ComplaintsforPRISMA Health

• Initial Complaint

  03/19/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I received a debt collection letter from ****** * ****** *** stating that I owed PrismaHealthcare money when in fact I do not. Not only does Prisma's MyChart clearly state (see attached) that I owe nothing but as a permanent and total, 100% service connected, unemployable, disabled Veteran, who is also over the age of 65 - I have insurance that is paid at 100% thru the Veterans Administration or in cases of outside the VA medical service, then **************** covers the 1st part and the VA picks up anything not covered. If Prisma has an issue I recommend they take it up with the above mentioned insurance companies but if there is no balance due what are they trying to pull? Looks like they are committing fraud to me by attempting to gain monies from the actual patient in addition to monies they received from my insurance. I want letter from Prisma apologizing for their error, a letter from Harris & Harris that yes the debt has been paid in full, and that there is nothing showing on my credit report.

  Business response

  03/19/2024

  Review of this patient's account shows that we did not have VA authorization for the 2/4/23 visit, therefore it was not billed to the VA secondary. I have sent the account to our accounts receivable team to review and confirm with the VA if this date of service was authorized. I do show that the account is with ****** *** ******, which is a first placement collection agency, meaning they do not credit report. Once the review is complete, we will contact the patient with an update. We sincerely apologize for any inconvenience and look forward to providing additional information soon. If the patient has any additional questions in the meantime, please call our customer service department at ************. Thank you. 

• Initial Complaint

  03/19/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  Prisma Health say i owe them $120.13 and states it over when in fact united health care paid them the 120.13 02/14/2024. i have railroad medicare with United as secondary plan f. Medical claim #**********-1 The amount owed by uhc was 120.13 which was paid by uhc. with uhc plan they pay 100 of %of what medicare doesnt and they did. Yet Primsa will not answer my messeges or answer there phone. These people are imposible to deal with. and uhc says i owe then 0. Help Thank you ******* * *****

  Business response

  03/19/2024

  Review of this patient's account shows that we did receive an insurance payment for $120.13 from ***, but it wasn't applied. I have sent the patient's account to our accounts receivable department to have the payment applied to the patient's account. Once this is done, the patient's balance will reflect zero. We apologize for any inconvenience or confusion this may have caused. 

  Customer response

  03/21/2024

  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. 
  
  Regards,
  
  ******* *****

• Initial Complaint

  03/13/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I was seen for healthcare services on 11/21/2023 at the Prisma Cancer Institute - ********. I received bloodwork, a routine medication injection, and was seen by my oncologist for a follow-up visit. Prisma Healthcare billed my insurance for a chemotherapy administration despite no chemotherapy being delivered. They also billed my insurance $18,878.80 for the medication they injected - the same medication is listed in their outpatient pharmacy as costing approximately $1600. Overall, Prisma is billing me $484.88 for these services - I believe these are incorrect charges and am requesting a rebill. I requested a formal review of these charges by a 3rd party in early January and was informed it would take 10-14 business days. I have now called to follow-up 5 times - each time spending over an hour on the phone. Each time they tell me that they haven't gotten to it yet and that they will "escalate" my request. They promise to call within 3 business days and then never call. I have also tried going through their patient advocates who similarly claim that they are "escalating" my request to a supervisor to no outcome or resolution. In the meantime, I have had to enroll in a payment plan to avoid Prisma sending me to collections over this bill - they have repeated declined to extend the due date despite their failure to review the bill in a timely fashion. They insist that I should pay and they will "pay me back" if they conclude the charges are incorrect.

  Business response

  03/19/2024

  We do apologize for the inconvenience this has caused, but I do show that billing management currently has this patient's account under review with our charge/pricing review team. The account is placed on hold pending this review and management will follow back up with the patient upon completion. This patient will not be billed for the balance until review is completed. 

  Business response

  03/27/2024

  I have checked for an update on this patient's account and show that per charge review, ***** has been removed, due to it being posted in error. The Pharmacy has reviewed ***** and verified dosage and charge amount are correct. Prisma follows Medicare guidelines and based on Medicare Chemo administration code ***** is appropriate with *****. Per the remittance, patient balance is co-insurance. 

   

  We have submitted a corrected claim to insurance. The patient at this time does not owe anything for this date of service, pending insurance re-processing. Once insurance has processed the corrected claim, the patient will receive an updated statement for any balance due. We sincerely apologize for the amount of time the patient has spent trying to get this resolved and look forward to providing an additional update as soon as one is available. Thank you. 

  Customer response

  03/27/2024

  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. 
  
  Regards,
  
  ****** *******

• Initial Complaint

  03/12/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I received an email from Prisma Health MY Chart stating I had a balance. I contacted the billing department on February 13, 2024 via telephone and spoke to a representative asking for the charge to be removed. The agent said it would be removed on February 13, 2024. I received another notice via email on March 11, 2024 stating the balance was past due. I tried to contact them via telephone again but I was not able to get anyone on the line. I was on hold for 30 minutes then the call disconnected. I went to the *** ***** **** address and asked to speak with a billing specialist and was told there was no one onsite and that they all worked remote. They told me I could make a payment but they couldn't help me resolve an error. I was finally able to speak to a financial counselor who told me it would be removed again on March 11, 2024. I asked if there was something I could have in writing but they said no. They told me to log back in to my chart and it would be removed. I logged back in and the balance was decreased but there was still a charge. The patient information on the statement did not belong to me. I told them this was also a HIPPA violation. I am still able to see this individuals information. I am concerned that the account showing a past due amount could damage my credit rating and I should not be able to see another patients health and personal information.

  Business response

  03/13/2024

  We apologize for the inconvenience and for this not being corrected in a timely manner. I have removed the incorrect guarantor after confirming that this guarantor was added to this patient's account in error. The patient's mother signed the permission forms and we have located the correct guarantor for this patient's account. I have requested additional information regarding payment that was received yesterday and will process a refund accordingly, if the payment was made by the incorrect guarantor. This issue has been resolved, pending response regarding the payment. 

  Customer response

  03/13/2024

  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. 
  
  Regards,
  
  ******* ********

• Initial Complaint

  03/08/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had surgery on 8/1/23. I received an email that I was being sent a refund of $440.18 on 10/31/23; that refund was sent to a closed HSA account. That bank has confirmed they did not received the money. A few weeks after I received the email, I also then received a bill for $440.18, which I paid, however I've never been able to get an explanation or copy of charges showing where my refund went and why I was changed the exact same amount of what my refund was, the $440.18. I've been calling since 11/8. I have called and reviewed every detail with numerous billing reps, i have at least 8 calls documented, a few more I did not get to document. I'm told I'm not allowed to speak with any managers and am not allowed to come in to review my bill with anyone. Even though the bank ran a trace and confirmed the money was never received, Prisma billing continues to tell me the bank must have the money...so they are telling me the bank is lying to me. I would like my original refund of $440.18 and the additional $440.18 sent to me. AND for them to stop sending me notices, emails, phone calls stating I still owe a balance of $440.18. There is no reason I or anyone should have to call nearly a dozen times, wasting hours and hours of my time, and have made absolutely zero progress on getting a refund, that Prisma emailed me stating I was being sent.

  Business response

  03/14/2024

  We apologize for the inconvenience caused to this patient. I do see that the patient has called in numerous times and the account has been escalated to management, pending a callback. I have also sent the patient's account to our refunds manager with the details the patient has provided. I will reach out to the patient once I hear back from our refunds department, and will also reach out to billing management to get a callback to the patient ASAP. 

  Business response

  03/15/2024

  We apologize for the inconvenience, however, according to our records, the refund was approved and went through. We have attached the receipt showing that this refund was sent to credit card ending in 2495 and was approved.  If this was an HSA credit card, the patient will need to contact the company where is HSA card is from. 

  Customer response

  03/15/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and have determined that this does not resolve my complaint. 
  

  Hi Cindy, please see attached for the document I initially included, on the second page shows the closed HSA account, with no new transactions after 8/31/23, at which time I had paid &25 fee to the bank for the closure fee.  The account remains closed, the balance shows $0 and nothing was received after 8/31/23.
  

  
  

  
  I have told Prisma numerous times the bank has confirmed they do not have the money. They never received it. They ran a full trace and confirmed they do not have it. 
  Health Equity - case *********

  I have requested to call the bank with Prisma and they decline. The bank suggested Prisma cancel the credit card transaction and redo it. But there is nothing else the bank can do as they confirmed 100% they do not and never had that money. 
  

  I’ve also asked Prisma why I was charged an additional $440.18 about 10 days after they sent me the refund email  I paid it but they will not provide me a list of charges and credits  

  
  Regards,
  
  ***** *****

• Initial Complaint

  02/20/2024

  Complaint Type:

  Billing Issues

  Status:

  Unresolved

  More info

  On New Years Eve night I went to Hillcrest Hospital (Now Prisma). I was extremely lightheaded and have been bleed for 6 weeks. They got me to a room fast, drew blood, felt on my tummy, gave me some medicine and told me I need to see my doctor bc they don't specialize in the problems that I was having. She never looked at my problem. I went home and lost consciousness. I confined myself to my bed until my doctor could see me the next day. She took 1 look at me and said my blood was coming out like water. She admitted me to the hospital (**** ********...the only hospital I will use going forward) where I sent 3 days, had to have 2 iron transfusions, 4 blood transfusions and emergency surgery. At one point my hemoglobin was down to 5. I do not have a problem with Prisma accentually turning me away bc they don't specialize in the issue that I was having. That's fine. But don't charge me $1000 when you were not able to meet my medical needs and sent me home to basically die. Yes, that's how bad things were and they sent me home. I have all my records from Self Reginal to prove it. I want an apology and my bill to be eliminated.

  Business response

  03/04/2024

  We sincerely apologize for the inconvenience caused to you and are working to get this reviewed. I have sent the account to Patient Advocacy for follow up. Someone in patient advocacy should be reaching out to the patient shortly. 

  Customer response

  03/12/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. 
  
  Nobody has contacted me to resolve this issue.
  
  Regards,
  
  ********* *******

• Initial Complaint

  02/13/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had surgery for a partial tongue removal on 11/13/23. During surgery, it was determined that I had oral cancer, so a CT scan was done to determine if the cancer had spread in my mouth and throat. Which is was cancer. I also had other scans and tests done the next day 11/14/23. Since being discharged, I have been receiving bills for the scans done. My insurance company denied the claim because they say a pre-certification was required for the high tech CT scan. They instructed me to call Prisma billing and tell them all they needed to do was call my insurance company and request a retro certification and then it would be approved and paid. I contacted Prisma and told them all of this. Now today, I receive a FINAL NOTICE from Prisma stating that if I don't pay this is going to collections and go on my CREDIT all because Prisma refuses to contact the insurance company. Now today when I call my insurance company they say that Prisma NEVER contacted them and now because of the time that has passed, Prisma has to request the retro certification and may be potentially required to file an appeal in order to get paid. It was as simple as calling the insurance company and getting the certification, now my credit may be in jeopardy because of lazy customer service. Why should I be financially responsible for a bill that could be paid if they did their job and done the paperwork requested!???? I cannot submit these documents!!!!!

  Business response

  02/13/2024

  We apologize for the inconvenience and will be happy to have this looked into. We need additional information in order to assist with this issue. This is Prisma Health Billing, but we only bill for the hospital and the physicians. I do not see that we have ever sent this patient any billing statements, nor do I see any claims pending. If the patient is referring to a bill from Prisma Health Department of Radiology, that is a different billing entity, but I will be happy to reach out to Radiology leadership. If the patient will please provide a copy of the bill or additional information, we will be sure this gets to the correct department.  

  Customer response

  02/14/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and have determined that this does not resolve my complaint. 
  
  [To assist us in bringing this matter to a close, Please let us know below why you are rejecting the offer made by the business.]

  The attached document is from Prisma Health and when I call Prisma Health directly I'm transferred to the same number indicated on this notice. So if I call the hospital and request billing, why is it going to the same number listed here. I have called on 2/13 and they "say" they will look into and it won't go to collections but I haven't gotten a call from anyone in reference to this complaint.

  
  Regards,
  
  **** *****

  Business response

  02/16/2024

  On behalf of Prisma Health, we apologize for the inconvenience caused. Review of the statement provided shows that this is a Radiology bill. Prisma Health does not bill the Radiologists, as they are a separate billing entity. I have reached out to Radiology management for them to review this concern and follow up with the patient as soon as possible. 

• Initial Complaint

  01/22/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Compliant About Prisma Health I received a statement from a collection agency named ****** * ****** dated 1/8/2024. Because of all the scammers out there. I called to verify because I was making payments on a date of service 2/14/2023 at the hospital and the initial payment I made was $50.00 and thereafter $25.00. I made payment through May 17, 2023. I called to make a payment in June and was told there was no outstanding balance. My assumption were, okay they must have refiled the claim and the insurance paid an additional payment. Today I called the hospital and spoke with a supervisor by the name of Rico C******** His direct line is ************. When I called the first time the representative told me my claim was sent to the collection agency because I didn’t have payment arrangements. My question to the supervisor was if I made the initial call could the representative not inquire if I wanted to make an arrangement? He check the call and no comments were suggested and the representative only asked how much I would like to have paid. The supervisor stated it was the second agency the account was sent too. He place me on hold to find out the name of the first agency. When he came back he never could give me the first agency name but stated he would have it removed from collections and sent back to the hospital. I am requested the balance be charged off because it is under 500.00 and because I verified with a collection agency ***********, which is an agency the hospital used if they received the claim and they never did. I personally believe somehow this fill through the cracks and they later found their error and forwarded to the agency ****** *** ******. The account number for hospital is ************ and the agency number ********.

  Business response

  01/22/2024

  Review of the account shows that the patient spoke with the manager of billing customer service. The manager advised the patient that he would pull the account from bad debt as a courtesy and offered the patient a payment plan. We can set up a formal in-house payment plan for $25/month, interest-free. The patient declined to set up payment arrangements stating the bill should be adjusted off. The balance is patient responsibility per insurance, and no adjustments are warranted. Since the billing level has been reset to a level 1, the patient will need to either set up a payment plan with us, have a financial assistance application on file, or pay the balance in full within the 120-day statement cycle, or the account will age to collections again. We apologize for any inconvenience this has caused.

  Customer response

  01/23/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and have determined that this does not resolve my complaint. 
  
  [To assist us in bringing this matter to a close, Please let us know below why you are rejecting the offer made by the business.]
  
  Regards,
  
  ****** ****

  Customer response

  01/24/2024

  I believe the account ************ from Prisma was never forward to Medicredit.  I called and the account nor DOS 2/14/23 was received.  ************ number is ***************

  Business response

  01/24/2024

  We do not bill to *********** Typically, in these cases we provide the patient with an itemized bill, and they are responsible for submitting it to **********. I have requested the detailed bill be sent to the patient. The patient may call customer service at ************ if there are any additional questions. Thank you. 

  Customer response

  01/24/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and have determined that this does not resolve my complaint. 
  
  [To assist us in bringing this matter to a close, Please let us know below why you are rejecting the offer made by the business.]
  
  Regards,
  
  ****** ****

• Initial Complaint

  01/19/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  December 16 I went in for a miscarriage into ********** ********. I was there for 6 1/2 hours with no IV bleeding out. The only care that was given to me was ********* and ******* two hours before they sent me home. I filed a patient advocate complaint they said they’re findings Were that I had efficient healthcare. They also lied about my health status when they sent me home, I had to go to another hospital a few hours later my hemoglobin dropped tremendously, and other test results were dropping tremendously. They did not care for me properly they will not admit wrong or neglect so now I’m taking it a step further.

  Business response

  01/29/2024

  We apologize for the care the patient received at her December visit. I have reached out to Patient Advocacy management to request a follow up with the patient. 

• Initial Complaint

  01/17/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  i went into the Prisma Urgent Care Facilities on *** *********** *** ************* ** *****. I had been coughing and my chest was hurting and I also included in the information that I filled out during registration that I wanted an X-ray to be done on my chest. This was part of an wellness check that I wanted to have performed for my insurance rider and as I stated I have been having chest pains. The doctor that came in to see me was very rude and unprofessional. He wanted to know why I need a chest x-ray, He asked was I doing this just to get paid. I explain that I have been sick and I have been coughing and my chest hurt, I wanted to get checked out, I also explain the chest xray as a wellness check up for my insurance. He went on to say that I did not need chest xrays and he wasn't going to order them, He did not address any of the issues that I came in for, I paid a $15 co-payment and I felt that I did not get any type of solutions or help. I had this doctor before and he is very rude and not personable at all,

  Business response

  01/22/2024

  We appreciate the patient bringing this to our attention. If we can please request the date of service the patient is referencing, I will be glad to have this complaint submitted to patient advocacy for review of the care concern. The patient may also call ************ to provide this information. 

  Customer response

  01/22/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. 
  The date of service was 1/16. Im attaching my receipt. I want a refund. 
  
  Regards,
  
  ****** ***

  Business response

  01/22/2024

  Review of the account shows that this was for an ****** **** ****t, for which we do not bill. The center is branded as Prisma Health and will continue to be clinically integrated with our system, but they bill out of EPIC under a different service area that we do not have visibility into.

  
  ********** ******* ****** ****** *****, has their own AR follow up, coding, cash posting, claims, customer service, refunds and billing team that currently handles their calls. They also send their own billing statements.
  
  Below you will find their contact information.
  
  Billing Customer Service #: ************
  Billing Customer Service email: *************************  

  We apologize for any confusion this may cause. 

*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. ↩