ComplaintsforCleveland Clinic Foundation

• Initial Complaint

  06/20/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  06/20/2022 around 11AM EST I contacted the Cleveland clinic to schedule an appointment to discuss issues I am having with a medication that is prescribed by my primary care provider. My insurance has changed and I gave the information to the customer support representative. They told me I had to wait 7 days to hear back about the insurance claim. I attempted to ask to pay out of pocket and was told they couldn't help. I asked for a manager and was denied, and transferred to the billing department. They told me they would need to transfer me again and I waited on the phone for 20 minutes before I was hung up on. They are refusing to allow me to schedule with my doctor who has the information needed.

  

  Business response

  06/29/2022

  
  Dear ****** *****,
  
  This letter is in response to the billing complaint filed by Mr. ****** to the Ohio Better Business Bureau on 6/20/22.
  
  A thorough investigation has been completed on Mr. ******’s account. I would like to apologize for any confusion surrounding Mr. ****** and being able to set up an appointment. When a patient has out of network insurance the turnaround time for getting an appointment is up to two weeks while obtaining authorization and going through the whole financial clearance process.
  
  I escalated this concern to our Patient Financial Advocate team, who handles the financial clearance process so that appointments can be scheduled. I was advised by our Patient Financial Advocate team that Mr. ****** was contacted on 6/23/22, cleared to proceed for an appointment, and an appointment was scheduled.
  
  Thank you for allowing us the opportunity to address Mr. ******’s concerns. If we can be of any further assistance, please feel free to contact me directly at ************.
  
  Best Regards,
  
  
  Tiffany *******
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  
  

• Initial Complaint

  06/15/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My husband ****** was transported by ambulance to the Cleveland Clinic on 4-18-22, Cleveland Clinic did admit him, and we gave them his insurance card, we were told there were no issues. Once he was released, (3 days later) I started the process to make sure that everything was in order, I called the clinic and found that he had been assigned a new Member ID, I gave this information to the clinic and they are refusing to bill the insurance company claiming they are out of network, however his card clearly states that ALL LICENSED MEDICAL PROVIDERS ARE ACCEPTED. I feel that since we were not told while he was in the hospital that there were issues with them billing his insurance, we were misled into believing that they would do their due diligence and ensure they would be paid. When I received a statement from them on 5-9-22, I called and once again gave them his insurance information, they again refused to bill them, citing something about it not being part of the affordable care act? I have repeatedly advised them if they want to get paid, they need to bill his insurance, to which they keep refusing. I have also asked them for detail to the charges on the statements they have sent as it's all codes, they claim it was emailed however, we have never received it.

  

  Business response

  06/21/2022

  
  Dear ****** *****,
  
  This letter is in response to the billing complaint filed by ***** ******** on behalf of her husband, Tom ******** to the Ohio Better Business Bureau on 6/15/2022.
  
  I would first like to offer my sincere apology for any frustration this may have caused Mrs. ********. Mr. ******** was transported to our facility by ambulance on 4/18/2022; Cleveland Clinic’s main priority is to ensure the health and wellness of the patient; therefore, medical care will not be denied.
  
  The root cause of the complaint was to have the charges billed to Mr. *******'s insurance policy. I have undertaken a full review of the concerns mentioned and I am satisfied that all issues raised have been researched and addressed appropriately.
  
   Unfortunately, your insurance does not have a contract with the Cleveland Clinic; therefore, the charges cannot be billed directly to them. Per our policy, the Cleveland Clinic sends the Claim forms to the patient’s address and is the patient’s responsibility to submit the forms for reimbursement.
  I forwarded Mr. ********'s insurance information to our registration department to ensure the information was registered and billed correctly per our policy. After further review, the insurance card scanned into our records is considered a Reference Based payer.  Mr. ********'s Reference-Based plan is a form of a self-funded health plan that is not contracted per our Cleveland Clinic policy.
  
  Thank you for allowing us the opportunity to address Mrs. ********’s concerns. If we can be of any further assistance, please feel free to contact me directly at ************.
  
  Respectfully,
  Ruth H*****
  Financial Ombudsman
  Revenue Cycle Management, CCHS

• Initial Complaint

  04/19/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I visited Cleveland clinic for a hernia and cyst I had. It started out pretty good but further down the line it was just apt with doctors that never even came in the room. Being pressured to schedule surgery with the nurses without even a understanding what was being done. I was told by a nurse my testis would still be enlarged after the surgery. I asked to speak with the doc so I can more understand they told me he wasn’t available. They have nurses come in look at my private parts for no reason when the dr isn’t even there. I felt very pressured into the hernia surgery without any info from the dr at all. I found terrifying reviews of the hernia dr by somebody stating it came right back. Upon further research the doctors family’s practice was sued for malpractice. I ended up getting the surgery a ways away Friday m home by a world renown hernia dr that explained the entire surgery process face to face. I paid Cleveland clinic thousands and the insurance paid them tens of thousands for absolutely nothing but a ct scan. Multiple worthless apt kept billing me etc. To throw gas on the fire I continued paying the bills in full even after I wasn’t even going to Cleveland clinic. The last bill I paid was $442. They now sent that to collections which negatively effected my credit. How can you just send bills to collections that have already been payed?

  

  Business response

  04/19/2022

  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.

• Initial Complaint

  04/18/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I paid my copay the day of service but my account has not been credited. I received a bill showing that payment outstanding.

  

  Business response

  04/29/2022

  
  Dear ****** *****,
  
  This letter is in response to the billing complaint filed by Mrs. ********** to the Ohio Better Business Bureau on 4/18/22.
  
  A thorough investigation has been completed on Mrs. **********’s account. I contacted her via telephone on 4/19/22 due to another complaint she also filed with our Medical Ombudsmen’s office that was forwarded to my attention. I explained that her $35 copay did get credited to her account, however it posted to date of service 2/10/22 ref# *********** instead of the intended date of service 3/2/22 ref# ***********. I apologized to Mrs. ********** and explained that I removed the $35 payment from that charge and placed it on date of service 3/2/22 ref# *********** where it was intended to be applied. I advised her that since we moved the $35 off of date of service 2/10/22 ref# *********** it would raise the balance on that date of service by $35, so instead of her owing $132.84 on that charge like her April statement reflected, she would now owe $167.84 on ref# *********** and date of service 3/2/22 ref# *********** would now reflect a $0.00 balance due.
  
  Mrs. ********** brought up another issue she was having regarding a date of service from 4/15/21-4/17/21. She stated that she never saw the physician she was billed for, ******** **********, however, documentation from the physician in her medical records supports this service. Mrs. ********** continued to dispute this service, so she was provided with the phone number to our Medical Ombudsman’s office so she could file a formal complaint for them to investigate further.
  
  In addition, I was advised of another date of service that Mrs. ********** said that she didn’t agree with. She stated that she believed date of service 2/10/22 was coded improperly. Per our coding department, date of service 2/10/22 was reviewed and the charges from that date are accurate and supported by the documentation in her medical record. The balance of $167.84 that she owes towards this date of service is what her insurance states is her responsibility. If she is in disagreement with the liability she owes for this date of service, I encourage her to contact Anthem and discuss those concerns with them directly so they can assist her and provide her with the details of her insurance policy.
  
  Thank you for allowing us the opportunity to address Mrs. **********’s concerns.
  
  Best Regards,
  
  
  Tiffany B******
  Financial Ombudsman
  Revenue Cycle Management, CCHS

• Initial Complaint

  04/09/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Less than satisfied with medical care received at Cleveland Clinic. 8 hours in hallway. 2 CT scans. No results. $11,000 bill. Was told nothing found in CT scan. Sent home major pain. Followed up urologist that week who looked at CT scan from clinic and found kidney stone. Placed on medication to pass. No health insurance. Should not be responsible for clinic bill. Horrible service and no compassion.

  

  Business response

  04/25/2022

  Thank you for letting us know about Mr. *******'s concern.

  We will communicate directly with Mr. ******* regarding his concern.

• Initial Complaint

  04/05/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  I was referred to this neurologist specialist by a neurologist within Cleveland. My first visit with her was on 2/2/22 she ordered I stop ALL my medications. Including those of my cardiologist, pulmonologist, primary ETC and only take the medications she prescribed for the specific time. She needed to see if the migraines would subside or not in order to determine if there were in fact migraines or some other problem. She also had me go get another MRI with contrast which I have allergies to but, she said it had to be done, I DID. I also had to have a specific eye exam which causes severe migraines I DID. I made sure she had those results before returning to see her on 2/22/22. I arrived 6 min late, THEN I stood in line to register an additional approx 8 minutes. During this time no one called my name. 5 min later, a nurse came out and told me she would not see me as I was late. I migraine DAILY, she had me stop all my medications with NO REGARD! she had me take tests causing me many EXPTRA out of pocket expenses with NO REGARD! to date 4/5/22 I have tried to reach her with not a return call. The FL Dept of Health is back logged 5 yrs, you cannot submit a complaint. There are criminals practicing medicine in this state!! I NEED HELP. The negligence is beyond and no one to account for the actions of these "professionals" The patient experience office do not answer calls or emails and neither does the ombudsman dept, I have the dozens of emails to prove it. My tel number is 954-531-3418. HELP. I reached out to the CEO's assistant and I am sure she never related my message to Dr. ***** *******. I need HELP. I did not do all of these tests to not be able to get an answer on what my results are.

  

  Business response

  04/06/2022

  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.

• Initial Complaint

  04/05/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I had a CT and an MRI done at ******** Hospital last year. CT's and MRI's are costly tests. ******** Hospital is part of the Cleveland Clinic system. I recently got a bill in the mail from a provider that I did not recognize using the CCF name and logo, but had a different mailing address, payment link and account number. The bill actually came from ********, and I thought that my personal account and health information was hacked. After calling Medicare last week, I found that Cleveland Clinic farmed out the reading of my CT and MRI to a non Cleveland Clinic company, ******** ******* ******** *******, LLC. I called this company today and they indicated that they are not Cleveland Clinic doctors. Anyhow, I asked for an itemized billing from CCF for all of 2021 and as of 12/2021 my account balance was zero. I called CCF billing last week and was told that my account balance is still zero, so I called ******** ******* ******** *******, LLC today to find out who they are. They told me that they are a separate company that is not part of Cleveland Clinic. I am still wondering why when Cleveland Clinic has thousands of doctors on contract and run a medical school why they would farm out another company to read very expensive CT's and MRI's. Additionally, It is not ethical for a company who is not a Cleveland Clinic affiliate to be using the Cleveland Clinic name and logo. I also should have been notified of non Cleveland Clinic ******** Hospital doctors reading my expensive tests. At least then, I would have expected another bill from someone who I don't know.

  

  Business response

  04/06/2022

  Dear Ms. *****,
  
  This letter is in response to a billing complaint filed in your office by Ms. ******** **** to the Ohio Better Business Bureau on 04/04/2022. The complaint was sent to the Financial Ombudsman department to review and respond back to you.
  
  A thorough investigation has been completed on Ms. ****’s account. Ms. **** was advised Cleveland Clinic has physicians who practice at Cleveland Clinic facilities but choose not to bill on our consolidated statement. It was explained that third party billing may occur when seen at one of our community hospitals and for the following services: ER doctor billing, radiology doctor billing, pathology doctor billing, anesthesia doctor billing and in-house physician billing. The third party billing statement may look similar to ours - some of the providers are Cleveland Clinic doctors and they use CCF letterhead; however, the account numbers, phone number and payment address are all different and bill separately. Clinical Medical Service is one of our third party billers who happened to bill Ms. **** for services provided.
  
  Technical (/ hospital) charges are billed on our consolidated monthly billing statement but some doctor/ professional bills may come from the third party. We do not have access to the charges the third party is billing the patient for, nor can we provide any itemized statements that includes these charges.  Our Customer Service call center representatives cannot access these bills and MyChart, our patient bill pay portal, does not reflect these balances either.
  
  The amount being billed to Ms. **** by Clinical Medical Services is a valid patient liability per her insurance company. Any further questions or discussion about the charges billed or the balance owed need to be directed to Clinical Medical Services. She can also contact Humana Medicare to discuss how the claims processed at 1-800-457-4708.
  
  Thank you for allowing us the opportunity to address Ms. ****’s concerns. If we can be of further assistance, please feel free to contact me directly at 216-442-1475.
  
  Respectfully,
  
  
  Stacy Werchelowsky
  Revenue Cycle Management Analyst II
  Revenue Cycle Management, CCHS
  
  Cc: ******** ****

  Customer response

  04/06/2022

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID 16981354, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  I have extensively researched this company.  IT IS NOT A CLEVELAND CLINIC COMPANY NOR CLEVELAND CLINIC PHYSICIANS.  THIS IS AN OUTSIDE COMPANY AND THAT IS WHY THEY HAVE THEIR OWN BILLING DEPARTMENT.  THIS COMPANY HAS ITS OWN LLC DESIGNATION.  It is extremely unethical and dishonest to have patients think that they are being treated by the Cleveland Clinic when they are actually having  something as important as a diagnosis being made by an unknown entity.  To give you an example, I had an MRI done about a year ago and was told by my physician at the Cleveland Clinic that I needed to have brain surgery based on the MRI report.  I went to another facility, had another MRI and was told that I was just fine.

  I did receive a phone call yesterday from ******** ******* ******** *******, LLC.  The person calling me represented herself as the supervisor of patient financial services at Cleveland Clinic.  I already know and have been corresponding with ******* ******** who is the director of revenue at Cleveland Clinic and this young lady did not even know who he is.  Hence, if she actually worked for Cleveland Clinic she would know who Mr. ******** is.  The phone number of the person who called yesterday was ************.  When I called that number back, I just got a voice mail to leave a message.  The phone number on the fake Cleveland Clinic bill is ************.  Again, it is not ethical to have patients believe that they are being treated by Cleveland Clinic doctors when they aren't.  Additionally, a separate company that is not Cleveland Clinic should not legally be allowed to use the Cleveland Clinic name or logo since it is misleading.

  The person replying to you is not correct in many ways.  First, I did not dispute my $10.40 balance and I never asked the the balance be adjusted.   Second, I had the CT and charges in question at ******** Hospital which is a Clevealnd Clinic hospital.  ******** Hospital always bills through the normal Cleveland Clinic billing.  I m attaching a copy of that page for you.  Third, my concern was having fragmented care by having non Cleveland Clinic physicians rendering something as important as a diagnosis.  Fourth, the person replying to you is further covering up that Cleveland Clinic doctors reading my x-rays were not Cleveland Clinic physicians. 

  The Cleveland Clinic has farmed out the most important part of having anything radiology. They farmed out the diagnosis.  I suppose on a positive note, this experience taught me that if I want an accurate diagnosis for anything complex, I need to seek help elsewhere.  I will never again have expensive complex procedures at Cleveland Clinic. 
  

  
  

   

   

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

• Initial Complaint

  02/01/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  December 15-18 2021. I called for appointments at Cleveland clinic. Before I made the appointments, I confirmed with them that they accepted my insurance, ***. They verified that they accepted my insurance before I made the appointments. They have all of my insurance info, however they are not filing the claims to my insurance for payment. They keep sending me bills for the full amount of services. I have continued to check my insurance to see if they have filed the claims but they have not.

  

  Business response

  02/04/2022

  
  
  Dear ****** *****,
  
  This letter is in response to the billing complaint filed by Mrs. ***** ******** to the Ohio Better Business Bureau on 2/1/2022.
  
  A thorough investigation has been completed on Mrs. ********’s account. Per my review, it was determined that there was an issue with the insurance coverage eligibility. On12/14/2021 a phone message was left for Mrs. ******** to contact Cleveland Clinic to offer her updated insurance information. Cleveland Clinic received insurance coverage plan information via fax on 12/24/2021 from Mrs. ********.  Prior to updating the insurance coverage, billing statements were sent to the patient 12/26/2021 and 1/26/2022.
  
  I contacted Mrs. ******** via phone on 2/2/2022 to explain and advise the claims were submitted to the ****** ********** insurance on 1/28/2022. At this time for dates of service 12/7/2021, 12/13/2021, and 12/15/2021 Mrs. ******** has a zero balance.   
  
  Thank you for allowing us the opportunity to address Mrs. ********’s concerns. If we can be of any further assistance, please feel free to contact us directly at ***** ********
  
  Best regards
  
  
  Tina L. ****** 
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  

• Initial Complaint

  01/16/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Ive spent 2 weeks, several hours each day on the phone w/ CCF Billing Dept customer service reps and CCF Billing Supervisor *******, & w/ ***** insurance company regarding the billing codes for daughters yearly physical & immunization. I have also discussed with them that CCF is triple billing me for the Meningitis B vaccine on claims they submitted to *****. 3 claims were submitted to ***** totaling $1610. First claim submitted for 09/29/21 was correct. They charged for the physical w/***** ******* & charged for first dose of the 2 dose meningitis b vaccine. Total charge was $477. ***** paid CCF the contracted fee of $287.40. Then CCF submitted another claim for that same DOS for $1005.09! They coded it as non emergency services performed at an urgent care facility. They charged for 2 meningitis b vaccines on this claim totaling $977.09 & then charged for an emotional behavior assessment for $35.00. Total billing this claim was $1005.09. ***** denied it. This bill & claim submitted is completely fraudulent. Next date of service is 11/26/21. We went to doctors office & nurse gave her 2nd dose of Meningitis B vaccine. CCF submits claim to ***** charging $610!! They charged $577 again for the second dose of vaccine & charged $27.85 for shot administered. So vaccine was triple charged! ***** wont pay for that either. By law,physicals & immunizations are to be covered 100%. CCF wont fix this mess. CCF & ***** will be turned in to the **** ***** Dept of Health & Attorney Generals office. CCF is incorrectly & fraudulently billing me. Multiple phone calls & messages have been left on CCF Ombudsmans phones. They dont answer phones and dont return messages, 2 weeks-still no response. If no resolution...meaning both 09/29/21 & 11/26/2021 bills are not permanently removed from my account, I will be taking CCF to court for charging $1600 for physical & immunization which is outrageous billing & for refusing to code claims correctly to *****.

  

  Business response

  01/18/2022

  
  
  Dear ****** *****,
  
  This letter is in response to the billing complaint filed by Mrs. ******* to the Ohio Better Business Bureau on 1/16/22.
  
  A thorough investigation has been completed on Mrs. *******’s daughter’s account, ******* *******. I spoke with Mrs. ******* today via telephone and we will be communicating via telephone until her concerns are fully resolved. A brief overview of what has transpired on her daughter’s account are as follows:
  
  Date of service 9/29/21 has been sent to our coding department for a review and I will be following up with Mrs. ******* regarding the outcome.
  I spoke with Mrs. *******’s insurance regarding both dates of service she had concerns with, 9/29/21 and 11/26/21. According to her insurance, they processed the claims improperly and they are re-processing them. This will take 30 days and I will follow up with Mrs. ******* once I see that they have re-processed both dates of service.
  
  Thank you for allowing us the opportunity to address Mrs. *******’s concerns. If I can be of any further assistance regarding these two dates of service, please feel free to contact me directly at ************.
  
  Best Regards,
  
  
  
  Tiffany *******
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  

• Initial Complaint

  01/13/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Was diagnosed with ling cancer. Went to Cleveland Clinic ****** for medical assistance. Was prescribed a Nuclear Scan. Had it there at a trailer office. Was told to remove my gold chain and medal before the test. The chain was a heavy one. The chain was not returned to me after the test. Due to the fact that al my family lived in Wisconsin I went there for chemo and radiation. I called Cleveland Clinic inquiring about my chain and was told they were to investigate the issue. Called the several times after that to no avail. I recently called them again and was told that due to the fact that it had been to long there was nothing they could do for me. This chain had a sentimental value...belonged to my grandmother. It was an expensive piece if jewelry.

  

  Business response

  01/14/2022

  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. 

*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. ↩