typically less than what they would cover for an in-network provider. The patient is then responsible for their out-of-network coinsurance, covering the remainder.

  2. If the insurance policy lacks coverage for out-of-network providers, the facility still bills the insurance to verify the accuracy of the provided network status. However, since the policy doesn't include out-of-network coverage, the insurance won't contribute, and the patient is responsible for the entire amount.

  As discussed during the phone call with our Billing Team on 12/07/23 at 2:05 PM, with *********************, the Billing Specialist conveyed that, due to services rendered and the absence of out-of-network benefits in the insurance policy, we couldn't waive the entire cost. However, we've adjusted the amount to the Self Pay Discount, typically applicable to our uninsured patients.

  I trust this information brings clarity and a deeper understanding of the billing process when dealing with out-of-network insurance, as well as the steps taken to alleviate the associated financial burden. 

  Take care and be well,

  Sage

  ZoomCare Patient Relations

  Customer response

  01/02/2024

  Apparently the billing department at Zoomcare can't do basic math. As can be seen in the updated invoice they posted here, the adjusted patient responsibility is not $279.75. The company made an adjustment to the bill that they refer to as a "problem solvers write off" in the amount of $295.75. The actual charge they are demanding is $321.68.

  Frankly, that just sounds like more insurance fraud to me. If they can't get it out of the patient, they'll just claim a loss on their umbrella coverage. Must be nice!

  Something needs to be done about this company's patient care and billing practices.

  Customer response

  01/02/2024

  Please note that I have not received the invoice dated 12/21/2023 from the company by any other means than via the BBB. No emails, no paper in the mail, nothing. They have made no good faith attempt to perform the most basic due diligence in contacting the patient or their guardian in order to resolve this billing issue.

  After my last submission to the BBB I contacted Zoomcare to resolve the final balance on the invoice that was posted in this thread. I was informed by the billing department that there was no balance due from the patient, but they were attempting to bill the insurance company AGAIN, even though we are now 100% certain they do not accept our insurance.

  I am now concerned that the company is attempting to take punitive action against a customer for filing a complaint about their business practices. Other complaints about this company have indicated they delay billing or do not send bills, then send the account to a collections agency which has a detrimental impact on the customer and their credit rating that is very difficult to remedy across the three credit reporting agencies.

  At best, this is severe negligence in billing, and at worst these are predatory practices that go against the basic principles of providing health care. The company should be investigated.

• Initial Complaint

  11/08/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  ZoomCare repeatedly billed the incorrect insurance and refused to correct it resulting in the bill being sent to collections. I have a timeline and complete explanation including proof of attempts to resolve this available.

  Customer response

  11/09/2023

  Patient Beware Nefarious Billing Practices
  My wife was seen for a telemedicine urgent-care visit with ZoomCare through this location in March of 2022.  While I will not comment on the quality of the visit, I will say the visit lasted approximately 5 minutes in total. 
  Since that time, I have been going back and forth with their billing department.  4 months after the visit I received a billing notice indicating that the billing was rejected by my insurance.  This bill was for $300.  I immediately noticed the issue; they billed the incorrect ********** Organization. They billed Regence BCBS, not the correct insurance company Horizon BCBS.  These are two separate companies and have completely separate billing departments. When I inquired with my insurance company, they advised they had no record of the bill, and it would need to be rebilled properly through Horizon.  I also verified that the correct insurance information was provided at the time of the visit, so the incorrect billing was solely the responsibility of ZoomCare. Accordingly, I wrote a brief letter explaining the situation and provided an additional copy of my insurance card and mailed it back along with the copy of the original bill indicating they needed to bill the proper insurance company.  Nothing occurs for another few months until I get another bill indicating the balance was still outstanding and that once again, it had been rejected by REGENCE BCBS,not Horizon.
  At this point I thought it was best to pick up the phone and call them.  I reached the billing department and told them I needed to update insurance information because they had transcribed it incorrectly.  They said they would be able to help me initially but changed their tune because they said I did not have a HIIPA release on file.  I politely informed them that there would be no HIIPA release required, as the named insured on my insurance policy and an authorized billing agent on behalf of my wife, I am able to speak for all outstanding accounts.  I very specifically advised I would not need access to any confidential medical records, simply to update insurance information.  This is very clearly outlined on the US ********** of ****** and ***** Services website as well (of note, I also sent this through the secure messaging system and have proof that I had let them know this through that system.  The woman insisted I provide it, so she directed me to the release of information.  Later that night I had my wife sign it and mailed it in as directed by the customer service agent.  I also, once again included the proper insurance information.
  A few months pass and once again I receive another bill.  I call numerous times and they refuse to talk to me once again, I advised that I had already sent in the release, and even if I hadnt, they are still permitted to discuss with me.  I informed them that I would need a call back from a manager to comment on the policy because it was not compliant with accepted billing practices.  They told me they would have their documents research team attempt to locate the missing authorization and advised a manager would be calling me back within one week.  I received confirmation of this request via ZenDesk customer portal on the same date.  No manager ever attempted to call me back and quite candidly I forgot about it again.
  I now flash forward to yesterday in which my wife received a collection notice from a predator collections company Quick Collect Incorporated (QCI).  This was to inform us that the debt had been assigned to them for collection, at this point the debt had ballooned to $434.12.  I called them and advised there had been many attempts to resolve this directly with ZoomCare and they had failed to respond.  I was told that they would attack my wifes credit until the full balance was paid and there was nothing, I could do about it.  I asked to speak to a supervisor and was denied. I asked for their documents pertaining to the bill in question and was also denied.  The incredibly rude representative ******** advised that she doesnt owe me anything and doesnt have to talk to me.  I informed her of my rights under the financial agreement with ZoomCare and she advised she did not care. 
  I called ZoomCare back and let them know that this was incorrectly sent to collections, and I had numerous attempts to resolve this,all of which went unanswered.  They said they would not talk to me either and refused to answer any questions.  By this point, they were finally in receipt of the release of information.
  That is where I am now. ZoomCares billing incompetence coupled with their lack of desire to resolve this issue have resulted in direct harm to my wifes credit.  I have given them every opportunity to resolve and yet still they do not.
  

  Business response

  11/17/2023

  Dear ****,

  I hope this email finds you well. I wanted to provide you with an update regarding the issue your wife experienced with her billing at ZoomCare. We truly appreciate your patience during this time.

  I want to reassure you that your wife is in direct communication with our billing manager as they work together to rectify the issue. They are actively addressing her concerns and making every effort to resolve the outstanding bill.

  Please be assured that we take this matter seriously and are committed to finding a satisfactory resolution. We understand the frustration this situation has caused and apologize for any inconvenience.

  We value your support and are grateful for your understanding. If you have any further questions or concerns, please don't hesitate to reach out. We are here to assist you in any way we can.

  Thank you for your patience and cooperation.

  Kind regards,

   

  Sage

  ZoomCare Patient Relations

  *****************************************

• Initial Complaint

  11/08/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On June 16, 2023, I visited the Zoom Care Center at **********************************************************************. Before proceeding with the visit, I asked the representative at the front desk to check if they were in network with my insurance. I had used Zoom Care services before, and they had been in network, but I always like to ask to make sure. The representative in the front desk assured me they were in network and I proceed with the visit. At the end of the visit, I was told what I owed and my card was charged $116.79.On September 29, 2023, I received a letter from Zoom Care PO Box *****, ******, ** 97281-3577, indicating I owed $414.83 for the visit on June 16, 2023. I called the Zoom Care customer service right away and after a very long wait I was able to reach a representative. The representative told me I was being charged the additional $414.83 because that specific clinic I visited was out of network with my insurance, and I had not met the deducible for out of network services with my insurance so I was responsible for the full $531.62 the insurance did not pay. I explained to her that I specifically asked about this to the person before the visit and she assured me that they we in network. Plus, I explained, I had visited other locations in the past and they had been in network. She said that some Zoom clinics are in network and some are not, and that it was my responsibility to check with my insurance first. I explained how unreasonable expectation that is, specially when their representative assured me they were in network with my insurance. She sustained it was my reposibility. I then proceeded to ask for a grievance, she apparently took my information, but I never heard back from them regarding any approval or denial. I received a letter dated October 17, 2023 indicating it was the final demand for payment. Please help. I was misled, tricked by this business into getting a service. If I would have known truth, I would have refused to get the service.

  Business response

  11/17/2023

  Dear *******,

  
  I hope this email finds you well. I am writing to provide you with an update on the concerns you raised regarding your recent visit to the ZoomCare Super in *********** on June 16, 2023.

  Firstly, I would like to apologize for any confusion or frustration you experienced due to conflicting information about your insurance coverage. We appreciate your patience in bringing this matter to our attention and giving us the opportunity to rectify the situation.
  After a careful review of your case, we have discounted $200 off the balance of $414.83 as a reflection of the conflicting information provided and its negative impact on your experience with ZoomCare. An updated invoice reflecting the revised charges has been attached to this email for your reference. If you have any further questions or concerns, don't hesitate to reach out to us. We value your feedback, and our team is here to assist you.

  Once again, we sincerely apologize for any inconvenience or frustration this matter has caused. At ZoomCare, we continuously strive to improve our processes and ensure our patients' satisfaction. We greatly appreciate your understanding, and we look forward to serving you better in the future.

  Warm regards,

  
  Sage
  ZoomCare Patient Relations
  *****************************************

• Initial Complaint

  10/16/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  On May 9, 2023 I was seen in the Zoom Care Super ER. My insurance was not active at this point and I was told I would have to pay out of pocket. Per the ZoomCare website and every staff member the flat rate of $630 would cover any and all diagnostics, labs, imaging done in house. I consented to this price. In August the team reached out to me because insurance declined the claim since it was not active but they told me now they had to bill insurance. Even though they have flat rates for uninsured. 8 weeks ago I asked ***** (*****) **** for my itemized invoice and never got it. I asked again 17 days ago and there was no response. I then contacted ******************* 6 days ago requesting an invoice and did not receive it. I requested it again 4 days ago and finally got what I was trying to be billed. The problem is the invoice I am now being shown is not the same invoice I consented to at the time of treatment and I had never seen it until then. I only consented to treatment because I could afford the flat rate without my insurance and now it is being billed as though thats not what I was told and I am being told I owe $1,896. I brought up this billing problem and am trying to figure it out and when I brought up it being against their policy I am now again being ignored and not responded to at all since Tuesday. I keep having to message and nobody responds to me. The first person I spoke with went on leave but I feel my case needed to be redirected to somebody else. I am very upset that now my invoice is changing 5 months after the fact and after my visit. After I was given a set price. I will attach my invoice from the day of 5/9/2023 and the one I was just sent last week. The articles posted by zoom even state "we'll give you a quote up front so you know what to expect. Our pricing isn't the only thing that's transparent". My quote and end price for my visit was stated at $667 so this new bill is a shock when everything on my first bill was accounted for. Review pictures.

  Customer response

  10/19/2023

  Good evening,

  They deleted my double invoice and refunded money that was owed to me; however I am asking for proof of insurance cancellation and confirmation that they will no longer be billing me and I am getting ignored again. I just want proof that they contacted insurance for my records and proof that they will not try to double bill me again in the future.

  I contacted them 3 days ago and have heard nothing in return.

  Thank you,

  *********************************

  Business response

  10/20/2023

  Dear ********,
  
  We sincerely appreciate your valuable feedback concerning your recent visit, and I would like to extend my gratitude for taking the time to share your experience with us.
  Your feedback has been carefully documented, and we will promptly communicate it to our leadership team to ensure that we continuously strive to improve our patient experience.
  
  I'm delighted to inform you that our Billing Manager, *******************, reached out to you via email on Monday, 10/16/23, and confirmed that your claim with United Healthcare has been successfully voided. Furthermore, we have re-applied the uninsured pricing that was initially quoted to you during your check-out process. In addition, we are also refunding you $12, which was an in relation to an overpayment for a specific line item on your visit bill. Therefore, the final total billed to you will now stand at $655.
  
  We regret any inconvenience our delay in resolving your concern *** have caused and are genuinely thankful for the opportunity to address and rectify the issue to your satisfaction.
  Thank you once again for sharing your experience with us, and if you have any further questions or concerns, please do not hesitate to reach out.

  Customer response

  10/24/2023

  The last message I sent I am still disappointed with the service because they will not provide documentation that the insurance claim was cancelled nor will they tell me that they will no longer bill me. I am again being ignored since last week. 

  Business response

  11/17/2023

  Hi ********,
  
  I wanted to reach out and give you an update on your concerns about receiving confirmation that ZoomCare did not bill your insurance more than once for your visit. I'm happy to confirm that your request has been taken care of. Based on your conversation with our Billing Manager, *******************, (email attached), they were able to provide the documentation you requested as of November 8, 2023.
  
  I sincerely appreciate you reaching out to us and giving us the opportunity to improve our services. If you have any further questions or concerns, please don't hesitate to reach out to us for assistance.
  
  Best regards,

  Sage

  ZoomCare Patient Relations

  *****************************************

• Initial Complaint

  08/30/2023

  Complaint Type:

  Order Issues

  Status:

  Resolved

  More info

  Date of transaction: Aug 31st 2023 Date of the service: Jan 18th 2023 Place that I got the service: ******************************************************************************* The amount of money you paid the business: $82.94 What the business committed to provide you: They told me this will be covered by insurance but after half a year, they told me this won't be covered.What the nature of dispute is: Before the service starts each time, I ask their front desk about what will be covered by the insurance company and how much I need to pay. After I got the confirmed answer, I start the service. You can also see some other bills after Jan 18th are covered by insurance company. I never owe any money to zoom care. Each time when I see the bill, I paid that immediately. After more than half a year, they suddenly told me I need to pay more money. I can't imagine if I paid this time, I probably will receive more bills next half year.Whether or not the business has tried to resolve the problem: they didn't try to resolve the problem.Bill Number: H3511205

  Business response

  09/10/2023

  Hi ********, 

  Thank you for reaching out about your experience. 

  I looked into your visit with the referenced bill ID and I see that the reason you received a bill was because your HRA balance that you have with Premera Amazon plan was exhausted. Since you had multiple claims in process, your insurance on 1/18/23 estimated that you still had an HRA balance but by 01/26/23 your claims prior to 1/18/23 had been processed by your insurance and your HRA was updated. We notified you on that date that your HRA had been exhausted and thus your Deductible and benefits now apply for all subsequent visits. This is why your insurance processed the claim against your deductible and notified us that you had a balance due for your patient responsibility for the care you received. You can contact your insurance company and they can confirm which of your visits went towards your HRA and the official date that your HRA was no longer available. I can see that you also paid for the remaining visits that you had with this information.

  As a medical facility, we are contracted with your insurance company to collect the amount they set as the rate for the services you were provided. It did take a while for your claim to be finalized as they initially denied the claim and we've been going back and forth with them since January of this year and only reached a final determination in August. Which is when you were notified of the final balance provided by your insurance company. We try to reduce suprise bills as much as possible by providing estimates but know that the estimates that insurances provide *** change upon the final determination of the claim since they do not guarantee benefits or coverage prior to a visit. 

  As a financial courtesy, we will refund the $82.94. You will see that on the card that was charged in about 5-9 business days, sometimes sooner just depends on how quickly your card administer accepts the refund transaction. I hope this helps to prevent this situation being a surprise in the future with this information about how claims can impact your available HRA and generate a bill per your insurance company. 

  Please let  us know if there is anything else we can assist with and take care.

  Customer response

  09/11/2023

   
  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

  07/28/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I went in for some stomache pain that I was having, under the assumption they took my insurance because that's what it said on their website. Once I was seen by the Dr. I was mis-diagnosed for a ruptured appendix, so they scheduled me another appointment on the same day to go get more tests and scans done. I did all this, still under the assumption my Insurance was covering it, nobody said i wasn't covered when I initially signed in either. After all the tests, blood work, scans I was told that my insurance actually wasn't covered and I had to pay 500 just to get misdiagnosed, and **** for additional tests with my insurance covering none of it. Out of bitterness I neglected to pay and it's now in collections with a company called quick collect who is now filed to **** I've never had a worse experience with healthcare in my life, you guys are the worst, it's really unsetlling how you pull the rug out from people after doing all the tests then to tell them how much they owe and go after them. I was just about to put money down on a new house and our lease is up, now we have to pull money out of somewhere we don't have just to not get a judgement made against us and then we'll have no money for a down payment.. I hope nobody has to experience this.

  Business response

  08/14/2023

  Hi ******, 

  I am sorry to hear about your experience in regards to your billing when seeking care at our facility. We try to make the billing processes with Insurance and estimates as smoothly as we can and make every attempt to resolve balances before escalating the account further. 

  Your visits were last year (End of 2022) and looking at your benefits, it wasn't that you were Out of Network. It's that your plan had a high deductible of $3,250 that you have to meet before your coinsurance benefit of 20% takes effect. This means that per the plan you enrolled in with ********** Blue Shield, that your patient responsibility is the full allowed amount (rate set by your insurance company) for the services that were rendered until you meet your deductible of $3,250. This is why you received a bill and we did let you know this estimate at checkout. We have a note that you had concern for your insurance and the cost but that we would await for your claim to process with your insurance to see what they finalized your patient responsibility as. Next time you enroll in your  health insurance, see if there is another option for copayment versus a deductible plan. This could help reduce the need for paying towards a deductible before your insurance company begins to be partially pay for costs in your care.

  Over the course of 6 months we've made 12 attempts to contact you across phone, mail, and email in order to resolve the balances for the care provided. You would have also received an explanation of benefits for both of those claims from your insurance company. We did not receive any response from you in regards to this matter nor in regards to your experience with your care. We would have been more than happy to discuss options with you but did not receive a reply to any of our attempts. Due to this, your account was escalated to collections. Based on the contact information you provided on this form, this matches your patient record of where we attempted to contact you. At this point, all communication and resolutions do have to go through Quick Collect and we would be unable to assist further with this balance at this point. 

  I will document and share your feedback to our leadership team regarding your experience. Thank you for taking the time to share your feedback. 

*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. ↩