Complaints

• Initial Complaint

  06/07/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  In February 2023, I was due for my annual checkup regarding my sleep apnea condition. For the past few years, these checkups have been conducted over the phone because there are no complicated matters to discuss, it is more of a formality to certify my condition/prescription for insurance to cover my CPAP and supplies. Further, the sleep doctors have access to all of the data from my CPAP device. So these calls have lasted just a few minutes. This year, when the sleep medicine office called me to schedule my checkup, they were adamant that I come to the office in person. I pushed to keep the appointment over the phone, but they would not allow it and wouldn't give me a reason. Finally, I relented and scheduled the in-person appointment. This appointment occurred on February 20, 2023 and, as expected, it lasted only a few minutes. Nothing was discussed or examined that could not have taken place over the phone. When I received the bill for this visit, I was billed not only the $30 co-pay for doctor's visits, but an additional $194.06 for a "facility usage fee." At no point prior to or during my visit did any of the staff inform me of this additional fee. They forced me to have the appointment in person, rather than over the phone, even though it was not medically necessary because they wanted to charge me the additional facilities fee. And because I was not informed of this fee, I believe I am being fraudulently charged. I paid the $30 co-pay but I have not paid the facilities fee. I want the entire $194.06 amount removed from my bill.

  Business response

  06/27/2023

  Thank you for making us aware of this patient’s concerns and allowing us the opportunity to respond. We have reviewed the patient's HIPAA authorization form and may now disclose pertinent information related to this complaint.

  This patient had a sleep study performed at home in 2019. In September of 2020, they had a virtual (telehealth) visit with their doctor. In October 2021, the patient had another virtual appointment with their doctor. At that time, the doctor made a note in the patient’s medical record that the patient’s next appointment had to be conducted face-to-face as he was not yet seen in-person by the provider. This visit was scheduled for October 2022. The patient subsequently cancelled this visit. The patient’s next appointment was scheduled for February 2023 as an in-person clinic visit. There is signage (attached) at the front desk of the clinic that informs the patient that they will receive two bills for their visit, one from the hospital and one from the provider (doctor). This is common and appropriate billing for a clinic that is considered “hospital-based.” There are two components to this type of billing – a technical component (the hospital bill) and a professional component (the provider’s bill). This is why the patient was billed $194.06 for the “facility usage fee” or technical component and also was subject to his $30 co-pay. This is not fraudulent or inappropriate billing and, as previously stated, is a common practice across healthcare.

  We sincerely hope that this clarifies the billing scenario and explains why the patient was appropriately charged for his clinic visit. Please reach out to us for further information if needed.

  Customer response

  06/28/2023

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  I don't agree that a sign in the waiting room is enough notice about two bills. They should be required to inform patients about the billing prior to their appointment and to confirm at the time of the appointment that they will receive two bills. While I understand now that many clinics that are owned by hospitals are charging a facility usage fee, I don't agree or accept that this is an acceptable practice. It passes extra costs onto the patient without adding any value to the medical services rendered.
  
  Regards,
  
  ****** *******

*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. ↩