ComplaintsforOrthoCincy Orthopaedics & Sports Medicine

• Initial Complaint

  08/22/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I have ******** as my primary insurance and **** ******** as secondary insurance. I am is what is called a Qualified ******** Beneficiary. I saw Dr. D******** last week and his office scheduled an injection in my back. I received a call today that they were canceling the injection as their Kentucky office doesn't accept **** ********. It is aFederal law for a doctor that doesn't take ******** has to accept ******** as full payment. This is an agreement that doctors sign to bill ********. I called the billing office and the woman there said that she understood that a QMB was only to pay ******** premiums and never heard that doctors that didn't accept ******** had to accept ******** as full payment. She transferred me to a number that never answered the phone. A big problem at Orthocincy!

  Business response

  08/25/2023

  08/24/2023
  
  BBB
  1 E. 4th, Suite 600
  Cincinnati, OH 45202
  
  Re:  ********
  
  We are in receipt of complaint ********.  We attempted to speak with the patient regarding the complaint on 08/23/2023.  The patient ended the call before we could review her complaint.  We were successful in speaking with the daughter.   The patient was initially referred to other providers but they would not return her calls or gave her the “run around”.  The patient does have a secondary plan that Dr. D********* is not in network for and she was simply requested to schedule an appointment to be seen by a provider within OrthoCincy that is in network with her insurance.   For patient satisfaction purposes, the patient was rescheduled with Dr. D********* for the same date/time.  OrthoCincy has contacted the patient numerous time to confirm the appointment.  To date, she has not returned any of our phone calls.
  
  Please note, the patient has never been billed from OrthoCincy.  We have accepted what her insurance has paid for services rendered.  OrthoCincy is compliant with all billing requirements.
  
  Should you need further information, please feel free to contact the office.
  
  Thank you,
  
  Janie O******
  COO
  ###-###-####
  

• Initial Complaint

  09/09/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  After having asked for permission to keep my phone so that I could alert my GF (who was my post-op ride) as to the exact time I went to the theatre for surgery so she could be aware of when she should return, I was not given my phone back for almost a week. They were rude, nasty and dismissive of my GF who was trying to recover my phone immediately after surgery, from the time I was wheeled out to the car until they wouldn’t speak to her anymore. They talked down to her, lied (saying she had the phone and lost it) and were just overall very self-important and many less kind words I will gloss over here. As far as the surgery, a week later I am doing well. But it was not easy being hobbled without a phone. I wonder what would happen to most people without their phones, just a in general. Loss of employment, difficulty in coordination. All my passwords were on my phone so I was having trouble doing little things like banking and oh yes following up with my doctors about my surgery!

  Business response

  09/13/2022

  I personally called the patient and informed him that the surgery was at *** ********* Hospital not OrthoCincy Orthopaedics & Sports Medicine.   OrthoCincy is a medical practice not a hospital.   He stated he would correct the statement on BBB.  I did contact *** ********* Hospital and informed them of the complaint.  They stated that they would contact the patient to correct the issue.

   

  JoAnn M. R***

  Customer response

  09/15/2022

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this is not really a resolution but a shifting of the blame. You can say, "It wasn't out organization that did this." but it is your organization that has decided to engage in business practices in such a way as to have an environment where blame is nebulous and for what reason that is, I do not know. A non-profit hospital allowing a for-profit organization to operate in their facility. Does that seem shady? Yeah. Is it related to my complaint? I would say only tangentially. But the fact that my loved ones had to call around and get the run around from both organizations while I was incapacitated still leaves a bad taste in my mouth. I think we are all just about done being fucked over by the intentionally obtuse corporatist scum.

  I am choosing to call the issue resolved because at the very least, the people I had contact with at OrthoCincy SAY they care and SAY they will troubleshoot to make this not happen to other people. The person who called me was attentive as was PA Matt G***e (sp?). So, I will be copy and pasting my complaint and resubmitting it to reflect that apparently the party at fault is *** *********, although it still pisses me off that this little forum is all I get for airing my grievances and you have all disrespected my time in a way I don't think I will let go of anytime soon.

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

• Initial Complaint

  03/15/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Mis-use of billing codes. My daughter broke her foot. A tiny fracture, all that was done to her foot was examination, x-rays, and given a boot device, with 1 urgent care visit and 2 regular doctors visits. The billing codes used were hospital surgery codes. No surgery was done. No movement of the bone back in place was done as the fracture was not a complete break. I called ortho cincy because of a large bill that was not our copay amounts, and they said it was "fracture care". That people were not coming to all their follow up appointments so they bill a Lot at first and then don't charge for further care, so people will keep coming to follow up appointments. She said it can stink for those who only need 3 visits like us, but those with larger breaks it is a lot cheaper. (Since a majority of breaks are small, the business must be making a lot more money off of this tactic.) I called my insurance company for explanation. They said there is no such thing as a billing code called "fracture care" that the business cannot charge for future visits. That the codes used were surgical codes. I asked if that seemed right since no surgery or manipulations of the break were done. She said it did Not sound right at All. My daughter's name is **** ******, my husband's name is **** ******, he took her to the visit. I ***** ****** am dealing with this issue as the only time to call the business is during my husband's work hours, as is the only time to call the insurance.

  Business response

  03/23/2022

  We contacted the client and settled the issue.  Please see the attached letter from my Billing Manager.

  We are in receipt of complaint *********  We did review the patient’s concern of the mentioned services on 12.23.21 with a billing/coding auditor.  The auditor did confirm the billing for the services was in accordance with billing standards and regulations.  However, in an effort to provide the patient’s mother with a resolution which she would be satisfied with, we have adjusted the balance to what an office copay would have been. This was reviewed with Mrs. ****** and she was satisfied with this outcome. We consider this matter resolved.
  

  JoAnn M. R
  

*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. ↩