ComplaintsforMcLaren St. Luke's

• Initial Complaint

  12/19/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Let me start by stating that I had great patient care at McLaren's St. Luke's hospital for multiple dates of service (DOS). However, the financial side of their business leaves much to be desired. I started working with McLaren's billing in mid-May 2022 for dates of service (DOS) as old as 10/19/21. The McLaren's contact log will show just shy of 20 attempts -- with billing, CEO and CFO -- to resolve their errors. After 7 months and numerous billing errors, we have one left to resolve. My open balance shows a balance $308.31. Here's the thing: McLaren's has yet to submit the claim to my insurance. Once insurance reviews the claim and determines "patient responsibility", I will remit payment expeditiously (something that McLaren's does not practice) for any remaining monies. Attached documents: McLaren's Contact Log, Remaining Balance & Copy of Insurer's Patient Portal showing no claims being submitted for 04/12/22. All I am asking for is for McLaren to accurate complete the business side of DOS 04/12/22. No one should ever have to demonstrate to a healthcare provider how to accurate submit insurance claims and for those people in my parent's age group (80 + years old), my heart goes out to you as you have to tackle such issues with McLaren's as I know I am not in the minority in their patient pool with this "hot mess" they call billing. Attached are the outstanding balance, McLaren's contact log and a screen print from my insurer's patient portal showing no submitted claims for 04/12/22. Please let me know if you need more documentation as their is a file quantity limit on this application. I have copies of all correspondence -- letters, emails, etc.

  Business response

  12/20/2022

  Good Afternoon Ms. *******,

  I have reached out to the McLaren billing company about your concerns. I have attached a correspondence that was sent on 10/27/2022 about your accounts. I have reviewed the letter and it appears that your insurance company has been billed for the April encounter. I have left a voicemail on the phone number that you have provided to discuss in further detail if the attached documents do not address your concerns. Mr. ******** is no longer with McLaren St. Luke's so I cannot follow your concerns with him. Please let me know if I can do anything else for you. My office number is ************

  ******* **********, MSN, RN                                                                                                                                                                                                                 Director, Quality Improvement & Organizational Excellence

   

  Customer response

  12/20/2022

  
  Complaint: ********
  
  I am rejecting this response because:  Your supporting “claims documentation” is for a date of service of 4/27/22 NOT 4/12/22 as you bill reflects.
  Unfortunately, we are now working on more than 20 correspondence and your signature block states “Organization Excellence”.  I have a very large folder and numerous emails where I can disprove your moniker.  Also, I reserved the BBB complaint as an option of last resort after 7 months as I feel that this billing could and should have been resolved months ago.  I have done my due diligence and all I am asking is for your company to return the favor.  I am not asking for any free service , just simply billed correctly.  It’s unfortunate that I have to detail the next steps:
  
  1.  If you want payment for a DOS of 4/27/22 then send me a bill with the proper date of service denoted.  If this is not feasible, then clear my balance.
  

  2.   STOP the collection calls.  I am not delinquent on my account.  Your billing department is delinquent in their billing acumen.
  

  If you need to discuss anything with me, please do so through my email ***********************.

   

  Sincerely,
  
  ***** *******

  Business response

  12/21/2022

  Good Morning,

  I have attached a copy of the bill to better explain the how physical therapy charges are billed.

  The physical therapy department registered you for therapy on 4/12/2022, that is why this date is listed on  the bill. On the day of registration the scheduler booked your appointment for April 27th and this is what is listed on your bill for April

  Billing occurs at the end of the month. Physical Therapy may see patients for a few months and they are in the system as a series patient. 

  Please let me know if this addresses your billing concerns.

  ******* **********, MSN, RN                                                                                                                                                                                                                                                                                                                                              Director, Quality Improvement and Organizational Excellence.

  Customer response

  12/21/2022

  
  Complaint: ********
  
  I am rejecting this response because: my bill for services does not coincide with my Explanation of Benefits (EOB) and respective date of service.   With all my documentation of 8 McLaren’s billing errors since May 2022, your response on this issue is that my EOB reflects that date MADE AN APPOINTMENT WITH PHYSICAL THERAPY and not the date that I received PT Evaluation and PT?  Really? I have been corresponding with your CFO (who has since left your organization), billing supervisor and other various billing personnel since August and this is the FIRST time you mention this – “Sorry!  For this DOS on your bill, we used the date you made your physical therapy appointment with absolutely no reference to the actual date of the appointment/services rendered”.
  

  As ludicrous as your response was and since it has been a few years since I worked in hospital administration, I contacted Mutual Health Services (my insurer) and our corporate attorney to review your response:

  
  MUTUAL HEALTH SERVICES RESPONSE:  The purpose of the EOB is for the patient to have full disclosure of services rendered on the DOS, how this was handled financially from the insurer and any patient financial responsibility to the provider.  Shortly after talking with customer service, I received a call from Mutual Health Services Corporate Compliance officer and she asked me to forward all my documentation and correspondence as your explanation of billing practices as your interpretation in your response is NOT proper billing protocol.  Her statement was there is only one correct DOS and it is the actual DATE OF SERVICE.
  

  CORPORATE ATTORNEY REVIEW:  In the state of Ohio, a service provider’s bill needs to answer these questions: “Who?”, “What?”, “When?”, And “Where?”.  Your current billing does not accurately reflect the correct answer to the “When?” question.

  CONSISTENCY OF BILLING:  The PT appointment at the center of this matter (McLaren’s is now saying DOS 4/27/22, even though the invoice reflects a DOS of 4/12/22) was for physical therapy and evaluation on my LEFT knee.  However, I had a total right knee replacement done at McLarens in June and made an appointment on one day for the PT evaluation and therapy, but the actual appointment was for a different day.  HOWEVER, in this case, you billed the correct DOS and not the date the appointment was made.

  
  As I stated in my previous response, it appears that because this issue is in the public BBB forum, you are doing everything to expeditiously close this case without addressing the issue.  After reviewing all the documentation on these billing errors, the corporate attorney stated with less than stellar business operations in your company, if I paid my current bill with the wrong DOS, McLarens could come back in a couple of months and bill me again for the DOS 04/27/22 and I would have yet another billing situation with your hospital.
  
  The only acceptable resolution to this situation is:
   1.  Receipt of a hard-copy bill reflecting the actual DOS of 4/27/22.  (Please note this bill needs to be on the same form you use for all billing and I will NOT accept resolution on this BBB case until I have that bill in hand (no email).  As stated in every one of my notes and emails I will immediately pay any monies due as determined by my insurer, Mutual Health Services.
   2.  All collection calls must stop immediately.  Next week, I will be checking with the credit bureaus to ensure that your error isn’t reflecting poorly on my credit.  If there is any notation at on my credit report, we will be looking at other actions for remediation.
  3.  If you cannot provide said bill with an accurate DOS that matches my insurer’s EOB, then clear my account balance.

  This resolution is simply asking for an accurate invoice for services rendered according to standard business operations.  If you need to discuss anything with me, please contact me via email at ***********************.
  
  Sincerely,
  
  ***** *******

• Initial Complaint

  10/26/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  I was in the emergency room on October 25, 2022 . I was transported by ambulance from home for 3rd degree burns on my arm and smoke inhalation The nurse treated me was nasty, gave me a dirty look when I asked for something to drink. When I was finished she threw the paperwork on my lap and did not explain anything. When I got home, my wife read the paperwork and noticed that I was to be given two prescriptions, one for pain and one an antibiotic. They were not included. My wife called the emergency room and they stated they were too busy to check into it and to get my prescriptions from my family doctor. My wife called my family doctor at 8:30 this morning, explained what had happened and asked them to please fill my prescriptions. It is now 1:00 p.m. and the pharmacy has yet to get the prescriptions. This is something that I should have started this morning. I feel that the nurse was negligent in not explaining my burn care, and medications that I was to be taking. On the positive side, the physician that took care of me was extremely nice and caring.

  Customer response

  10/28/2022

  From: *************** <***************>

  Sent: Wednesday, October 26, 2022 5:44 PM
  To: Info <******************>
  Subject: Message from *******

   

  The head of St. Luke's hospital or emergency room contacted me, and honestly made me feel like I was at fault. She now played everything I said and just kept saying that her emergency room is employed with the best of nursing care. I understand that hospitals like everything else is understand, employees are tired. But I also am tired of being treated less than. I just wanted to let you know this. Thank you!

  Sent from ****** ******* (l********************)

  Business response

  10/31/2022

  Mr. *******,

  The Emergency Room Director at McLaren's St. Luke's has informed me that see had spoken with you and had addressed your concerns. Please let me know if there is anything else that I can assist you with.

   

  ******* **********, MSN, RN

  Director, Quality Improvement & Organizational Excellence

  McLaren St. Luke's Hospital

  Customer response

  10/31/2022

  
  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.
  
  Sincerely,
  
  ****** *******

*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. ↩