Complaints

• Initial Complaint

  08/15/2024

  Complaint Type:

  Billing Issues

  Status:

  Unresolved

  More info

  Date of the transaction: Mar 22, 2024

  The amount of money you paid the business: $2,533.98

  What the business committed to provide you: ER service

  What the nature of the dispute is: A failure to follow the rules.

  Whether or not the business has tried to resolve the problem: No. After I finally got hold of them, they did talk to me and sent me elsewhere.

  If the issue involves advertising, when and where the ad was seen or heard: No. I made over 10 phone calls to ADENA from April 15 to May 6: call **********: ###-###-#### automatic request of itemized bill from menu call 2024-04-22?: ###-###-#### disputed the bill, asked for the itemized bill 2024-04-24: received call back from J. ###-###-#### , I was at work 8 calls to *******, ADENA escalation team, ###-###-####, ext ****  Finally on 2024-05-06: received call back from J., she gave me mail address and phone: Attn. Patient advocate, ###-###-####. 2024-05-06: I called there, but they don't deal with billing issues.

  I was to call for billing concerns at ###-###-####, But that is the same phone number where I started on April 15.

  So I decided to write a dispute letter. I sent it on May 24 as a certified mail with all the evidence and - asked again for the itemized bill - asked for the link to the Price information list, as per ORC 3727.42 - disputed upcoded ER level - disputed useless CT scan taken against my condition The certified letter was delivered on 2024-05-28 (tracking#: **** **** **** **** ****).

  I have received no response nor the itemized bill so I called again on Aug 7 and they told me that they haven't received any letter. So there was no dispute process for me. This doesn't seem to be a coincidence since my friends have the same experience.

  And they also sent a certified letter (tracking#: **** **** **** **** ****).

   

  Business response

  08/30/2024

  **********************
  
  Good Morning!
  
                  Patient has requested itemized bills for services, and he was not successful in receiving them. I attempted to contact the patient on 8/21/2024, 8/22/2024, and 8/23/2024 to get more information on what itemized bills he specifically needs. I was not able to make contact with him. I did however leave a voicemail each time with my direct line to call me back and as of 8/30/2024, I had not received any contact from him. Please reach out to me if you have further questions regarding this matter.
  
  Thank you!
  
  *******
   
  ******* *****
  Customer Service Representative II, Escalations
  
  ***** **** ******* ******** *********** ** *****
  

  Customer response

  09/04/2024

  They called when I was at work and when I called back it said "not available" or "closed", or waiting time was too long. So dedicated two days from 3pm until 6pm the next day. Then I got hold of ****** at ###-###-####. I said that I am returning their calls. She didn't know about any calls. I repeated my main complaints, she had no knowledge about that and couldn't respond. After reviewing my account she said that all reviews were finished, all charges stay, that is what they wanted to tell me, and she cannot do anything about it. She also tried to reach the "escalation team" but they were not available. I tried to setup an appointment over the phone or in person but she said that is not possible.

  I also returned calls to ###-###-####, ext.**** and to ******* at ext.**** both days and left messages to call me back. They haven't.

  
  In sum, they called when I was at work, or when I called back it, or it said "not available" or "closed", or waiting time was too long, or it sent me to voice mail, or when I got hold of a live person, they said they cannot do anything and no appointments are possible and no response to my mail. This behavior is consistently same since April and also with the experience of my friends. It is much worse than 20 years ago when it was the other time I dealt with hospitals. I don't know any other business that do this to their customers. 

  
  Consequently, I got no response to any of my complaints, and no real dispute process happened.
  
  

  Regards,
  

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

• Initial Complaint

  07/18/2024

  Complaint Type:

  Billing Issues

  Status:

  Unresolved

  More info

  Mammogram performed 1/9/2024. Secondary diagnosis attached (thyroid nodule) to my claim is incorrect and has caused my claim to process as diagnostic vs screening/preventative. This has resulted in a patient responsibility balance. I have spoke with Adena on numerous occasions and provided instructions from my insurance on how to correct/resolve but to date they still have not made that correction and have turned my account of $436.75 into collections with ***** ******* **** I have disputed this amount with that agency. My insurance will only accept a corrected claim for a certain length of time, timely filing guidelines will then apply. I am getting no resolution from Adena on this issue.

  Business response

  08/30/2024

  *************************
  
  Good Morning!
  
                  I have reached out to the patient and discussed her account in detail. I have forwarded the account to the coding leadership team for their review, as the claim was submitted to coding on two separate occasions. Each time, it was determined that the claim is coded accurately, and no further actions are possible at this stage. I advised the patient to contact her physician to explore the possibility of obtaining a corrected order, which would enable us to resubmit a revised claim. Regarding the current coding of the claim, it has been confirmed as accurate. Additionally, I consulted with the billing department to determine if there was a possibility of billing the services separately; however, they informed me that, due to the services being provided on the same day, they must be billed together. I communicated to the patient that there are no further options available through the billing department unless there are changes at the registration level. She mentioned that she is also seeking assistance from another party. I have now concluded my involvement in this matter, as I have exhausted all avenues to review and rectify the situation.
  
  Thank you!
  
  *******
  
   
  
  Michael Drake
  
  Customer Service Representative II, Escalations
  
  11511 Reed Hartman Highway, Cincinnati, OH 45241
  

  Customer response

  08/30/2024

  ***********
  ******* is absolutely not up to date on the situation. I have had to contact the manager of mammography at Adena to obtain a copy of my mammogram order myself. I have provided this to ********* ****** who is working with ***** ***** who also has an escalating this claim to coding again. This order proves that the mammogram should have one diagnosis only attached and that is screening mammogram z12.31. Why I had to do this leg work vs Adena themselves I don’t know. This is an absolute coding error. I have spoken with my insurance on several occasions and they will accept a corrective claim up to 365 days from the date of service. That should be Adena’s next step. 

• Initial Complaint

  05/09/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Back in August of 2023 I had a procedure done at Adena. When I was sent the first EOB from my health care provider they told me I did not owe anything (0.00).

  Unbeknownst to me Adena refiled the bill and then it was processed. I did not get a new EOB from UHC so I did not know that I owed anything until November that I got a bill for 2000.00 I played phone tag with everyone trying to figure out what was happening. I asked Adena to put the bill into their escalation department in February. They called and left messages for me and I will call back and everytime I did it would go straight to voicemail. I asked for an email address so that I could keep a running record in print and they refused. I called over and over and over and finally they put me in touch with someone one April 4th which was ******* *****. He told me that my bill was sent to collections. I asked why since no one from the escalation department had ever talked to me in person. He said he would try and pull it back from collections.

  In the meantime I filed with the Attorney Generals office and since Adena refused to work with the complaint the bill still lies in collections. They refused a face to face meeting and to give me an email address to start a running record. All I want is the bill pulled back from collections so that it does not effect my credit score and so that I can pay it.

  Business response

  05/17/2024

  *************************
                  I have reviewed this complaint and I had sent a request to pull the account back from collections per patient request. My request was denied because the patient was made aware that the balance was correct on 2/28/2024. I also pushed back on the denial, and that the push back was also denied. Please see the attached thread.  
  Thank you!
  
  *******
  ******* *****
  
  

• Initial Complaint

  04/14/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  ***** ******** got X-rays done at Adena Hospital in Washington Court House, Ohio. ******** paid $1323.94. Secondary insurance, ****** ** ***** paid the balance due which was $264.79. I have talked to Adena billing department 4 times and they have validated that ****** ** ***** sent the check for $264.79 and they had received it but it had not been applied to or processed yet to pay the balance due of $264.79. I have talked with ****** ** ***** twice and they have validated that the check for $264..79 has been sent to Adena. I am now getting emails from *** ******** saying we still owe them $264.79 for their services. I’m still getting bills from Adena saying we still owe $264.79. I want this resolved because I don’t want to be turned over to collections.

  Business response

  05/05/2023

  Complaint ID: ******** has been resolved. The balance is now at a $0.00 balance. 

  Customer response

  05/12/2023

  On Fri, May 12, 2023 at 12:04 PM '***** ********' via Dispute Resolution - Shared Inbox <disputeresolution@centralohio.bbb.org> wrote:
  I have sent the form you asked for and it was signed.  Adena requested that I have Mutual of Omaha fax the EOB to them again validating that the bill has been paid.  That was done.  I am still getting a bill from Adena saying I owe that amount.  I do not know what is going on or what the problem is.  I have done everting I have been asked to do.
  Could you please call me ###-###-#### and let me know what is going on.  ********* *********** sent this email to me.  I am so frustrated.
  Thank you, 
  ***** ********
  
  Sent from my iPhone
  

  
  

• Initial Complaint

  10/29/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  Adena Health System account number **********  On 7/22/2022 I received medical treatment at Adena Regional medical Center. I have health insurance through my husband's health insurance plan, Aetna. Several tests and procedures were performed with one of the items billed to Aetna was for Urinalysis, Auto. W/Scope ***** in the amount of $15.12. In the Explanation of Benefits (EOB) of our health insurance I received from Aetna, they did not pay this fee with a note under the column, pending or not payable, remarks, (6) "You do not have to pay this. Your plan covers charges we find to be reasonable and appropriate. This service is included in the overall fee of another procedure or is usually not done at the same time as another procedure on the same day." After receiving a initial bill for this $15.12, my husband telephoned their billing department and explained what Aetna's EOB said concerning this fee and that we did not have to pay it. After receiving a 2nd notice, my husband mailed a copy of the EOB with a note that we did not have to pay it. Today, 10/29/2022, we received a 3rd notice marked URGENT. With a note that the account is seriously past due. Unless payment in full is received by the due date, your account will be referred to a collection agency. The date listed on the due date is AMOUNT NOW DUE. It's my understanding that for Adena Regional Medical Center to be listed as an Aetna "in network provider" they agree to the terms of payment from Aetna. I would request that Adena agree to the explanation from Aetna and that this procedure is either not payable or was included in the fee for another procedure and that I am not required to pay the $15.12 in question.

  Customer response

  02/03/2023

  [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 accept the business's response to resolve this complaint.
  Regards,
  
  Carla Cox

*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. ↩