Complaints

• Initial Complaint

  03/02/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I am filing a complaint in regards to statement No. XXXXXX, and have attached the statement and my proof of payment for reference. Before booking appointment for ***************************** area, I checked with my insurance on what would be covered. I told it would be all out of pocket since I have a $***** deductible that had not been met yet. I called dermatology offices within my network and explained the situation. Before booking an appointment, I asked for an exact price and if I could use my health savings account since I would pay for everything out of pocket. I was told the visit and lab work would cost $******. I agreed for the appointment and paid that amount after the visit on Dec. 1, 2021 as shown on the attached sheet. I then received a call and a billing notice (attached) that I owe $******. The billing notice is incorrect for numerous reasons. 1. The billing notice does not calculate my payment of $******. It only lists me as making a payment for $94.99. 2. The billing notice charged me for a second visit on Dec. 15, 2021 for $***. I was told ahead of time I would not be charged for that visit because they were simply sharing results from the biopsy and lab work. I decided not to have any further procedures after they shared the information. 3. The biggest error involved the totality of the charge. I was told upfront that it would cost $******, and I sought that clarity since I knew I would be responsible for any charges. I contacted ******************** and Skin ****** Institute twice about this issues, and they refused to correct the mistakes and take responsibility. They insisted they only gave estimates, which is incorrect. They denied they said a second visit would not cost anything, which is also incorrect. And they also stated that the $****** wasn't applied because "it was going toward my deductible." That explanation does not make sense since I was always responsible out-of-pocket for any charge.

  Business response

  07/01/2022

  Business Response /* (1000, 8, 2022/06/13) */ Case#******* Patient was seen on 12/1/21 and 12/15/21, patient has a high deductible, which means he will be paying out of pocket for all his visit. The patients bill will be explained in the Explanation of Benefits (EOB), which is sent to us and the patient by the insurance company. Any billing statment we send out will be based on the explanation of benefits that each patients insurance sends us, this is based on the type of insurance and benefit each patient have. The patients total responsibility per explanation of benefits for both visit is $******, patient inital payment was $ ****** (estimated fee schedule for initial visit, total balance = $******. Patient paid this balance on 5/11/22. Patient also did sign our payment policy where it indicates, charges not covered by the insurance copany is the patients responsibility. We also offered to speak to the patients insurance company to help clarify the *************************** representative ***** did confirm that the total responsibility based on the explanaton of benefits is $****** ,she stated she will also call the patient to explain this to him.

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