ComplaintsforVCU Health/ VCU Physicians

• Initial Complaint

  03/20/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  *** Health failed to document progress/ medical necessity in physical therapy for my son. They failed to respond to requests for documentation from insurance to authorize visits. Now that they treated my son without same, the visits were denied and they are billing me. Insurance said *** must write off but *** continues to bill me $3000. Insurance says I must secure attorney because what *** is doing is illegal.

  

  Business response

  03/25/2024

  Good afternoon,
  
  
  *** Health takes all complaints seriously and works directly with the patient/guardian to reach a satisfactory resolution that is within compliance of the Health Insurance Portability and Accountability Act and provider contracts. This concern will be investigated and will be worked on by *** Health to get it resolved to a favorable resolution as quickly as possible. Contact with the patient/guardian will be made soon. The account is being investigated and *** Health is diligently working to ensure that the patients account is processed correctly. *** Health will continue to update the patient/guardian on the progress of the account review until we have reached the best possible resolution on this account. 
  
  

  
  Thank you.

  Customer response

  03/25/2024

  [A default letter is provided here which indicates your acceptance of the business's offer.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the offer made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved. If the company does not perform as promised I can get back to you at: **********************************************.
  
  Regards,
  
  *************************
  
  
  
  

  Customer response

  04/08/2024

  I am writing to reopen this complaint.  *** health left me one voice mail that they were looking into the matter and would call me back next business day. That was 2 weeks ago.  I have called them multiple times since with no response.  Moreover, they have added to my bill.  I cannot reach the person who is supposedly looking into my account.   How do I escalate my BBB complaint because *** is not responding to the concern?

   

  

  Business response

  04/11/2024

  Good morning,
  
  
  *** Health takes all complaints seriously and works directly with the patient/guardian to reach a satisfactory resolution that is within compliance of the Health Insurance Portability and Accountability Act and provider contracts. This concern will be investigated and will be worked on by *** Health to get it resolved to a favorable resolution as quickly as possible. Contact with the patient/guardian was made on 4/8/2024. The account is being investigated and *** Health is diligently working to ensure that the patients account is processed correctly. *** Health will continue to update the patient/guardian on the progress of the account review until we have reached the best possible resolution on this account. 
  
  
  
  Thank you.

  Customer response

  04/11/2024

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  

  While I agree with *** Health's response that they did indeed make contact with me on 4/8/24, this matter has been ongoing for several months.  I continue to await resolution of the matter.  The last time that I accepted their response, I did not hear from them again until I reopened this complaint.  Moreover, when I spoke to **************** on 4/8/24 she stated she would remove the February charge which she did.  However, that charge reappeared the next business day.  I do not feel that contacting me regarding my complaint is a resolution.  We need actual resolution to the fact that my son was treated for 3 months beyond the time when he was showing measurable progress and each treatment note was identical, thus setting us up for denials.  As a therapist myself I am well aware that we must stop treatment when medical necessity can no longer be demonstrated. 
  
  Regards,
  
  *************************
  
  
  
  

  
  

  

  Business response

  04/18/2024

  Good morning,
  

  
  Currently, our senior escalations agent is collaborating with the provider's office to resolve the issue. They have also been in communication with the patient's mother since the beginning of this week to provide an update on the progress of rectifying the issue. Once an update is provided to the escalations agent she will back in touch. 
  

  
  Thank you.

  Customer response

  04/18/2024

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  I agree with **** response that the escalation department has been in communication with me.  But as of yet there has been no resolution to the issue.  Moreover, we received another bill this week. I appreciate the escalation personnel maintaining contact; however, I would prefer this complaint remain open until the matter is actually resolved. 
  
  Regards,
  
  *************************
  
  
  
  
  

• Initial Complaint

  12/03/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I have continually been asking *** to amend their double billing for my ONE visit on July 21, 2023 to *************************************, MD, Orthopedics. My co-pay is $35 and statement #************, had the correct co-pay OF $35. The duplicate statement, #************, had an excessive copay of over $200!! FOR THE SAME VISIT ON THE SAME DATE!! I am a senior making monthly payments on all *** bills to the best of my abliity and protest this duplicate statement which has several entries items TWICE!!. *** has continually threatened to send my account to collection despite their cashing all my monthly bank checks remitted to them. I protest this excessive bill; it is not correct and I will not pay double for ONE visit!!JULY 21, 2023 VISIT AT ONE OFFICE ONE Lidocaine 1% solution @ $60.25 ONE Radex Wrist Complete @ $41 NOT 2ND Radex Wrist Complete @ $703 ONE OP ***** Mins @ $468 NOT 2ND ************* @ $377 ONE Bethmethasone Sodium Phosphate 6mg @ $111.05 ONE Arthocentesis Injection @ $254 NOT 2ND Arthocentesis Injection @ $644

  

  Business response

  12/04/2023

  Good afternoon, 

   

  I greatly apologize for the confusion. When a provider participates in Provider Based Billing, there is a separate claim for the Physician/Doctor, and a claim for the facility/hospital.

  One charge for the professional services from the doctor you see; One charge for the facility, which covers the use of the room and any medical or technical supplies, equipment and support staff and this will result in 2 charges for the one office visit. 

  I will have our billing advocate reach out to you to explain. 

   

  Thank you. 

  Customer response

  12/04/2023

  [A default letter is provided here which indicates your acceptance of the business's offer.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the offer made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved. If the company does not perform as promised, and they HAVE NOT despite my many attempts to work with them, I SHALL get back to you at: **********************************************.
  
  Thank you for your assistance.

   

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

  
  

• Initial Complaint

  11/29/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My son had surgery on January 10, 2023 in the children's urology department. We paid up front for the surgery and care. It totaled ********. On Nov. 1st we received a bill for ******* for his surgery. After calling costumer service on 11/6/23 or thereabouts I was informed that I had to talk to insurance. I did. They said their end was covered. I called *** back and talked to a different costumer representative who looked into the account and noticed that I was refunded ******* on January 27. According to the representative there were no notes as to why I was refunded the money. We never received notification about this refund. She passed my info along to their escalation department because there were no notes in the file as to why it was refunded. The representative said the escalations department would be in touch with me. ******, from escalations called on November 22 around 10 am. I called her back at the number she left and left a voicemail at 3pm. I called Monday, Tuesday and today (Wednesday) and left messages for her to call back. The bill is due on Friday (12/1/23). I want to know why we were refunded money with no notification. We thought our bills were all paid and then to find out before the holidays that it's not is incredibly frustrating. Also, if it was the hospitals mistake than I think they should cover part of the bill.

  

  Business response

  12/04/2023

  Good morning, 

   

  I have my billing advocate investigating your complaint and she will be in contact with you soon. I greatly apologize for another representative that was working on your complaint not calling you back, I'm looking into that as well. 

   

  Thank you.

   

• Initial Complaint

  11/28/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  This is for my hospital stay from September *****, 2023. *** has my account balance as $300, which is my typical co-pay; however, I completed a maternity management program through my insurance that waived this. My insurance, Anthem, provided me with a letter and I gave this to *** when I was a patient in the hospital. When my account balance still reflected this amount at the end of September, I provided the letter again through MyChart, to the ************ and the ***************** to name a few. A Billing Supervisor even contacted me on November 9 when I complained that my account still had not been resolved to the *****************, but since then I cannot get her to call me back nor has she taken action to resolve the $300 balance on my account that I do not owe. I have been waiting over the 60 days I was told it can take to make this (simple) adjustment. I need assistance resolving this since *** is ignoring my requests.

  

  Business response

  11/29/2023

  Good morning,

  I greatly apologize for the inconvenience; I had reviewed your account along with my billing advocate and your insurance had left the copay that they were telling you in the letter that was supposed to be waived as your responsibility. Our escalations department has been working to help resolve this for you, and earlier this morning we did get permission to adjust off the balance. As for the insurance if they were waiving this co-pay, they should never have left the balance to your responsibility on the explanation of benefits for that service. The balance has been adjusted off and our escalations representative should be in contact with you shortly to advise of this outcome. 

   

  Thank you. 

  Customer response

  11/29/2023

  [A default letter is provided here which indicates your acceptance of the business's offer.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the offer made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved. If the company does not perform as promised I can get back to you at: **********************************************.

  I would like to respond to the business response and say that the escalation team was working with me, but didnt follow-up for nearly three weeks until I submitted my BBB complaint and called the ***************** at *** again. Furthermore, in the waiver letter I provided, it says that the hospital can contact Anthem with any questions about the waiver. My understanding is they never did. I should not be responsible for making sure Anthem didnt list a balance on my EOB once I provided the waiver letter. This was **** responsibility when billing me. However, my account has now been resolved and I am satisfied.

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

  
  

• Initial Complaint

  11/12/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  On my *** health billing portal on August1st, 2023, I was given a refund of $118.73 in Patient Adjustments for a guarantorrefund,but I never received any money from the refund. I have moved out of state, and will no longer be going to *** health, so I would like my refund of $118.73 to be sent to **** have made multiple attempts to receive access to this refund. See below.On September 18th, 2023, I messaged on the *** messaging portal asking "Thank you. How do I get access to the $118.73 in Patient Adjustments from my July 18th? It shows up in my chart as a guarantor refund, but I haven't recieved anything." and a customerservice representative, *****, responded September22nd, 2023 saying "Hello, The account has been sent to refund team to review. This may take some time; we apologize for the inconvenience. Thank You." I received no further response.On October29th, 2023, I messagedon the *** messaging portal asking "Hi, I was given a refund of $118.73 in Patient Adjustments from my July 18th. It shows up in my chart in thee billing section. I have never recieved this money, and was told that it should cover future bills. Why has this charge of $59.84 not been covered by the refund?" I received no response.On November 5th, 2023, I messaged on theVCU messaging portal again in a separate chat"Hi, I was given a refund of $118.73 in Patient Adjustments from my July 18th. It shows up in my chart in the billing section. I have never recieved this money, and was told that it should cover future bills. Why has this charge of $59.84 not been covered by the refund?"I received no response.I now on November 12, 2023 had to pay a bill of $59.84 out of pocket because *** said my bill would be overdue, instead of my refund covering the bill.I have moved out of state, and will no longer be going to *** health, so I would like my refund of $118.73 to be sent to me.

  

  Business response

  11/14/2023

  Good morning, 

   

  I apologize for the issue; I will have my patient billing advocate on the escalations team investigate to see if the $118.35 was refunded to you or if it was applied open balances. She will investigate and reach out to you soon. 

   

  Thank you. 

• Initial Complaint

  11/07/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  They told me they will take me to ********************** next time if i dont do what they say. They kept putting me in the psych **** over and over because they said im mentally ill like other people who were mass shooters. so i should be punished for what they did

  

  Business response

  11/07/2023

  Good afternoon, 

   

  I apologize for the inconvenience; I have submitted this information to our Billing Advocate and Patient Experience for review.

   

  Thank you.

• Initial Complaint

  10/30/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I am Power of attorney for my mother, *****************************. On 12/13/21 we had a Dr. visit. Apparently they underwent a change in billing or insurance or something. My mother disputed the transaction for a while and has become in too poor health to do so now. I finally agreed to pay it and it has been pulled from out checking account and has not been credited to the account.. I have been fighting with them since mid Jan. I've sent and shown them proof of payment but still manage to get an overdue payment each month.. I did telehealth messages for the first few months and the past 3 months or so I've been speaking with someone within the office.. Account number is ******

  

  Business response

  10/31/2023

  Good morning, 

   

  I apologize for the issues. I have forwarded the information and proof of payment to my billing advocate that investigates billing issues. She will be investigating and reaching out to the cash posting supervisor to get assistance in getting the payment posted, she will be reaching out to you soon. 

   

  Thank you. 

• Initial Complaint

  09/12/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On 4/18/2022 my daughter received ****** services from *** Health Children Services on ************ one told me the services on that day will not be covered. On July 28, 2023, I received a bill for $411.31. After weeks of researching and calling *** billing and Delta ******, according to Delta ******, they received a submittal for payment for dental services on 7/4/2023; Delta ****** denied the claim and *** billed us for services over a year and 2 months ago. I applied for medical assistance through ***'s Health Public Benefits and received approval for 100%. I thought this would assist me but the date of service was too far in the past, and the Public Health only goes back 8 months after approval. We are stuck with a bill because *** Health wanted too long to submit for approval through Delta ******.

  

  Business response

  09/18/2023

  Good afternoon, 

   

  I sent this complaint over to a senior account specialist in our escalations department asking that the billing and claims be fully investigated, and necessary corrections be made. The specialist has also been asked to follow up with the patient's father as quick as possible. 

   

  Thank you. 

  Customer response

  09/27/2023

  BBB,

   

  I have not heard anything back from *** and this complaint has been closed out.

  I left a message at BBB and no one contacted me back.

  Can I get this complaint reopened?

   

   

  Regards,

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

  

  Business response

  10/17/2023

  Good evening, 

   

  I had my customer service escalation agent investigate the bill and she has made two attempts so far to reach the patient's father in regard to the patient's bill. 

   

  Thank you. 

  Customer response

  10/17/2023

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  I have not receive any phone calls or left message. I am not sure what phone #, they are dialing but it is not mine. I had message and I returned 3 phones without no response.

  Please update them on my ph# ************.
  
  Regards,
  
  ***********************
  
  
  
  

  
  

  

  Business response

  10/27/2023

  Good morning, 

   

  I've had the Patient Advocate in the escalations department make several outbound calls out to both contact numbers that is listed in the patient's account since 9/27/2023. A final attempt has been made as of 10:23 AM this morning to make contact at the mobile number provided. A voicemail was left with the advocate's direct number, extension, and hours that she can be reached here at our office. 

   

  Thank you.

  Customer response

  10/27/2023

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  *** resolution team left me a message today at 10:21AM and I return *****'s message and left a v-mail. The other message left was on 9/28 at 11:49 AM and that message I left 3 messages. *** resolution are indicating they have let other messages and that is not the true. My cell phone seems not to ring when they call, so I believe ******* has them listed a spam. Every message I received, I have return phone calls. I even call the ************ and spoke to a representative and got no where with that person.

  This issue needs to be escalated to a manager in the *** resolution and step a time that I can call them. They can emailed me at ******************** to setup a time to resolve this issue.
  
  Regards,
  
  ***********************
  
  
  
  

  
  

• Initial Complaint

  09/07/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I had an outpatient procedure at a *** health facility on 12/8/22. I have employer-based medical. The majority of the bills have been processed and paid. One claim was denied by my insurer as a duplicate claim for the amount of *******. The claim was for surgical pathology. The same claim was processed and paid already. I have contacted *** Health more than half a dozen times. Each time they claim they will be reviewing it but I never hear back on the outcome of this review. The bill just magically reappears with the threat of going into past due status. I have tried to get a representative from the review department on the phone but I get gatekept by the frontline representatives stating that a supervisor isn't available. On the last call, I was promised a callback within ***** business hours from a supervisor. As I write this I have gone 48 hours without a callback but they have one more day to be within their estimation. Several of the calls I have made with my insurance company on the line as well and even they are unable to get an answer from *** Health as to why I'm being billed this amount.

  

  Business response

  09/18/2023

  Good afternoon, 

   

  I passed the complaint along to a senior account specialist that is a part of our escalation team and asked that this issue be investigated and fully resolved for the patient. 

   

  Thank you. 

  Customer response

  09/18/2023

  [A default letter is provided here which indicates your acceptance of the business's offer.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the offer made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved. If the company does not perform as promised I can get back to you at: **********************************************.
  
  Regards,
  
  ***********************
  
  
  
  

• Initial Complaint

  08/22/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had hip surgery at *** Health (VCUH) on 3/30/22. From 3/30/22 to 3/16/23, I paid $2,231.35 which I owed after my insurance paid their part (see attach. 1). In 4/23/23, I received a $388 bill for the surgery (see attach. 2). On 5/9/23, I conferenced in VCUH (spoke to ******** ****** (spoke to *******) in an effort to get this situation resolved. Both confirmed the $388 bill was in *************** said she would submit the bill for review, which would take 45 days. I hadn't heard back as of 6/27/23, so I called VCUH & spoke with ******. ****** said she saw the note that ******* had entered, but the review had been done on the hospital portion of the bill & not the physician portion of the bill. ****** resubmitted the bill for review. I received a statement on 7/11/23 showing a surgery charge of $344.61 instead of $388, plus a charge of $43.39 for an x-ray done on 5/23/23 that I paid for on 6/27/23 (see attach. 3 & 1). On 8/13/23, I received another statement with the same charges & the $43.39 charge was now past due (see attach. 4). I hadnt heard back as of 8/21/23, so I called VCUH back & spoke to **************** She saw the notes that **************** had entered, & she said that payments were only made to the facility charge & not the physician charge. I mentioned to her that I was now receiving an additional charge of $62.76 for the 5/23/23 x-ray which I already paid $43.39 for on 6/27/23, but the $43.39 was still showing on my bill along with the erroneous additional $62.76 charge (see attach. 5 & 1). She moved funds to pay for the physician charges & said the changes should be in effect as of 11pm this evening, & that I should no longer owe anything. I checked my balance the morning of 8/22/23 & charges of $450.76 are still showing, so I am escalating this to the BBB since I have gotten no resolution despite reaching out to ***** billing department on 3 occasions. I do not want my credit score to be affected by these erroneous past due bills.

  

  Business response

  08/23/2023

  Good afternoon, 

   

  I'm having my billing advocate investigate and work towards a resolution. The patient should hear from her soon. 

   

  Thank you! 

   

  ************** 

  Customer response

  08/23/2023

  I read the response from *** Health saying "I'm having my billing advocate investigate and work towards a resolution. The patient should hear from her soon." Your system is asking me to either Accept Offer or Reject Offer. However, in my opinion there is no offer of anything that's been made so far - there's only been a comment from *** Health that they are investigating and working toward a resolution. So at this point I don't know what option I should select since there is no Offer to accept or reject. Please advise how I should respond. 

  Customer response

  08/24/2023

  Better Business Bureau:
  
  I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  Date Sent: 8/23/2023 4:30:24 PM
  I read the response from *** Health saying "I'm having my billing advocate investigate and work towards a resolution. The patient should hear from her soon." Your system is asking me to either Accept Offer or Reject Offer. However, in my opinion there is no offer of anything that's been made so far - there's only been a comment from *** Health that they are investigating and working toward a resolution. So at this point I don't know what option I should select since there is no Offer to accept or reject. Please advise how I should respond. 
  
  Regards,
  
  *****************************
  
  
  
  
  

  Customer response

  09/01/2023

  I strongly disagree with this compliant being closed. I have not heard anything from *** Health about this issue, even though they entered a response to my initial complaint on 8/23 saying that they would have someone contact me soon. As of 9/1, no one from *** Health has contacted me regarding this compliant, nor have I seen an adjustment to my bill which still shows as $450.76. I did not accept the business' "offer" on 8/23 because there was no offer made, and as of 9/1 there has been no communication from them or any additional information received. I AM VERY UNHAPPY WITH BBB'S RESPONSE TO MY COMPLAINT. WHO DO I REPORT THAT TO?

*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. ↩