Complaints

• Initial Complaint

  01/20/2025

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Hello, I had went in for my annual physical checkup. As part of that they took some basic labs. The whole point of this visit was that we are entitled a free annual physical. I was later charged $58.49 for these labs. If I was told I was going to be charged for these I never would have had them performed. I am otherwise healthy and not overly necessary. I believe this was a deceitful practice rather than be able to state upfront of what they pricing would be. They had my insurance information so should have been able to understand what is/isn't covered.

  Business response

  01/24/2025

  Hello,

  Thank you for the opportunity to review this concern.  We are working with the patient directly for a resolution.

  Illinois Patient Billing Contact Center Manager

• Initial Complaint

  01/09/2025

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  *6-12-2024- Prostate Biopsy was performed -I was asked to pay $269.82 (Mastercard) up front so I did. *11-20-2024- Received bill from Advocate Health Care for $2,539.01. We called our insurance provider, ***** @ ************** who said they never received this bill. After investigating, they told us we owe nothing out of pocket since our out-of-pocket costs were maximized/met on 6-12-2004 (with the final $141.02 the day of the biopsy). When we told them we had paid $269.82 that day(6-12-2024) at ******* Hospital, Aetna subtracted $269.82-$141.02=$128.80. They told us this is what Advocate Health Care owes US. *We called Advocate @************** on... 12/6(******/********), ..12/20(*****), and..... 1/3/2025(*****)..all **** put us on numerous holds and said they were passing it on the ************* We have asked for a call back and received NONE. No action has taken place. We are waiting for a check for $128.80.

  Business response

  01/13/2025

  Hello,

  We were able to resolve the issue.  The patient was pleased with the outcome.  Thank you for the opportunity to review his concern.

  Illinois Patient Billing Contact Center Manager

• Initial Complaint

  12/12/2024

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  Policy # All State Benefits - 55ER560241 What I need to close this complaint is the following: For me to obtain my disability benefits through All State Benefits, I must have a completed and faxed Physician form on or before 12/13/2024. The form has not been sent correctly as of 12/12/2024. Only half of the required documentation has been completed, causing immense hardship for me; as I was injured and this form was faxed twice by ***** (in the disability department of Advocate Health Care) on December 3rd and December 10th, these forms were not correctly sent, according to All State Benefits. As a result of ******* negligence, I am unable to receive the short-term disability benefits I require. My request to Advocate Healthcare is to fax the CORRECT and COMPLETE Physician's Form; without this form, the disability claim cannot proceed. It appears the COMPLETED Physician's form has not been faxed on December 3rd and December 10th. Please have someone, other than *****, from your office fax this form and reply to this complaint as soon as possible. The fax number is ************. I need this completed before 12/13/2024 I will be forced to file a complaint with the Illinois Department of Public Health and the **************** if this action is not taken, and if I do not receive a response from someone. I will take any action necessary, available to me, to ensure that my health information is accurately sent to the ************************ I look forward to an expedient resolution.

  Business response

  12/16/2024

  Hello,

  We have taken care of this.  Thank you for the opportunity to review this concern.

  Illinois Patient Billing Contact Center Manager

• Initial Complaint

  11/14/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  11/14/24 - Date of transaction. Was charged an additional $1115.00 for 2 replacement lenses as part of a cataract procedure. For this procedure I opted for multi-focal lenses, which were not covered by ********. I paid $4,000.00 each for these lenses a few weeks prior to the surgery. My left eye was done on 11/11/24. On 11/14/24, at approximately 6:30PM, I received a call from the hospital billing department telling me that I owed the additional charges and, if I refused to pay, the second surgery, scheduled for 11/18/24 would be cancelled. I felt like a gun was being held to my head and because I did not want the second surgery cancelled, I paid the charge. I did ask for an itemized receipt or some detail regarding the justification for this additional charge and was told that none would be provided. When I asked why I was not told about this before the first procedure, I was informed that it took a while to calculate the charge and someone did leave me a message on 11/11/24. I was at the hospital until almost noon, did not receive a call that afternoon and have no voicemail record indicating that this actually happened at any time during that date . It is my strong belief that, since the hospital would receive no ******** reimbursement for the lenses, they calculated what that amount would have been and passed that charge along to me. The only documentation that I have is a copy of the credit card transaction in the amount of $8,000.00. I believe that a strong case could be made for consumer fraud. If you can not obtain a refund, I fully intend to seek a remedy through the judicial system.

  Customer response

  11/17/2024

  receipts for lenses and the additional charge that I am disputing.

  Business response

  12/06/2024

  Hello,

  We will be contacting Mr. *********** soon.  We are still reviewing his concern.  We will be able to explain the lens charges that Advocate supplies, but if he has questions about his payment of $8000, he will need to contact the surgeon.  He is not an Advocate employed physician, so we do not do the billing for him.

  Illinois Patient Billing Contact Center Manager

  Customer response

  12/16/2024

   
  Complaint: 22559489
  
  I am rejecting this response because: I requested documentation listing the actual cost of the lenses to the hospital and this has not been provided. Secondly the unprofessional. gun to my head approach that was used to notify me of the charges borders on business malpractice.  Additionally I believe it is a violation of required medical disclosure mandates. I feel that a simple apology is not sufficient and would like to see a price adjustment in the form of a credit.

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

  Business response

  12/16/2024

  Hello,

  I am sorry we are unable to issue a refund or not charge a fee for a supply that was requested, ordered and provided.  I would recommend discussing this with your surgeon.  He is not an Advocate employed physician.  He should be able to tell you what the  8K payment you made was supposed to cover.

  Illinois Patient Billing Contact Center Manager

  Customer response

  12/16/2024

   
  Complaint: 22559489
  
  I am rejecting this response because: I have already discussed this matter with my physician.  I will not be issuing any further payments until I receive a copy of the actual invoice paid by Advocate to the lens provider.
  
  Sincerely,
  
  ******* ***********

  Business response

  12/17/2024

  Hello,

  We have done our best to accommodate your concerns.  I apologize we could not come to an amicable resolution,

  Illinois Patient Biling Contact Center Manager

• Initial Complaint

  11/14/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On 10/7/2024, I visited a ********* Clinic, as I needed antibiotics for a sinus infection urgently. I had come to find out that my PCP, had retired, therefore did not have a PCP at the time. Seeing that ********* provided basic medical services, such as sick call, and were available and saw that they accepted BCBSIL (calling beforehand and ensuring benefits), I proceeded with making an appointment to be seen. I was charged on the visit the copay of $25, which was was expected. Fast forward a few weeks and I receive a patient responsible bill of an additional $15. Not knowing what that was for I waited for my EOB from ****** to provide more context and come to find out that it was for the copay. This did not compute as what I was told before going and what I was charged were in line with the expected $25. I contacted ****** first and was told it was billed as specialty visit and therefore that is how it was processed. They advised that I call Advocate back and have the claim resubmitted not as a specialist visit to be processed appropriately. I continued to call Advocate and explain the situation, but was told in no uncertain terms that they will not change anything and that I was seen by a nurse practitioner and therefore it is a specialist - a quick Gen ** search as well as my logic disagrees with that. Trying to find out who or how this was getting coded, I proceeded to call the ********* Clinic and they provided my the number back into Advocate, so here we are.Bottom line, not sure what is going on and why no one wants to take responsibility, but it is totally unfair and a bait and switch scenario to the patient, who needed immediate care, and is presented one financial scenario upfront, only to find out a different one later on. Each year we pay more and more on premiums, but receive less benefits, and it seems the providers are partnered up to shift the financial responsibility back to the patient with a system that doesn't benefits the consumers.

  Business response

  12/02/2024

  Hello,

   

  We have left several messages for the patient to discuss her concern.  She has not returned our call.  We look forward to connecting to resolve her concern.

  Illinois Patient Billing Contact Center Manager

  Customer response

  12/05/2024

   
  Complaint: 22557763
  
  I am rejecting this response because: I don't have the time to discuss the issue. It is quite clear that ***, insurance companies and providers are in collusion against the patients in terms of offsetting their costs to patients, when it is clear with the service that was provided that it was nothing more that a run of the mill office visit. Then everyone points the finger at the other entity and no one takes responsibility.
  
  Sincerely,
  
  ******* ******

  Business response

  12/06/2024

  Hello,

  We would welcome the opportunity to speak to regarding your concerns.

  Illinois Patient Billing Contact Center

• Initial Complaint

  09/17/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  For the last five weeks, I have tried to get my medical office to send over the required information to my insurance company so I can continue to be paid by my short term disability. They have failed to do so even when being asked multiple times a week for the last five weeks Ive called multiple times, they have done absolutely nothing. I have two children and a third on the way and my bank account is now currently negative due to their incompetency and neglect. It was only today when I called yet again for the last time that they said that they were going to send the last bit of information to get my short-term disability approved again all I needed was the primary physicians authorization statement to complete the short term disability information to continue my payments. They continue to promise that it was going to be this day that day the same day that things would be done yet I would call and they would say they just started on it, this would be the day after two days after three days after possibly a week and if they are doing this to me chances are they are doing this to somebody else I am going to lose two storage units possibly my car and possibly my home due to them, not seeming to have a Care in the world about their so-called patients. 

  Business response

  10/02/2024

  Hello,

  I apologize for the delayed response.  We worked directly with the patient and the office provided what he requested.

  Illinois Patient Billing Contact Center Manager

   

• Initial Complaint

  08/25/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I started with a new company 4/15/2024; their insurance became effective 5/1/2024. I called Advocate's customer service and they said all I had to do was upload a picture of the current insurance card and delete the old one. I did that.I had blood work done in their lab 6/14 - then I got billed 8/5...which showed patient responsibility of ***** - so I paid it.I had an office visit 6/21 - and I got billed 8/22 for $188.** and when I looked at that bill it showed Advocate billed the wrong insurance company.I called and spoke to 3 people on 8/22. The first ****** was in billing and they were very rude and they transferred me to customer service. That customer service *** said, "we can't take the patience word for eligibility with insurance providers."Then I called back an hour later and spoke to a 3rd ****** who said they will re-process both claims with the current insurance company, however I am wanting a refund of the $43.** I paid on 8/5 since they billed the wrong insurance company.This is NOT the first time Advocate has billed the incorrect insurance company.

  Business response

  08/27/2024

  Hello,

  Thank you for the opportunity to review this concern.  We reached out to the patient and we were able to address all concerns.

  Illinois Patient Billing Contact Center Manager

  Customer response

  08/27/2024

   
  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.
  
  Sincerely,
  
  *************************

• Initial Complaint

  07/15/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On June 11, 2024 I had routine follow up visit for medical of services I have been treated for approximately 10 years through Advocate Aurora. However the bill for this date has additional charge of $400 for initial program fee I ask how am I charged initial program fee for follow up visit for services I have had nearly 10 years. Advocate only response is bill coded correctly. I believe this is error and over charge. This was not presented to my insurance cause it was not on EOB which is all the more apparent as being made up charge to rip me off.

  Business response

  07/24/2024

  Hello,

  Thank you for the opportunity to review this concern.  We are working directly with the patient towards a resolution.

  Illinois Patient Billing Contact Center Manager

  Customer response

  07/24/2024

   
  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.
  
  Sincerely,
  
  ***************************

• Initial Complaint

  06/27/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  This healthcare provider billed me for date of service 10/26/23 which at the time I disputed. It was in my opinion coded incorrectly. After much back and forth, they insisted that the bill was correct and that I owed $186.34.I made 2 payments in *********** 2024 and paid the amount of $186.34 IN FULL.I have received a voicemail from a collection agency for the same amount which is extremely upsetting as I am elderly.I contacted Advocate and they NOW day that it is from a date of service in 2022! The account number ****** has shown a zero balance since the account was paid earlier this year. This account is paid in full, in fact, they received a payment from an agency as well AFTER I paid the account so in essence, it should have a credit balance!

  Business response

  07/11/2024

  Hello,

  We are working directly with ****************** regarding her concern.  Thank you for the opportunity to review.

  Illinois Patient Billing Contact Center Manager

  Customer response

  07/12/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have to accept their explanation. That being said, I remain convinced that this is an incorrect charge. I will no longer see any Dr at any Advocate Healthcare setting. Thank you for your help BBB,
  
  Sincerely,
  
  *****************************

• Initial Complaint

  04/18/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I go to luthern general hospital in ********** il to see ********************** and I have ********** blue shield hmo understand outside network my site 447 gave me referral to see ********************** on 4/19/2024 but the billing department tells me cant bill insurance when site 447 gave me referral to see him there, since closer to me. Called site 447 sed Im approved to be bill by luthern general hospital thay called over there tells 5hem will bill it but when I call tells me cant why not using my insurance like 447 site gave me referral so can bill?

  Business response

  04/18/2024

  Hello,

  We spoke to ************ and we were able to resolve his concerns.

  Illinois Patient Billing Contact Center Manager

*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. ↩