Complaints

• Initial Complaint

  02/15/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Surgery performed 1/9/24. At time of surgery the provided required $3620 payment. Their ASSUMPTIONs included that they would file first, have their claim accepted, and be designated by the insurer (*****) to receive my entire deductible $3200 and 10% of the remaining charge up to a maximum out of pocket of $7200. Now, 5+ weeks later, further information is known, the assumptions are certain to be wrong, and New Mexico Orthopaedic Surgery Center refuses to discuss resolving the problem and is very difficult to contact by phone. Here are the facts as they are now known. - My personal max out of pocket is $3600. So, that was exceeded by $20 and should result in a prompt return. In conversation the provider representative tried to justify their incomplete information, but refused discussing corrective action. - Their claim has so far been rejected by ***** which is an issue for the Surgery Center to resolve. So far they have been designated to receive none of my deductible. - In parallel with this, the anesthesiologist and doctor have submitted their claims and had them approved by *****. According to ***** as of this date, the portion of my deductible that should be paid to entities other than NM Orthopaedic Surgery Center is $1870.44. So, in addition to the $20 described above, this further amount is needed IMMEDIATELY. Why are assumption and immediately stressed? NM Orthopaedic Surgery Center is aggressively insists on payment with no delayed terms based on their interpretation of their own best case. When their assumptions are known to be wrong they should be just as quick to correct the situation - immediately, as I paid, with no delay. Instead, they refuse to even discuss the topic, as if the present facts cannot be know. This is an abuse of their customer. Please have them correct their behavior and return $1890.44 immediately and I may need them to return more later depending on insurance process outcomes. Thank you. Regards, ****.

  Business response

  03/22/2024

  Patient has been in contact with the business office since 02/12/2024 and spoken to multiple staff members in regard to updates on claim status as patient updated his insurance information with *****.  Business Manager agreed to not abide by company policy and issued a refund PRIOR to insurance carrier payment to satisfy patient. Refund was credited back to patient's credit card in the amount of 3620.00 on 02/23/2024 card ending in 8160.Copy of refund issued has been attached.

   

  Sincerely,

  NM Surgery Center Orthopaedics

   

• Initial Complaint

  01/12/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I had rotator cuff on 1/17/23 at the NM Surgery Orthopaedics Center. The amount I owed after insurance was 892.87, which has been paid in full. I made two payments, the final being in March 2023. For each and every month since the amount was fully paid, I have continued to receive statements saying I still owe $292.87. I have called the billing office several times, emailed them on their website, and sent a hard copy letter to them on 11/13/23. I was told on at least two occasions that the auto billing would stop, as I owe $0.00. However, I continue to be invoiced for an amount I do not owe. I stated in my letter to them that if the billing were to continue, I would file a complaint with the BBB. I never heard back from them and the latest bill was dated 12/19/2023. My account number is *****. I am requesting that this monthly harassing stop immediately and for an acknowledgement from the office that it has been done. I have read some of the complaints here, and see that this is an ongoing issue. It's just a shame that the wonderful surgeons at New Mexico Orthopedics are tied to such a shoddy billing practice. Thank you, ****** * *****

  Business response

  01/30/2024

  Mr. ****** ****.  It pains me to think that we have been so delinquent in resolving your experience with the New Mexico Surgery Center Orthopaedics. This is absolutely not the way we every day strive for positive patient experience including the business side of your surgery.  It is with sincere apologies that after researching and understanding your plight that it is inexcusable that it took so long to process this claim on your account. 

  In reviewing your account payment for the balance due $292.87 month's ago, we found that the payment was processed by a third part (merchant center).  Again, for determining this, this is excusable that we did not know and we more so failed in our communications.  Simply stated we did not capture the payment on the 30th of April that was not captured in our system in our facility at our month end closing.  Hence, now, your account has been adjusted and currently reflects a zero balance as of today January 28, 2024. I hope that this clears up this outstanding confusion and error on our part.  I sincerely hope that your surgery went well and that you are back on the mend, so to speak. 

  I am happy to discuss live. As a function of this investigation, we have subsequently changed how we notice and notify patients and make note of the error(s) uncovered by the NMSCO.  

  Thank you.  

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

  Administrator, NM Surgery Center Orthopaedics

  Cell:  ************
  

• Initial Complaint

  11/29/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I had surgery on 8/23/2023 at NM Orthopaedic Surgery Center. At that time, I paid what they had estimated was my share of $2,429.00. On 9/19/2023 the insurance issued the EOB showing my share to be $1,633.10. Therefore I am due a refund of 795.90. I called 10/12/2023 to inquire about the refund. I was told it would be issued and received in 3 weeks. On 11/8/2023 I called to follow up since the refund had not been received. Since my call was not returned, I called back 11/15/2023. At that point I was told they were awaiting approval and would mail the checks on Friday, 11/17/2023. As of 11/29/2023, I still have not received the refund, I have called twice more and have not received a call back.

  Business response

  11/30/2023

  From *** *******:  ************  

  We just called and spoke with Ms. ****** and let her know that her refund check was processed on 11/21/23 and that she should be receiving it any day now. We did verify her PO Box with her and she said that it is correct.  We gave her my direct # and asked her to let me know either way if she receives or does not receive the check within the next couple of days, she stated that she will. 
   
  She was very kind and understanding.
   
  Let us know if there is anything further, we need to do. 

  With apologies, thank you. 

  
  

  Customer response

  12/04/2023

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  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. I have received my refund. I do wish that during this process there had been more communication. I'm disappointed that the refund took so long and so much effort on my part, to the point that I was not sure I would receive the refund without filing this complaint.
  
  Regards,
  
  ***** ******

• Initial Complaint

  09/28/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I had a surgical procedure scheduled at NMOSC with Dr. *** ********** of New Mexico Orthopedics on Thursday, August 3, 2023. Prior to my procedure I called the surgery center to see what my out-of-pocket portion of the facilities charge would be. I was told that with my ************ Health Insurance I would be required to pay 30% of the $8,383.76, or $2516.00 which I did upon checking in. A few weeks later, I received a claim payment summary form from ************ indicating ************ had a negotiated provider discount of $2,206.25, and my responsibility was $1858.25; I was over charged by NMOSC by $625.31. I phoned the NMOSC business office (************) in mid-August about the overpayment and was told that the refund would be processed, and a check for the overpayment would be mailed to me. I followed up with the business office on August 25, and was told that the refund would be processed in two weeks. I followed up again on September 14, and was told I would receive my payment by September 16th. I followed up again on September 20th and was told the check was coming from Dallas so “give it a couple of days." Yesterday, September 26, my call was not answered so I left a voicemail stating I hadn’t received the refund, and suggested they credit my ******** *******, overnight a check to me or do an ACH transfer into my checking account. As of today, September 27th, 2023, I still have not received the refund. That makes 38 business days since the overpayment and, were the tables turned, I am certain NMOSC would report my account as “overdue.” I also think my situation may not be an isolated incident. When I looked at NMOSC Google Reviews the other day, I saw some that reference similar issues. I can’t help but wonder how many people face similar challenges with this organization. I added my own Google Review and hope people read it before engaging in any financial transactions with NMOSC. Is this something the BBB would be able to help me with?

  Customer response

  10/06/2023

  Good morning,
  I am reaching out to let you know that this morning I received the refund owed to me. The full amount, $625.31 was credited to my ******** ******* card.
  Please let me know if you have questions or would like additional information.
  All the best,
  ****** ******

• Initial Complaint

  06/22/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On March 9th 2023 I had an orthopedic prosecute done. In April I received a bill (expected) and quickly made arrangements for payment. I utilized their Care Credit availability. A week later I noticed the payment had not posted on my CareCredit account so I called NM Surgery Center and the next day 4/18/23 it posted. Then in May I received a statement saying my account was 30 days passed due. I called the inquire and they said there was a note stating I was using CareCredit but it hadn't posted. The woman I spoke to, Ora assured me she'd follow up. A week later no response so I called back. She hasn't heard back but said she requested I be removed from the debt collection agency. Another week with no response so I called Ora back and she said they were closing the month and she would be out of the office but she'd follow up when she returned to assure me it was taken care of, by this time it was June 1st 2023. I didn't get a response as she promised but today June 22nd 2023 I received another bill saying I was 60 days passed due. I called Ora again and demanded to speak to her supervisor who was out of the office so I left her a voice mail. I also insisted Ora send me all documentation she said she sent her supervisor but have not received anything. How is it 2 months after the payment was submitted am I 60 days late and being reported?

  Customer response

  08/28/2023

  Verbal Update: Issue has been resolved. They did not initiate contact with me.  I had to contact then several times to have this corrected. 

*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. ↩