Complaints

• Initial Complaint

  10/15/2023

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  Re: ***********, 10-4-23, my wife called Dr’s office & spoke to RN Katie to get a good faith estimate (GFE) as this is self-pay. Katie didn’t know what Dr. would chg, said I could bring $80-100 & they’d bill me for balance. She failed to disclose new patient charge (NPC) -- minimum $130, which Dr had just raised to $200 w/o her knowledge. My wife was clear I’m a new pt, but Katie never mentioned $130 NPC (only the $80-100 range). Procedure took < 5 min, but Offc. Mgr, Tanya, sts Dr chgd $216, since NPC is $200. She said the Dr sets prices, & I could “pay whatever amount I wished”; I paid $80. CMS.gov sts the "No Surprise Act" (NSA) protects uninsured consumers from surprise bills (legal right to rcv a GFE). // On 10-5-23 rcvd bill for remaining $136, after Tanya’d told me on 10-4-23 that she "understood" & I could “pay whatever I’d like”. Katie told me that “Dr. B**** had raised NPC to $200 this week w/o anyone's knowledge”. However, she still knew NPC wb $130, plus any add’l chgs Dr wished to chg. Katie h/u on me on 10-5-23 when I spoke to her about this. Tanya (Offc. Mgr) told me on 10-5-23 that Dr sts "the price is what it is," & she’d have Amari (Billing & Claims) call me. // Spoke to Amari 10-11-23, who said NPC varies depending on procedure; they don’t know what it’ll be until I’m seen. She said there’s a range of codes that I cb billed for. I said Katie should’ve told wife on 10-4-23, when she called to get a GFE for me as a new pt, that I’d be charged a NPC in addition to procedure cost, & she should’ve given us the NPC range (E.g., $130-200). She sts they don’t have to tell us that, & she claims we "only called for GFE for cost of procedure". I told her we wanted GFE for entire cost, & NPC was part of that, which was withheld from us. She refused to write off remaining balance. She also claims the No Surprise Act only applies to facilities, not Dr’s offices. She lectured me that their NPCs are much lower than other Drs in town. She also h/u on me.

  Customer response

  10/25/2023

  I have not h**** from the business in response to my complaint, except a bill in the mail for $136 (see attached).

  
  

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