ComplaintsforCleveland Clinic Foundation

• Initial Complaint

  04/03/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  --On 22 Jan/2024, I began physiotherapy, at the Cleveland Clinic's ******* ******* ******, for concussion and whiplash caused by a motor vehicle. (MVA) --This ****** is a branch of Cleveland Clinic, USA --I was given paperwork stating that my auto insurance would reimburse the Cleveland Clinic through an **** payment system after I received my benefit for each visit from my extended health care insurance. See attached. --Instead, the Cleveland Clinic required me to pay them up front 100% of the cost of each visit. --The Cleveland Clinic, in violation of their own **** arrangement with my auto insurance, did not submit claims to the **** --The Cleveland Clinic told me I have to submit claims to my auto insurance. --My claims were denied by my auto insurance because of the **** arrangement they have with the Cleveland Clinic. --Instead of refunding the money to me, ******** **** in accounting at the Cleveland Clinic told me to continue to come for physio and they would stop charging me. --I paid Cleveland Clinic $110/visit for 11 physio treatments. --I received $20/visit from my extended health care insurance. --Cleveland Clinic, to date, has not submitted claims to the **** with my auto insurance, nor have they provided any refund to me. --I was also told by ******* *********, patient experience officer at Cleveland Clinic ******, that I was overbilled by them, and should have been charged $10.20 less than the $110 I was charged/visit. --******* emailed me last week that there would be a refund on my credit card early this week. --There is no such refund in my account. --I want the Cleveland Clinic to refund 100% of the money I paid them, and then charge me whatever the balance is after they have submitted the claims to my auto insurance via the ****.

  

  Business response

  04/15/2024

  
  Dear ****** *****,
  
  This letter is in response to the billing complaint filed by, ***** **** to the Ohio Better Business Bureau on 4/4/2024. This complaint was received in the Financial Ombudsman office for review on behalf of the Cleveland Clinic.
  
  After reviewing Mrs. ****’s account thoroughly, we are pleased to confirm that Mrs. ****’s account was refunded on March 28 2024.In addition, we have verified that we fol****d the correct protocol in processing her auto accident claim.
  
  The procedure for processing accident claims is as follows:
  1. At the time of service, patients are required to pay for their appointments.
  2. After your appointment, you submit claims to your private insurance provider for coverage.
  3. Once you receive an Explanation of Benefits (EOB) from your private insurance, you provide this document to CC ******.
  4. CC ****** will reimburse any funds not covered by your private insurance provider.
  5. Once you complete your proposed treatment plan, CC ****** will submit claims to your auto insurance provider.
  
  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 ******
  Financial Ombudsman
  Revenue Cycle Management

  Customer response

  04/15/2024

  [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

  03/26/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  I was referred to Cleveland clinic to obtain an ***** that’s not provided by my local hospital. It was performed by *** ********* ******* on January 12, 2024. I was supposed to have the results for my follow up on March 14. During such follow up, the report had not been sent only a graph of a raw data, which my doctor cannot read. I have called six times. I spoke with Customer Service, the neurology secretaries, the ombudsman twice. They also said they would get back to me and yet 2 months later I have no idea what the results of my test were. I am severely disabled in a wheelchair, which is why I was getting this test done to see if there is a diagnosis so that I could get proper treatment. This is blatant discrimination, and against ADA. I just want my report. It shouldn’t have to come to this.

  

  Business response

  03/26/2024

  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.

  Customer response

  03/31/2024

  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 received a phone call from someone from the ombudsman department on Monday named Gina. I had previously spoken to someone named Juliana from that office the week before that never called me back. **** did not return my call after hearing my complaint and I have yet to receive a report. I hope they do the right thing and provide me the report with impressions since it’s my right and my insurance has paid for it. Both myself and my Dr have requested it from them multiple times to no avail. 
  
  [To assist us in bringing this matter to a close, we would like to know your view on the matter.]
  
  Regards,
  
  ********** ***
  
  
  
  
   

  

  Business response

  04/02/2024

  Patient has been contacted and concerns has been addressed. 

  Customer response

  04/03/2024

  [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

  03/18/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  3/16/2024 at 10:13 AM. I received an Email from CLEVELAND CLINIC BILLING DEPARTMENT. stating that I owe,$25.00 dollars. From medical services I received on 3/6/2023. From my cardiologist. I was on a payment plan for years with CLEVELAND CLINIC and never missed a payment. On 11/13/2023 I payed the total amount of my outstanding balance of 2,179.77 and received a ZERO balance account reading. For the period of 4 months and 2 days I had a ZERO BALANCE. With CLEVELAND CLINIC. NOW out of the blue, and without any type of explanation or Proof of this bill.This bill I'm being told I owe is one year and 9 day's old.And I'm just now being notified about this? I feel I already payed this bill on 11/132023 AND I KNOW how Cleveland clinic double bills people and have Deceptive Billing Practices. I don't owe this $25.00

  

  Business response

  03/20/2024

  ***** *** **** ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** ******* ********* ******* ******** **** ****** ********
  
  This letter is in response to a billing complaint from *** ******* filed in your office on March 18, 2024. This was sent to the Financial Ombudsman department to review and respond back to you.
  
  *** ******** *nsurance, ******* ********, originally processed this claim back on 8/17/23, however, all the charges were not on the original claim. The corrected claim was sent to his insurance on 8/18/23 and the balance remained pending with his insurance until they took back their original payment and reprocessed the claim. During this time, this date of service, 3/6/23, did not appear on a billing statement nor was it included in his balance that reflected on his 11/12/23 billing statement. ******* ******** did not reprocess this claim until 2/29/24, which is why he did not see it on a billing statement prior to his 3/12/24 billing statement. The final claim billed to his insurance on 8/18/23 was for $432.00, ******* ******** paid $19.82 on 2/29/24, the contractual adjustment was $387.18, and per the explanation of benefits, it states he owes $25.00 as his copay.
  
  Unfortunately, this balance will not be adjusted off as it is a valid balance that he owes. He should have received an explanation of benefits from Devoted Medicare showing that he owes $25.00 for this date of service.
  
  Should *** ****** have any further questions regarding this matter, he may contact me at 216-442-1117.
  
  
  
  
  
  
  
  Best Regards,
  
  
  
  
  ******* ******* ********* ********* ******* ***** *********** **** *** ******* *****

  Customer response

  03/20/2024

  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

  03/20/2024

  I still haven't been explained the reason for this late bill. I need to clearly understand why I'm paying this bill. No evidence has been presented to me to validate there statements. Cleveland Clinic has a bad reputation when it comes to billing.  I have payed on a payment plan for years and never missed a payment.  Also I payed, 2 179.77 not to mention a couple thousand dollars on the payment plan. I think I am entitled to a explanation. Thank You.

  

  Business response

  03/25/2024

  ***** *** **** ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** ******* ********* ******* ******** **** ****** ********
  
  This letter is in response to the rebuttal complaint from *** ******, filed in your office on March 21, 2024. This was sent to the Financial Ombudsman department to review and respond back to you.
  
  As stated in our previous response, not all of *** ******’s charges were entered onto the original claim sent to Devoted Medicare. When the claim was originally billed to his insurance company for $307.00, it only reflected the ECG, however the facility charge was not present on the claim. When this error was recognized, a corrected claim was sent to his insurance to reflect the ECG and facility charge, a total claim of $432.00. Devoted Medicare did a takeback and reprocessed the claim to reflect him owing a $25.00 copay. This amount is determined by his policy he has with Devoted Medicare, and he should have received an explanation of benefits from them reflecting this. I explained in detail in my original response that this charge has never appeared on a billing statement, until 3/12/24 due to his insurance company reprocessing the claim so it was not billed to him prior, nor did he pay for this charge because it was never a part of his previous payment plan.
  
  The Cleveland Clinic has sent numerous responses to *** ****** regarding this same date of service when he filed complaints through his MYCHART, and we have provided the explanation to him just as I have above and on the original response. If he does not agree with the amount his insurance is stating he owes for this service, he can reach out to Devoted Medicare and discuss it with someone in his benefits department so that they can also clarify his responsibility for this charge.
  
  I do show *** ****** paid this charge in full on 3/21/24 and we will be closing his case within our office as we have already provided a response to his concerns.
  
  
  Best Regards,
  
  
  
  
  ******* ******* ********* ********* ******* ***** *********** **** *** ******* ***** **** **** ****** **** ******* ****** **** ************ ** ** ** ******************************* *** *********** ** *** ********* ********** *******

  Customer response

  03/26/2024

  RECEIVED VIA EMAIL BY BBB STAFF MEMBER:

  Basically, they are admitting to an Error on there part. When someone, doesn't do there Job correctly. It effects other people. I have alot of medical issues, and I don't need this kind of turmoil in my life. Thank You. **** ****** ********
  
  *** ******

• Initial Complaint

  03/13/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Date of transaction 10/7/23 My husband passed 10/4/23. They told me while I was standing on a builder tile floor. I passed out and slammed my head on the floor. I decided to try ice/bedrest. 3 days after went to hospital for continued problems. Cleveland Clinic has every contact option imaginable - other than snail mail, they have phone and email. They chose to ONLY use snail mail. Unfortunately, my husband's sister passed just 2 months after him. She lived out of state. I received NO phone calls, and NO emails. 2 months ago, I got a bill. I logged into the online account and it said I didn't owe anything. I thought it was odd, but sometimes insurance crosses in the mail. The following month, I got the same bill AGAIN. I logged in again, and again, it said I don't owe anything. I called them. They checked and agreed that my account has a zero balance. Ok, that's odd. However, their tone got squirrely and changed. Then they said they had put the bill "into collections". What ? I explained what happened, to apparently empty space, reminded them they CERTAINLY could have contacted me via email and/or phone but they chose not to. I offered to pay the bill in full - since the online account kept saying there was no balance, but they REFUSED. They told me I'd have to deal with "someone else" but wouldn't tell me who that was. I haven't heard from anyone. Again, I tried to pay Cleveland Clinic in full and they REFUSED. I guess they don't want to be paid.

  

  Business response

  03/21/2024

  ***** *** **** ****** ******** ****** **** ****** **** *** ** ********** **** ********** ***** ****** *******           *** ********* *** ******** **** *******
  
  This letter is in response to the billing complaint filed by **** *****, to the Better Business Bureau on 3/13/2024. I would first like to offer my sincere apology for any frustration this may have caused **** *****. On behalf of Cleveland Clinic, I wanted to extend my sincere condolences for her loss.
  I called **** ***** at ************* the answering machine would not allow me to leave a voicemail. If **** ***** would like to pay the balance in full, she can call my direct number at ************ and I can assist her in making the payment. Once the payment has been paid in full, I can reach out to the collection agency advising them that **** ***** paid the balance and have them close the account.
  Thank you for allowing us the opportunity to address **** *****s concerns. If we can be of any further assistance, please feel free to contact me directly at ***********2.
  
  Respectfully,
  ****** ******* ********* ********* ******* ***** *********** **** *** **** *****

• Initial Complaint

  03/02/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On November 8th/2023 I went to cleveland clinic to start the kidney transplant process. The whole thing was a waste of time and money. I am willing to point out what a scam this has been on my insurance company. They required all new testing, using only cleveland clinic facilities, they so far are the ONLY hospital I have been to that will only let you use their facilities tests. The first appointments they made it sound as if I will be reviewed shortly after all of the tests are completed which was NOT the case. I finished the tests in 3 weeks and once I started asking for updates I was told by the coordinator that they wouldn't be accepting me until I showed I could stay on dialysis for a full 4 hours for 6 months rather than signing off 30 minutes early to go to work as I'm a social worker, keep in mind they knew my dialysis times BEFORE sending me for all of the tests and charging my insurance knowing the answer was NO, I have been on dialysis for 14 years for all but 4 years I was there my full time until I started to work and go to university at the same time. The messages are a small snip of what it was back and fourth with lies about timing, lies about who said what and lies about who had been talked to. These doctors could not keep the stories straight because they would claim one doctor said one thing then I would call and that doctor would claim they never talked to the first one. This is just one huge scam. Any doctor will tell you that it's dangerous to stay on dialysis yet cleveland decided 6 months longer would be fine which puts me in the time frame of needing new appointments which they can charge my insurance for all over again. When we brought up how others in their program got kidneys before even being on dialysis their response was "every situation is different" yet could not explain how that's possible. Or why people that have not been on dialysis for even 6 months got on the list. When you have good insurance they bleed it as much as they can

  

  Business response

  03/18/2024

  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.

• Initial Complaint

  02/15/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I was scheduled for surgery in January for March 18, 2024. I was called by Dr. ****'s secretary yesterday afternoon. I returned her call within 5 minutes and texted her back. She called me about an hour later informing me that the March 18 surgery wasn't available anymore and that I was going to have to push out my surgery into April. But she had a surgery slot available on Monday, February 19 with Dr. **** and another surgeon. I did everything I needed to do with work and the pain management procedure (scheduled for today) within 30 minutes to only be called later in the afternoon telling me that the surgery slot was double booked with another patient from the other surgeon. ******, Dr. ****'s secretary, told me she was waiting to hear from Dr. **** if surgery was going to be rescheduled or if I would have Monday's slot. I received a call from Anesthesia this morning about pushing out my appointment for clearance. I had not heard back from ******. I wouldn't have canceled my pain management procedure this morning had this debacle not happened. And my employer is going to be extremely frustrated about having to reschedule everything yet again. I understand that I'm just dealing with pain but to go months and to be jerked around with possible dates is no way to execute sound patient care and experience. I've been struggling with how to end this email because I am so upset, frustrated, sick, and in pain. If I could go to another healthcare system I would. But I cannot. So now I'm supposed to wait until April. Or maybe March - because Anesthesia wasn't sure. He was told it was on the schedule for March 18 again. After being told yesterday that March 18 was not available any more.

  

  Business response

  02/19/2024

  Patient has been contacted and the Ombudsman Office is following their process to file a formal grievance.

• Initial Complaint

  01/23/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  The Cleveland clinic is violating HIPPA laws by not releasing my medical records to me and my new medical providers at university hospital. For two weeks ive been calling in and given the run around instead of what needs to be done so my new doctor can see my old medical records. they have given me four different phone numbers and they dont go to anywhere ive even tried odsbudsman office they keep giving me the same number where either no one picks up the phone or they say i cant help you, ive also paid for two cd copies but haven't received those either

  

  Business response

  02/16/2024

  This patient has been spoken too and this complaint has been filed. Patient was able to obtain his medical records. Please contact patient for further needed information.

  Customer response

  02/16/2024

  [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

  01/11/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I was referred to the Cleveland Clinic endocrinology department by my cardiologist to assure my hypertension was not related to my endocrine system. I subsequently scheduled the appointment and received confirmation with visit instructions. My wife and I then drove 5 hours to my appointment, parked, entered the main facility and eventually found our way to where we needed to be. The normal routine of check-in, insurance, etc. was performed and I was directed to another area of the building for my appointment. Eventually I was led to an examination room with a few more *****ions, blood pressure, temp, etc. This process took about an hour, then another ½ hour awaiting the Endocrinologist to arrive. All was well at this point, assuming 1 ½ hours is standard wait time for this type of visit. This is where the experience changes a bit. The Endocrinologist did not know who I was or why I was at Cleveland Clinic. I asked if they had read the referral information and the answer was no since their office had not received any information. For the next 45 minutes I proceeded to provide history on my condition, my understanding of why I was at Cleveland Clinic and provided a copy of recent blood work. The Endocrinologist suggested we do additional blood work, asked if I wanted a COVID booster, suggested an Abdominal Aortic Aneurysm Screening and suggested scheduling another appointment with the Cleveland Clinic Spine Medical Center, since during part of the conversation I mentioned stenosis in my neck. I still get those appointment recommendations every time I log into the patient portal MyChart. Not sure why an Endocronologist would be upselling these services. I left the appointment a bit puzzled as to why the Endocrinologist did not have any background referral information and I found it strange the appointment was confirmed without having that detail. I proceeded to the blood work area which was a great experience. In and out in a timely manner and the nurse drawing the blood was exceptional. However, I found it odd 6 or 7 tubes of blood were drawn. My wife and I left to drive another 5 hours back home. Quite a long day. I never heard back from the Endocrinologist so I went to the patient portal MyChart and asked for the results which were subsequently posted. I noticed many of the blood tests done had already been performed by the referring doctor and my PCP, so puzzled as to why repeated. I asked the Endocrinologist to provide a medical opinion after reading through the referral information. Apparently, the Endocrinologist office does not have access to the Cleveland Clinic Referral System so they asked me to have my doctor send them the information. My doctor’s office resent the referral information, but stated they could only send to the Cleveland Clinic Referral Office per procedure. Well, this went back and forth for weeks. As far as I know, the Endocrinologist never did receive any information which I still think is very strange. Why accept a referral appointment without referral information and background. This should be mandatory before scheduling an appointment. Now the bills start surfacing. If you don’t login to the patient portal MyChart, then you don’t even know a bill exists. Eventually, I received a **** paper bill for the Endocrinologist services which was paid upon receipt. I still have not received a **** paper bill for the blood work, but the charges are exorbitant especially since many of the tests had already been done. I then contacted the billing office, explained my experience, mentioned that many of the blood tests should not have been repeated and if done at my local ***** or *** **** would have been ½ the cost. I was hoping for some type of concession due to my experience and was sent over to the Cleveland Clinic Ombudsman office where I detailed my experience. I received a call back a week or so later telling me there is nothing they could do, but their reason was based on non-factual incorrect information that occured well after the appointment. I proceeded to offer insight into the correct prior to the appointment details, however, I was told the decision was final and they would not review further. Wow! The Ombudsman office did mention they would look at changing their process, but no commitment nor insight into what type of changes would be made. I don’t think anything will be changing since their decision was based on inaccurate information which suggests everything happened as designed. I expected some level of compensation to cover the unnecessary repeated blood work. Even $200-300 would have been an acceptable resolution. Bottom line, if you have a referral don’t trust the Cleveland Clinic process works and demand referral background is received and reviewed prior to confirming an appointment. Also, if blood work is part of the process, review the suggested tests to assure no repeats and opt to have blood drawn at your local ***** or *** **** which will be ½ the cost.

  

  Business response

  01/16/2024

  Dear Ms. *****,
  
  This letter is in response to the billing complaint filed by Mr. ****** to the Ohio Better Business Bureau on 01/11/2024, regarding his appointment and subsequent lab work completed at Cleveland Clinic on 04/04/2023. Please be advised that this matter has been reviewed.
  
  A thorough investigation has been completed based on the patient’s concern regarding the balance for lab work completed after his endocrinologist visit. The balance of $642.50 is correct and will not be changed as it is patient responsibility and processed through his insurance, ******, towards his annual deductible. The lab work was ordered by his physician during his appointment and was deemed to be correct to be ordered based on the concerns discussed during his visit. Cleveland Clinic has the responsibility to bill each service appropriately and accurately based on the services provided and documentation.
  
  Additionally, if the patient still has concerns regarding the care he received prior to and during his appointment with Dr. ******** ***, he will need to contact the Medical Ombudsman office at ************.
  
  Thank you for allowing us the opportunity to address Mr. ******’ concerns. If I can be of any further assistance, please feel free to contact me directly at ************.
  
  Respectfully,
  
  
  
  Emily ******
  Financial Ombudsman
  Revenue Cycle Management, CCHS

  Customer response

  01/16/2024

  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.
  

  I've already escalated to the Ombudsman office as stated in my original complaint.  As a next step, I will certainly reach out to Emily ****** from the Ombudsman's office to discuss further.  However, the Ombudsman office stated they investigated the issue fully and that the Endocrinologist tried to obtain the referral information prior to the appointment.  I stated that was incorrect, in that no effort was made prior to my appointment to obtain referral information and should be reviewed again based on this corrected information.  The Ombudsman office stated the decision was final and would not be reviewed again, but will look at their processes.  I felt they were not at all empathetic, that process change was likely not going to occur and stated I would be leveraging social media to document my experience which I'm doing.  Although already discussed with the Ombudsman office, I did send a copy over to the Cleveland Clinic Patience Experience e-mail to assure it was documented with their office as well and they acknowledged receipt.

  In summary, the business response suggests escalating to the Ombudsman office which had already been done.  It appears my initial complaint was not read thoroughly in developing a response.

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

  

  Business response

  01/18/2024

  Dear Ms. *****,
  
  This letter is in response to the rebuttal filed by Mr. ****** to the Ohio Better Business on January 17, 2024. We appreciate efforts to resolve this matter. Please be advised that the patient’s full concern has been reviewed.
  
  An additional review has been completed based on the patient’s concern regarding the balance for lab work completed at the Cleveland Clinic. The balance has been deemed correct and will not be changed or adjusted, as the services were rendered and there are no financial errors. While the patient’s concern regarding his appointment with his Endocrinologist had been reviewed by the Medical Ombudsman prior, it is being sent back for an additional review.  
  
  Thank you for bringing these concerns to our attention. Please note, this is our final review on the above concern, any further *****ions related to their medical care, should be directed to the Medical Ombudsman.  
  
  Respectfully,
  
  
  
  Emily ******
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  
  Cc: ******, ******

• Initial Complaint

  12/19/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On 7/5/2023, I went to the location to receive Urgent Care services for a cut on my leg. This has nothing to do with the service, but I am being billed for a different deductible than I should be. I have contacted Cleveland Clinic and my insurance to try to remedy the situation. I am being charged $626 for services that should be $75. The reason this is being charged this way, is due to the way it was billed to my insurance. Which shows Cleveland Clinic ***** Hospital putting it as an outpatient hospital. When you search for Urgent Care facilities on the Cleveland Clinic website, it shows ***** Hospital as an Urgent Care facility. When talking with them via chat or through my insurance, they refuse to fix the coding of the billing, we've had them review the coding for the bill, which they said is correct. In chatting with them I was told the staples needed to close my wound was an Urgent Care service. I've attached my bill, which has the account information and a copy of my 2023 insurance coverage. If they properly billed my insurance, they would receive their amount due less my copay, but with how they billed it, it becomes an outpatient surgery, which is 20% after deductible. I've already tried the Department of Health, which pointed me to you. I thank you for your time.

  

  Business response

  12/29/2023

  
  Dear ******,
  
  This letter is in response to the billing complaint filed by ***** ******, to the Better Business Bureau on 12/20/2023. I would first like to offer my sincere apology for any frustration this may have caused Mr. ******.
  
  After speaking to **** (reference # **********), representative with ******, it was determined that the root cause of his complaint is that his insurance company processed the claim as outpatient and not as an Urgent Care visit. ****** is sending the claim back for review, please allow 14 business days for ****** to complete their review. I will continue to monitor this claim on my end to ensure it gets reprocessed.
  
  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 ************.
  
  Respectfully,
  Brendan *******
  
  Financial Ombudsman
  Revenue Cycle Management, CCHS
  Cc: ***** ******

• Initial Complaint

  12/16/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  To Whom It May Concern, I am writing to address serious concerns about the care management at Cleveland Clinic ******* ***** Family Health Center. Despite full coverage by **** ********, my requests to switch mental health providers have been unjustifiably denied, accompanied by inadequate communication. Issues: Denied Provider Change: Requested a new psychiatrist and therapist in October 2023 due to unsatisfactory care and my psychiatrist's maternity leave. These requests were declined without clear reasons. Communication Breakdown: Significant delays in responses from the care team. Initial contact in October 2023 led to a vague response only in November 2023. Medication Refill Issues: Without an interim psychiatrist, my medication refills were unjustly denied in November 2023. Inefficient Process: The long wait for handling my request and lack of direct dialogue with responsible staff is concerning. I have documented all interactions and responses, underscoring the lack of proper care management. Demands: Explanation: Require a detailed rationale for denying my request to switch providers. Immediate Dialogue: Request a direct conversation with a relevant Cleveland Clinic authority. Swift Resolution: Urgent review and action on assigning suitable mental health professionals. The handling of my case shows a disregard for patient choice and well-being. I expect a prompt and constructive response. ****** *. ******

  

  Business response

  01/08/2024

  Thank you for notification regarding this patient's concern. I have followed up with the patient directly. Please let me know if any additional information is needed. 

*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. ↩