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Complaint Details
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Initial Complaint
10/14/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
My labs were sent to Summit Pathology on 11/2/23. Two tests made it to my insurance and the other three were misrouted. I've been trying to work with Summit to actually resubmit the three tests to my insurance for review but a year later it's still ongoing. I continue to be billed for the same $276.15 and ********** Blue Shield has repeatedly said they do not see those three tests submitted at any point.I have spoke to at least 5 people at Summit across multiple conversations and hours. Each time they state this situation has been escalated, resubmitted to the "right" insurance, and there is a hold on my account so it will not be flagged for collections. When days and weeks go by without a claim hitting my insurance I follow up again, only to be told the same thing - as well as how they can see that I have been trying to get this resolved for quite some time. I am once again promised all the escalation, resubmission and hold steps will done but they can't tell me why it wasn't done after the previous call.Summit has reassured me that they are doing everything they can on their part to get this figured out. When I have had my insurance call Summit directly to assist with the processing and to help with any questions they may have, Summit indicates they will escalate or resubmit the claim "this time" but allude to the fact that it was not previously done.I will pay whatever portion of the $276.15 that I am responsible for, but only AFTER it has been properly sent to my insurance for review and I have an explanation of benefits on the claim. I don't believe Summit Pathology has been working in good faith to come to a resolution in this matter.
Business response
10/15/2024
Unfortunately this patient did not receive the typical service Summit Pathology usually provides. Most of the patient's claim was adjudicated correctly, but there were two tests that were not handled with the correct workflow. We have adjusted off this balance for the patient, which should have occurred at the time of service. We reached out to the patient by phone yesterday to let her know the bill is at a zero balance and apologized for her inconvenience. We have also used this case to further train our staff to follow the correct workflow for these specific tests.Customer response
10/15/2024
While the resolution I received yesterday was acceptable, I want it to be clear and accurate that it was three tests that were not submitted properly my insurance for the total amount of $276.15. The response from the business only mentioned two. I don't want to have any future issues where Summit later reaching out requesting payment for the third test when that was part of the total balance waived.Initial Complaint
09/09/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
Summit Pathology failed to submit the correct codes to my insurance provider resulting in the claim being denied by ******. I was in communication with Summit Pathology trying to correct the situation and was told that they would re-submit the claim and that I did not need to do anything else. Unfortunately while I was "sitting tight" , they sent my account to collections. This was an absolutely horrendous experience to get resolved.I subsequently paid the invoice on 07/24/24 (see uploaded file) and yet have still been receiving collection notices. Please note the account as paid or I will be forced to take further action.Business response
09/10/2024
Hello-
We apologize for this inconvenience. Summit Pathology has removed the account from collections and has marked the account as paid in full. Summit is verifying that the claim was adjudicated properly by the insurance company which will take ***** days. Summit Pathology will reach out to the consumer to discuss in further detail.
Thanks
***** *******
Customer response
09/23/2024
As of 09/23/24, I have received no communication from Summit Pathology or from the collection agency.Business response
10/09/2024
Summit Pathology has left several messages by phone for Mr. ***** since becoming aware of the complaint. He has not returned our calls. We left him an additional voicemail message 10/8/24. We also sent him an email explaining the status of our claim with ********** Blue Shield. We had resubmitted the claim following the initial denial by BCBS. They again denied the claim as a duplicate on 9/25/24. However, we will appeal that rejection. In the mean time, we will issue Mr. ***** a refund as we continue to work with **** to be paid for our claim. Our Director of Revenue Cycle Managment has provided Mr. ***** with her email and phone number to keep in contact should he have further questions.Initial Complaint
06/27/2023
- Complaint Type:
- Product Issues
- Status:
- Resolved
Summit Pathology sent a bill for $166.80 to me on 10/28/22 for services rendered on 8/15/22. The amount was the difference remaining after Medicare paid its portion of the charges. However, I have a supplemental policy with USAA Life Insurance Company, which paid the $166.80 on 9/21/22. I communicated this on 11/7/22 to Summit Pathology's billing department, who in turn asked for proof of payment. USAA Life Insurance Company obliged by sending a copy of the check by FAX on 11/7/22. Nevertheless, Summit Pathology sent another bill for $166.80 on 11/17/22. I called to complain on 12/9/22. "Laura" promised to escalate my complaint to the "cash team department" so that they could locate the payment and post it to my account. She also promised to block further payment requests. Today (6/26/23) I received another bill for $166.80 with a threat to send it to collections if I don't pay by 7/8/2023.
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Get a QuoteCustomer Complaints Summary
4 total complaints in the last 3 years.
2 complaints closed in the last 12 months.