ComplaintsforCleveland Clinic Foundation

• Initial Complaint

  08/02/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I went to Dr. for one issue for sleep apnea concern and have been referred out to 11 different dr. visits. It has been over 4 months. I have been offered no help for my original concern. I have been prescribed an Apap machine but the equipment place states they don't have the order. I have spent hours on the phone trying to get the order over to equipment provider. I spent hours on the phone with the health insurance company and the Cleveland clinic getting approval for the sleep study. The whole process has been phone call after phone call, for countless hours. I have spent well over 40 man hours just trying to get treatment for what I initially went to the dr. for.

  

  Business response

  08/05/2024

  Good morning and thank you for bringing these concerns to our attention.

  We will contact patient directly to discuss their concerns. 

   

• Initial Complaint

  08/01/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I have been deceptively charged by Cleveland Clinic (CC) for the service I did not ask about or needed. All my attempts to resolve it through my insurance company or through CC billing department have failed. Description of the problem: I had yearly physical checkup on April 18 2024. My insurance covers a physical checkup as a preventive procedure 100%. I did not have any additional complaints or requests during the visit. This year, during the visit I was asked a slew of questions about my emotional and mental wellbeing. Again, I did not ask about or needed mental assessment. I thought this is just part of the physical. To my surprise and frustration, I've received the bill with the code for mental assessment and had to pay $141.37 for service I did not ask or needed (please see attached bill). Multiple attempts by my insurance company and myself produced no results. The CC billing department representative brushed me off with an explanation that “mental assessment was mandatory as dictated by Affordable Care Act” (???!!).

  

  Business response

  08/08/2024

  August 7, 2024 
  
  Better Business Bureau 
  2800 Euclid Ave, 4th Fl 
  Cleveland, Ohio 44115-2408 
  Attn: ****** ******* 
  
  RE: Complaint ID: ******** 
  
  Dear ****** *******, 
  
  This letter is in response to the billing complaint filed by, Y*** ****** to the Ohio Better Business Bureau. This complaint was received in the Financial Ombudsman office for review and to respond back. 
  
  I would first like to offer my sincere apology for any frustration this may have caused **** ******. I have undertaken a full review of the concerns mentioned and I am satisfied that all issues raised have been researched and addressed appropriately.  
  
  As mandated by the Affordable Care Act, behavioral testing is considered part of the standard of care and must be included during office visits when appropriate. Please note that these services may result in a copay, deductible, or coinsurance, depending on the patient’s specific insurance policy. The charges in question have been correctly billed in alignment with the services provided.  
  
  Unfortunately, I cannot change the billing or coding from the office visit because the charges are supported in the provider documentation. The balance is patient responsibility. 
  
  Again, I apologize for any inconvenience this may have caused **** ****** and thank you for bringing these concerns to our attention. If we can be of any further assistance, don't hesitate to contact me directly at ************. 
  
  Respectfully,  
  Ruth H****** 
  Financial Ombudsman   
  Revenue Cycle Management 
  
  CC: *********** 

  Customer response

  08/14/2024

  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.
  The response from the Cleveland Clinic ombudsman Ruth H***** provides canned response instead of trying to resolve my issues. She could not even spell my name properly. 

  She stated "behavioral testing is considered part of the standard of care and must be included during office visits when appropriate". The key word is when appropriate. I came for physical checker up, and without being informed that mental assessment will be done and I will be responsible for payments. If I new that I would decline it. 

  I think it is outrageous practice by Cleveland Clinic and sleazy response from their financial services.
  
  Regards,
  
  **** ******
  
  
  
  
   

  

  Business response

  08/23/2024

  August 22, 2024
  
  Better Business Bureau
  2800 Euclid Ave, 4th Fl
  Cleveland, Ohio 44115-2408
  Attn: ****** *******
  
  RE: Complaint ID: ********
  
  Dear ****** ********
  
  This letter is in response to the billing complaint filed by, **** ****** to the Ohio Better Business Bureau. This complaint was received in the Financial Ombudsman office for review and respond back.
  
  I would first like to offer my sincere apology for any frustration this may have caused *** ******. I have undertaken a full review of the concerns mentioned and I am satisfied that all issues raised have been researched and addressed appropriately.
  
  After a thorough review, we have confirmed that the charges are billed correctly, and no further action will be taken on *** *******s account. Please understand that the behavioral assessment charges are part of our standard care practices and are necessary for providing care. As such, they are not optional and must be included in the services rendered. 
  Additionally, this will be the last time we address *** *******s concerns regarding the behavioral assessment. We have provided all necessary explanations, and no further adjustments or discussions will be given on this matter. 
  I also want to extend my sincere apologies for the misspelling of *** ******’s name in our previous correspondence. We strive for accuracy in all communications, and I regret any inconvenience this may have caused.
  Thank you for bringing these concerns to our attention.
  
  Respectfully,
  Ruth H***** 
  Financial Ombudsman 
  Revenue Cycle Management
  
  CC: ******* ****
  

  Customer response

  08/23/2024

  [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 ********* Their response is long and well written, and ,unfortunately,  it affirms their stance for deceptive and unfair practices.

  I would like this case to be closed though, as I do not see a prospect of resolving it and do not want to spend more time on this. I will take my health care to a different hospital instead. 
  
  Thank you for your help,
  
  **** ******
  
  

  
  

• Initial Complaint

  07/25/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  THE COMPLAINT DEPARTMENT [ OMBUDSMAN ] OFFICE . WILL NOT CALL ME TO PUT IN A COMPLAINT . FOR A MONTH NOW .

  

  Business response

  08/12/2024

  Thank you for the opportunity to respond to this patient’s concern. Cleveland Clinic is committed to providing safe, quality care, treatment and services to all patients. I have reached out to this patient directly to address their concern.
  
  Please let me know if there is anything further needed from this office.

  *********

• Initial Complaint

  07/24/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Feb 27, 2024 I went to Cleveland Clinic and saw two specialist. I have insurance through my employer and I have medicare. SOmehow medicare got taken out of their system. I have called multiple times and was told I needed to schedule with customer service or something and then they could bill my secondary for services which none of this has been done. I did schedule and talk with someone but still no billing. THey are still saying I owe $132.80 which is not accurate as they did not bill secondary insurance. Several phone calls later and still no resolution.

  

  Business response

  07/31/2024

  July 31, 2024
  Better Business Bureau
  2800 Euclid Ave, 4th FL
  Cleveland, Ohio 44115-2408
  Attn: ****** *******
  Re: Complaint ID# ********
  Dear ******,
  This letter is in response to the billing complaint filed by Deborah Hayworth, to the Better Business Bureau on 7/24/24. I would first like to offer my sincere apology for any frustration this may have caused *** *******h.
  The root cause of the complaint is that Medicare was not being billed for the 2/27/24 date of service. We have submitted the claims to Medicare as of 7/29/24. Please allow 7-10 business days from the date of submission for Medicare to receive the claim.
  Thank you for allowing us the opportunity to address *** ********** concerns. If we can be of any further assistance, please feel free to contact me directly at *************
  
  Respectfully,
  Brendan K*******
  Brendan K******
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  Cc: ******* ********
  
  

• Initial Complaint

  07/22/2024

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I visited Cleveland Clinic on 11/22/23 for an MRI and paid a $300 copay. A claim was submitted to my insurance and because I had hit my out of pocket max, my insurance covered the cost at 100%. I also paid $88.61 as a copay for an ultrasound on 12/1/23. Again, my insurance covered the cost at 100%. Rather than refund me the $388.61 that I overpaid, Cleveland Clinic applied these funds to a prior claim from 6/23/23 for another MRI, which my insurance had rejected. This claim was rejected because Cleveland Clinic did not seek preauthroization for the MRI as they should have. I had spoken to my insurance and Cleveland Clinic several times regarding this claim. My insurance was awaiting further information from Cleveland Clinic, and my understanding was Cleveland Clinic was not being responsive. I was told I had no responsibility to pay for this service. I have had many MRIs with Cleveland Clinic in the past and all have been covered without issue except for this one. I had no reason to think there would be an issue and was reassured multiple times that this would be resolved with my insurance. Instead of doing so, my 11/22 and 12/1 payments were inappropriately applied to a service from 5+ months prior without any notice to me. I have reached out to the billing department many times to get this resolved and have been told I will not be receiving a refund for the $388.61 I overpaid. I do not think it is appropriate that Cleveland Clinic applies payments however they see fit, especially when it is for an open claim that they should be working with my insurance on and had previously reassured me would be taken care of. This is a significant amount of money to me and I have been patiently waiting for my refund for about 8 months now, only to now be told I will not be refunded. Attached are copies of my insurance claims as well as receipts for the $388.61 I paid.

  

  Business response

  07/25/2024

  07/25/2024
  
  Better Business Bureau
  2800 Euclid Ave, 4th Fl
  Cleveland, Ohio 44115-2408
  Attn: ****** *****
  
  Complaint ID: ********
  
  Dear Ms. *****,
  
  This letter is in response to the billing complaint filed by ******** ***** to the Ohio Better Business on 07/22/2024 regarding the Brain MRI completed at Cleveland Clinic and misallocation of previous patient payments.
  
  A thorough investigation has been completed based on Ms. ******s concern regarding the denial from ***** for her MRI completed on 06/23/2023. This was sent to our denial department and is currently being appealed with *****, and while this is being completed the balance is pending at insurance level and is not patient responsibility. The appeal was sent on 06/20/2024 and ***** has 60 days to review. The appeal was checked and as of 07/17/2024 more time was needed. This concern will continue to be monitored.
  
  Additionally, the patient’s payments made on 11/22/2023 of $300.00 and 12/01/2023 of $88.61 are being refunded to the patient. This has been escalated and the refund has been requested as of 07/25/2024. Please allow up to 4 weeks to receive the refund.
  
  Thank you for allowing us the opportunity to address *** ***** concerns. If I can be of any further assistance, please feel free to contact me directly at ************.
  
  Respectfully,
  
  
  
  Emily P*****
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  
  *** ****** ********

  Customer response

  07/26/2024

  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 just received a message from the billing department in my patient portal - I have pasted the content of that message below. This response does not match the response that they provided the BBB regarding resolution of this matter. Cleveland Clinic has put my account on hold pending the appeal with my insurance company. However, they are not refunding the $388.61 that I have disputed and are going to continue to hold those funds until they work through this issue with my insurance. I disagree with this as the $388.61 payments were completely unrelated to the insurance claims that are pending insurance. Also, those insurance claims have been in process for over a year and Cleveland Clinic has been unresponsive to me and my insurance as they work to resolve this. I have not been able to get a response in that time, and my funds have been held for about 7 months now. I would like the $388.61 refunded to me rather than continuing to wait months and months for a resolution. Once they have worked with my insurance, they should then reach out to me about the matter rather than holding my funds.

  "Thank you for your recent inquiry to MyChart Billing Customer Service.
  
  As per responce recevied from they BBB we have notices that A thorough investigation has been completed based on *** *****'s concern regarding the denial from ***** for her MRI completed on 06/23/2023. This was sent to our denial department and is currently being appealed with *****, and while this is being completed the balance is pending at insurance level and is not patient responsibility. The appeal was sent on 06/20/2024 and ***** has 60 days to review. The appeal was checked and as of 07/17/2024 more time was needed. This concern will continue to be monitored.
  
  Once a refund is deemed necessary, your credit card may be refunded, or a refund check may be mailed to you via USPS mail. We thank you for your patience."

  
  Regards,
  ******** *****
  
  
  
  
   

  

  Business response

  07/29/2024

  July 29, 2024
  
  Better Business Bureau
  2800 Euclid Ave, 4th Fl
  Cleveland, Ohio 44115-2408
  Attn: ****** *******
  
  Complaint ID: ********
  
  Dear *** *******,
  
  This letter is in response to the rebuttal filed by *** ***** to the Ohio Better Business on July 26, 2024. Please be advised that the refund concern has been reviewed by the Cleveland Clinic.
  
  An additional review has been completed and it is confirmed that the overpayment in question was requested to be refunded to *** *****. Typically, refunds are processed after all services have been processed by the patient’s insurance; however, since this was escalated, and the overpayments are not related to the service that is in the appeal process, the refund was approved in the amount of $388.61 and is being mailed to the patient.  
  
  We apologize for the misinformation the patient was given by the Customer Service representative while this concern was being reviewed by the Financial Ombudsman unit.
  
  Thank you for bringing these concerns to our attention. Please note, this is our final review on the above concern, any further questions related to *** *****’s refund can be directed to me at ************.
  
  Respectfully,
  
  
  
  Emily P*****
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  
  *** ****** ********

  Customer response

  08/06/2024

  [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. 
  
  Regards,
  ******** *****
  
  
  

• Initial Complaint

  07/17/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  We were referred to Cleveland clinic Weston to see a general surgeon after seeing my primary care physician also at a Cleveland clinic location. As a specialist visit, we discussed scheduling of the consultation and subsequent appointments. I understood the specialty visit would entail a $40 co-pay. My complaints against Cleveland clinics deceptive practices of not disclosing their facility fees if we had given proper disclosure we Would have reconsidered where we got our consultation for the potential surgery. We are requesting that Cleveland clinic make right by their nondisclosure and failure to educate us on new fees.

  

  Business response

  07/19/2024

  07/19/2024
  
  Better Business Bureau
  2800 Euclid Ave, 4th Fl
  Cleveland, Ohio 44115-2408
  Attn: ****** *****
  
  Complaint ID: ********
  
  Dear *** ****** 
  
  This letter is in response to the billing complaint filed by *** ********* to the Ohio Better Business on 07/17/2024 regarding his outpatient visit completed at Cleveland Clinic.
  
  An investigation has been completed regarding the facility charge for the date of service 06/03/2024. Cleveland Clinic has the responsibility to bill each service appropriately and accurately based on the services provided and documentation. Cleveland Clinic has made the decision to designate all our outpatient areas on main campus and throughout our Family Health Centers - except Wooster - as hospital outpatient departments. Your patient bills will include two separate charges: One for the healthcare provider fee which covers your doctor’s services, treatment or procedures and one for a facility fee which covers the use of the room and any medical or technical services, supplies or equipment.
  
  A thorough review was performed by the coding department; it was determined an incorrect code was used. The charge has been voided on *** *********** account. The balance is now zero for reference number #***********.
  
  Thank you for allowing us the opportunity to address concerns. If I can be of any further assistance, please feel free to contact me directly at 216-636-8029.
  
  Respectfully,
  
  
  
  ***** ******
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  
  Cc: ********** *****

  Customer response

  07/19/2024

  [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. 
  
  Regards,
  
  ***** *********
  
  
  

• Initial Complaint

  07/10/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I have been visiting this gynecology office that is located inside Cleveland Clinic for over 7 years. I was recently charged $226.30 in Facility Charges twice for two separate visits to this office. At no point was there any letter or warning sent to me that they would now be charging these unexpected fees. Cleveland Clinic is not being transparent with their fees. They claim to have sent a letter to inform me, but there was no such letter sent. Letters are also found in mychart and there is no letter attached to mychart containing information on these new fees. There were also no email notifications sent. I should not have to pay for something I was never given a choice on. I would have never visited this office if I knew these fees would be charged.

  

  Business response

  07/16/2024

  **** *** **** ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** ******* *** ********* *** ******** **** *******
  This letter is in response to the billing complaint filed by ******** *******, to the Better Business Bureau on 07/10/24. I would like to first offer my sincere apologies for any frustration this may have caused *** *******.
  The root cause of her complaint was that *** *******’s states the Cleveland Clinic is not being transparent with our billing, for her recent visit with *** ****** ********
  A thorough investigation has been completed on *** *******’s financial concerns mentioned in her complaint. I reviewed the account in conjunction with the medical records associated with the services rendered from April 2, 2024, below are my findings:
  Facility charges:
  Cleveland Clinic's hospital outpatient areas and throughout our Family Health Centers, are classified as hospital outpatient facilities. This classification started on March 1, 2009, for Main Campus and Family Health Centers. Provider-Based Billing status is determined by the Centers for Medicare and Medicaid Services and means that the clinic functions as an extension of its respective hospital. Provider-Based Billing insures more appropriate reimbursement for physicians and facilities allowing us to maintain excellent care. Our patient bills include two separate charges - one for the healthcare provider fee and one for a facility or technical fee to partially defray the costs of providing non-physician staff, equipment, supplies, etc. Our goal is to be transparent with our patients and what their costs may be when they receive their care from us.
  · April 2, 2024, Hospital services (Reference # ***********): The Cleveland Clinic submitted the claim to Cigna for the facility charge in the amount of $293.00. Cigna sent the Cleveland Clinic the explanation of benefits on May 17, 2024. Per explanation of benefits, Cigna paid $0.00 and applied a contractual adjustment of $66.70, leaving $226.30 as patient responsibility as a deductible.
  · April 2, 2024, Professional services (Reference # ************: The Cleveland Clinic submitted the claim to Cigna for the visit with *** ******* in the amount of
  $221.00. ***** sent the Cleveland Clinic the explanation of benefits on May 9, 2024. Per explanation of benefits, Cigna paid $0.00 and applied a contractual adjustment of $148.12, leaving $72.88 as patient responsibility as a copay.
  Thank you for allowing us the opportunity to address *** *******’s concerns. Please keep in mind that it is the patient’s responsibility to understand their insurance coverage and benefits. If I can be of any further assistance, please feel free to contact me directly at ************.
  Respectfully,
  ****** ********
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  Cc: ******** *******

  Customer response

  07/16/2024

  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.
  
  [To assist us in bringing this matter to a close, we would like to know your view on the matter.]
  
  Regards,
  
  ******** *******
  
  
  
  
   

  Customer response

  07/17/2024

  I have been a patient at Cleveland Clinic for over 7 years and  have never been charged a facility fee. I have no record of ever being charged this fee. In the past, I have only paid copayments so there is no way they have been charging this amount since 2009. This was a change on Cleveland Clinic's part since they decided to recently begin charging these fees at the Weston location and did not inform their patients. How was I expected to inquire about a visit when I have going to the same doctor and have never paid this fee? I was told by their billing department that the Weston location began charging facility fees this year. I asked them to send me proof that I had been informed of this change, but they were unable to provide me with any since I was never informed of these changes. That is what I mean by "not being transparent." 

• Initial Complaint

  07/08/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  In Feb of 2024 my husband was referred to Cleveland Clinic to have an mri to measure the amount of iron in his liver. They were extremely behind at the time and he eventually had his mri 3 hours after his appointment time. Then come to find out they didn't even measure the amount of iron in the liver. They just said yup there's iron in there. So even in the radiology report the doctor said oops forgot to do that they'll have to come back. This is the only facility near us that does this test. In the end they charged us over 700 dollars to tell us what we already knew, but not what was asked. So I called and the financial ombudsman agreed and stated it would be written off. Well it has not. But on top of that, I've been told I needed to speak to a regular ombudsman who will now not speak to me. Nor will anyone else from Cleveland clinic. I've received no calls back. And the bill is getting ready to go to collection. The lack of communication is really the worst part. Especially after the ombudsman went out of her way to call my husband to get permission to take care of this. Now we're just ignored. What's going on?

  

  Business response

  07/24/2024

  Thank you for the opportunity to respond to this patient’s concern. Cleveland Clinic is committed to providing safe, quality care, treatment and services to all patients. We will reach out to this patient directly to address their concern.
  
  Please let me know if there is anything further needed from this office.

  Kindly,

  Amanda

• Initial Complaint

  06/28/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I am writing to formally lodge a complaint against *** ******, a Civil Surgeon, regarding the services provided to my family. In this instance, I engaged *** ****** for the completion of Form I-693, an immigration health check, for my mother as part of her green card application process. Upon payment of the requisite fee of $300, *** ****** proceeded to request that my mother undergo a series of standard tests and vaccinations as per her recommendations. Regrettably, one of the tests revealed a positive result for tuberculosis (TB), prompting *** ****** to refer us to the Department of Health for further evaluation and treatment. Subsequently, we have been embroiled in a protracted and arduous process with the Department of Health for over a year. Despite receiving clearance from a pulmonologist enlisted by the Department of Health, *** ****** insisted on awaiting formal clearance from the said department before proceeding with the paperwork. Following extensive diagnostic procedures, my mother has now obtained the necessary clearance and documentation from the Department of Health. However, *** ****** has informed me via email that her office has since closed and she is unable to complete the requisite paperwork. Furthermore, she has expressed her reluctance to refund the initial payment on the grounds of having expended effort on the case and the form potentially being outdated. It is deeply concerning that *** ****** failed to communicate the necessity of completing the paperwork in a timely manner and has withheld the reimbursement of the fee despite not fulfilling her professional obligations. My primary request is the prompt refund of the payment made for services that remain unfulfilled. I trust that the Better Business Bureau will investigate this matter thoroughly and facilitate a resolution that upholds the standards of professional conduct expected within the medical community. Thank you for your attention to this matter.

  

  Business response

  07/01/2024

  Good afternoon -

  The physician noted on this complaint *** **** ****** is not a Cleveland Clinic employed provider and therefore the Cleveland Clinic cannot assist further.

   

  Seems as though she is a independent provider in the community.

• Initial Complaint

  06/20/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have called Cleveland Clinic Cole Eye Institute three times in the past two months asking a question about an upcoming appointment. Each time I am told someone will get back to me with an answer and no one ever does.

  

  Business response

  07/10/2024

  Thank you for the opportunity to respond to this patient’s concern. Cleveland Clinic is committed to providing safe, quality care, treatment and services to all patients. We have reached out to this patient directly to address their concern and a formal Grievance was filed on their behalf.
  
  Please let me know if there is anything further needed from this office.

  Amer

  Ombudsman

*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. ↩