Centra Health, Inc.

I went to my PCP that is located in a Primary Care facility. The EOB came back as a specialist visit with a higher copay. I have called both Centra billing and Humana with no explanation as to how this is correct. Humana says they only go by what the provider sends them and cannot correct it. Centra billing can’t justify the “specialist “ charge but provided no reason why my pcp is suddenly a specialist. Creative billing!

Due to the inaccuracy of billing, I now have a significant credit. Was told that since other claims are still in process, not reimbursement can be made. Have sent the billing dept copies of my EOB's for the aging claims (Dec 20, Feb 21) showing they were paid or no patient balance due for each one. Confirmed with insurer that payment was made in April.
While the individuals in the billing area were very professional, suspect their system/process is horrible. They can't find account credits/payment for 2 months?
Paul Opdyke
540 266 2604
Yesterday I received an aging charge for a March date of service...so here comes another excuse why this can't be resolved

I am 63 years old with COPD and still have not been called by central health for a co-vid shot. Central health does not care about their patients only the Medicare money. I am looking for a better health care provider. Would not recommend central health.

Recently my husband needed surgical intervention for severe, intractable pain. Not only was the pain never addressed, or treated before or after the procedure. This resulted in (to date) over a month of continued suffering (we still have two weeks before the next injection series) . This currently continues. When treatment via injection @ Virginia Baptist hospital, the intervention by pain management physician resulted in no relief from his continued suffering. When we met with the physician, he never introduced himself nor were we given the opportunity to question, additionally he wore a xray protective garment which revealed another employees name, and never presented with a mask. Post procedure when attempting to ask questions and gain insight to the treatment/treatments, and alternatives, he was curt, insensitive, abrupt, and basically rude. When asked about my husbands current status regarding pain in the interim, he essentially ignored me. Please note my husband is on no medication, save aleve, he is 67 yo and is basically immobile due to the current spinal issues, has worked hard all of his life, and never complains. Where is the human compassion and empathy, is this the kind of care we deserve? For the record, every other encounter we experienced from e. D. , emergency surgery, post surgical admission, and out patient surgery center was exemplary.

I have reviewed the response offer made by the business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint For your reference, details of the offer I reviewed appear below I have been billed rimes for the $and each time I called they said no balance was dueI will not remove the complaint until they have cleared this matter up and sent me a statement that no money is due reflecting a zero balance [redacted]

The patient’s 6/10/claim was paid and has a zero balance The statement he received on 12/shows that but it also shows a balance from his encounter on 8/14/for $ It was this encounter that was billed under the wrong provider This encounter was corrected and rebilled under the correct provider as a result of the patient’s call to Customer Service The $balance is still outstanding to the insurance company A call was placed to the insurance company this morning and the claim is still being worked on by them No credit reporting has taken place because it is still outstanding to the insurance

There is an employee by the name of Brad Dawson who works in the computer department at Centra Health. Mr. Dawson is a drug/alcohol addict and has access to private, confidential HIPPA information. How can this company allow such a violation? I think the public needs to be notified of this since Mr. Dawson lives in another state without direct supervision.

I have reviewed the response offer made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
I have been billed 3 rimes for the $195 and each time I called they said no balance was due. I will not remove the complaint until they have cleared this matter up and sent me a statement that no money is due reflecting a zero balance. 
[redacted]

The patient’s 6/10/14 claim was
paid and has a zero balance.  The statement he received on 12/8 shows that
but it also shows a balance from his encounter on 8/14/14 for $195.  It
was this encounter that was billed under the wrong provider.  This
encounter was corrected and...

rebilled under the correct provider as a result of
the patient’s call to Customer Service.  The $195 balance is still
outstanding to the insurance company.  A call was placed to the insurance company this
morning and the claim is still being worked on by them.  No credit
reporting has taken place because it is still outstanding to the insurance.

Review: I went to this facility for minor medical care, spent a total of 45 minutes in the facility, and was billed an offensive amount and well beyond what we estimated by the staff at the time. I paid almost $300 out of pocket for the treatment, based on the administrator's estimate, but then later received two additional bills. I was charged an additional $700, for $1,000 total just for being in the medical facility. I was then charged an additional $500 for the actual nurse care that was provided over the course of 20 minutes.Desired Settlement: To charge a patient $1,500 for 6 stitches and a tetanus shot in [redacted] Virginia is absolutely disgraceful and in no way reflects the actual costs incurred by the facility to administer the treatment. My desired outcome is for their business ethics to be reviewed and my bill to be adjusted to something real, and reflective of the treatment I actually received.

Business

Response:

We have investigated the concern Mr. [redacted] presented. The estimate referred to only provides for the ED visit and not any procedures that take place in the ED. Charges are processed separately for facilities and provider which accounts for the two bills. Several discounts were given throughout the billing process including prompt pay, insurance adjustment and a courtesy adjustment and after careful review all services were billed accordingly.

Review: Dr [redacted] was my primary care physician in [redacted] And is a part of Centra Health Inc. I just received my third bill in the amount

of $195.00. I had discussed this bill on two

Different occasions with his billing department

at ###-###-#### and told I did not owe anything.

When I kept my appointment with Dr [redacted] I paid my

normal co-pay. However, I did not see Dr [redacted], I say

his Nurses Practioner [redacted]. I was improperly billed

and told it was their error.Desired Settlement: Correct the bill to reflect my co-pay with nothing

due. Correct any possible credit reporting they

May have reported incorrectly.

Business

Response:

The patient’s 6/10/14 claim was

paid and has a zero balance. The statement he received on 12/8 shows that

but it also shows a balance from his encounter on 8/14/14 for $195. It

was this encounter that was billed under the wrong provider. This

encounter was corrected and rebilled under the correct provider as a result of

the patient’s call to Customer Service. The $195 balance is still

outstanding to the insurance company. A call was placed to the insurance company this

morning and the claim is still being worked on by them. No credit

reporting has taken place because it is still outstanding to the insurance.

Consumer

Response:

I have reviewed the response offer made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

I have been billed 3 rimes for the $195 and each time I called they said no balance was due. I will not remove the complaint until they have cleared this matter up and sent me a statement that no money is due reflecting a zero balance.

Review: On 12/27/13 CENTRA MEDICAL GROUP Accepted payment of 194.21 for Account #[redacted]. This payment was not owned to Centra Medical Group. It was owned to Centra and the check needed to be payable to Centra. Billing for medical service should be mailed to [redacted]. billing for Hospital service mailed to [redacted]. I mistaking mailed both billings to [redacted].with the check payable to CENTRA MEDICAL GROUP.The check amount was 282.83 with 88.62 owned CENTRA MEDICAL GROUP. and 194.21 not owned.Desired Settlement: Centra Medical Group,LLC send me a refund in the amount of 194.21 so I can send payment to Centra. This billing is passed due.

Business

Response:

April 9, 2014

Attn: Western Virginia Revdex.com

We have looked at the account for the complaint referenced in the posted letter. We found that she did send in payment for all bills to the lockbox for Centra Medical Group. The payment that should have been sent for the hospital portion had been posted to her account as a credit. The refund check was processed and mailed out today, April 9, 2014.

We apologize for the delay.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID[redacted], and find that this resolution is satisfactory. The business has completed the resolution and apologized for the delay.

Thank you for your help Regards [redacted]

Review: I had a CT scan done on Nov. 30, '12 at a Centra facility. After insurance paid I was billed for the first time in March of '13. I sat up payment arrangements by phone and was told to start payments when I received bill in April at which time I made first payment. After receiving 2nd bill on May 9th I mailed 2nd payment that day. On May 13, I received a bill from Creditors Collection Service of Roanoke at which time I called and spoke with a delightful lady by the name of Mrs. [redacted] ###-###-#### and let her know how upset I was that this had been turned over to Collections after I had made payment arrangements. After a long discussion with her she assured me that as long as I made payments to them that everything would be fine and explained that after 6 months from the time of procedure that bills were automatically turned over to them to handle. I was fine with this arrangement and expected all future billing to come from the Collection Service concerning this bill. Several days ago I received another bill from Centra (same account number on both/not 2 seperate bills). At this point I called the number on my bill which is ###-###-#### Option 6 and asked to speak with a manager. I was told no one was available and left a message on a (?) managers voice mail by the name of [redacted] didn't return my call.On May 17, '13 I called and asked for a manager again and was told no one was available. I asked for her name and all I was told was her name was [redacted]. I told whomever I spoke with that I would be contacting the Revdex.com and would see them in court if this wasn't handled. Yesterday, [redacted] called me and I was not in front of my bills because I had just left the doctors office. She gave me a direct ####-###-#### ([redacted]) where she said I could reach her back. I called 2 times after getting home and left messages and she still has not returned my call.I believe they are double billing people from what it appears to me and would like this investigated.Desired Settlement: I would like an investigation to take place into this matter. If need be you may contact me at my email address provided or call me and I'll be glad to give you the account number and any other pertinent information you may need. Thank You!

Business

Response:

RE: Revdex.com Case # [redacted] – Centra Health, Inc. To Whom It May Concern: I am in receipt of the information sent by the Revdex.com to Centra Health, Inc. dated 05/30/2013 involving a complaint from one of our customers. We are sorry to hear that the customer was dissatisfied with our services. I have reviewed the account notes in question. Notes do indicate that Mr. [redacted] called in on 5/16/13 & 5/20/13 before receiving a call back from the requested representative. When the representative did contact Mr. [redacted] back on May 21, 2013, Mr. [redacted] was unable to talk at that time. The representative provided her contact information for Mr. [redacted] to call at his convenience. The representative received two voicemails from Mr. [redacted] on May 22, 2013. She returned the calls, leaving a voice mail message for Mr. [redacted] on May 23, 2013. Mr. [redacted] received the voicemail and returned the call to [redacted] later that day to discuss his concerns about his bill. Notes indicate that the representative apologized for her delayed response and any inconvenience it may have caused. Notes also indicate that the representative made a courtesy adjustment for the balance due to the problems patient had with his statements and for his inconvenience. In addition, the representative indicated that she contacted the collection agency and requested that they ensure there was no negative credit impact to the patient due to this account. We pride ourselves on providing excellent customer service in Patient Accounting at Centra. It is our policy to return all patient calls within 48 business hours. Clearly, this policy was not followed by our representative. I would like to apologize to Mr. [redacted] for his less than positive experience with our service in Patient Accounting. I would also like to thank Mr. [redacted] for his feedback as I will use the information provided in this complaint as a learning tool to re-educate our staff about the importance of following policies and responding to customers in a timely manner so situations such as this do not take place going forward. I have also reviewed the statements mailed to Mr. [redacted]. I do see that a statement mailing delay resulted in Mr. [redacted] receiving a statement from Centra after his account had already gone to collections. I apologize for this delay and any confusion that it may have caused Mr. [redacted]. I assure you there was absolutely no intent to double bill Mr. [redacted]. We work very closely with our vendors, including our collection agencies. Any payments received by either party are communicated daily via file transactions so balances can be updated timely and accurately to ensure no double billing takes place. In the event that multiple payments are received for an account resulting in a credit balance, a refund would be issued for any overpayment. I hope this information has been helpful. If I can assist you with any additional concerns or questions, please feel free to call me direct. I can be reached at ###-###-####. Sincerely, [redacted] Director, Patient Accounting Centra Health, Inc. 1204 Fenwick Drive Lynchburg, VA 24502 ###-###-#### – Telephone ###-###-#### – Fax [redacted] CC: [redacted] Mr. [redacted]