ComplaintsforZoom Care

• Initial Complaint

  08/13/2024

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  March 30th 2024 date of service was billed incorrectly as an initial wellness exam. My insurance stated that they do not accept ZoomCares own code of *****, and that it needs to be rebilled correctly with the proper office visit code of ***** so it can be processed like all of my other similar claims. I attempted to discuss this with ZoomCare and they are refusing to change the code and rebill as required by *****. This is a common issue that many other healthcare providers deal with on a daily basis. ZoomCare is negligent in their practices and acting in Bad Faith by not doing their part to resubmit with the correct code as required by insurance.

• Initial Complaint

  07/28/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  ZoomCare has long had a string of terrible customer service. The latest in this history, they migrated customer portals, eliminating access to my billing information and past visit history with NO WARNING. To this day, have no access to my past visit information. How is this legal?

• Initial Complaint

  07/19/2024

  Complaint Type:

  Product Issues

  Status:

  Unanswered

  More info

  Company has very deceptive practices. They tell you whatever you want to hear over the phone to get you into the office even though they know the care they are providing is not beneficial.Having COVID and wanting to get medication to lessen the severity, they told me over the phone that they could 100% help. The provided a prescription for Paxlovid. For over a year now, ****** has greedily increased the cost from ~$500 to $1,400.Insurance will only cover a small amount of that and Zoom Care knows this. Nobody in the bottom 98% of income earners can afford to pay $1,000+ for a glorified flu drug.Now, Zoom Care will want their money for what they know is a useless prescription.Do not go to Zoom Care for any assistance with Covid related illnesses.

• Initial Complaint

  06/14/2024

  Complaint Type:

  Product Issues

  Status:

  Unanswered

  More info

  I received care at Zoom Care beginning in January 2024. I received one bill and began making payments. I then emailed into the A/R to verify my payments were being received. Also to verify the amounts I was paying were going to keep me out of any collections. I received an email back 3 months ago, from *****, indicating the $50/month was acceptable and approved - I would not be sent to collections. I have this in writing and can send supports if needed. I did not receive any more bills and I could not access any online either. I emailed in again and asked to get bills so I could see my balance. I was sent a bill then told by ***** that I needed to pay more money - upwards of $150/month in order to not go to collections now. I had sought no new care since the initial written agreement. I attempted to explain the detrimental reliance in this case. I relied on the prior agreement to coordinate other billing plans with other companies I needed to pay. I do not have additional funds to increase the monthly payment amount. I detrimentally relied on the previous email from ***** and I do believe that Zoom Care cannot go back on the memorialized agreement - especially since I sought no new care (they stated they have new billing terms). They are estopped. ***** wrote me back and essentially stated that is too bad, to pay the amount offered and they would give me a credit. I did not agree. I then called in today and asked to talk with a supervisor about this. ***** was the gal who took my call. She stated their supervisors do not take calls. I asked twice and she said there was no one I could further escalate my concern to. Thus, I let her know I would go ahead and submit a complaint here.

• Initial Complaint

  06/10/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  On April 7th, I needed medical attention and contacted ZoomCare, who confirmed that my **************************************** was in-network. This information was also verified on ZoomCare's website, listing ****************** Blue Shield as a contracted partner. At the clinic, I presented my ID and insurance card and was assured once again that my insurance was accepted.However, on April 23rd, I received an automated email indicating that my card was charged $228.86, despite my expectation of a $40 copay based on ZoomCare's assurances and my insurance plan. I called ZoomCare during the week of May 6th, where they reiterated my coverage and we jointly contacted Premera BCBS. ZoomCare stated they would submit a new claim, affirming that I should only owe the $40 copay.Despite these assurances, the new claim was never submitted, and today, June 10th, I followed up with ZoomCare and was informed that they will not be submitting a new claim and that I remained liable for the $228.86. I feel misled by ZoomCare's multiple assurances regarding my insurance coverage, and I am concerned that other individuals may also be misinformed by ZoomCare's claims of being an in-network provider for Premera BCBS.

  Business response

  06/24/2024

  *Please see attached response*

• Initial Complaint

  04/09/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I contacted ZoomCare February of last year because I suspected I had a concussion after a car accident. ZoomCare provided an evaluation and a CAT scan. I requested that they go over billing and expenses with me before I departed from the office. Their billing specialist explained that it would be an ***** copay on my part, and I verbally verified it with her three times before leaving the office. I received a bill in the mail for ******* $. I called Zoomcare and they denied knowledge of the billing specialist confirming total cost to me would be ***** $. I notified them that they are in violation of the 'No Surprises Act', which states that no medical bill may be more than 400$ greater than the good faith estimate. They have already received ****** from insurance and the ***** payment that I was aware of. This means that under the 'No Surprises Act' they have been fully compensated to within 400$ of the original good faith estimate they provided. They turned the medical debt over to a debt collection agency, Quick Collect Incorporated, who have now contacted me. I want ZoomCare to drop the debt, as they have already been compensated, and I want Quick Collect Incorporated to cease and desist, which Zoomcare can arrange with them. I am reporting ZoomCare for predatory billing practices, and for not providing an accurate representation of cost to patient.

  Business response

  04/29/2024

  Hi ********,
  
  Thank you for reaching out to us regarding the billing for your visits at ZoomCare. We understand the importance of transparency in billing matters, and we appreciate the opportunity to address your concerns.
  
  After carefully reviewing the details of your visits, we would like to provide some clarification regarding the billing process:
  
  Insurance Information: According to our records, our benefits team were unable to verify your benefits based on the insurance details you provided at the time of your visit. As a result, we were unable to provide you with an estimate of your out-of-pocket costs. Our standard procedure in such cases is to inform patients that they will receive an Explanation of Benefits (EOB) from their insurance company once the claim is processed, which will outline any outstanding amounts due. Additionally, patients are directed to contact their insurance company to verify network status and coverage before proceeding with any healthcare services.
  
  
  Amounts Due:
  - Visit 2/1/2023 at the ***************************:
  -- Your insurance determined that you were required to pay towards your remaining deductible before they would pay their portion of the fees incurred. The outstanding amount due for this visit was determined to be $218.08, with your insurance paying $0. Since contacting our ********************** via phone and email, you were provided an additional 50% discount, setting the new balance for this visit to $109.04.
  - Visit 2/1/2023 at the ******************* Super clinic:
  -- Similarly, your insurance determined that you were required to pay towards your remaining deductible before they would pay their portion of the fees incurred. The outstanding amount due for this visit was determined to be $649.22, with your insurance paying $0. Since contacting our ********************** via phone and email, you were provided an additional 50% discount, setting the new balance for this visit to $324.61.
  
  While we understand that billing can be challenging to navigate, based on the information provided above, there is nothing further we can do at this time to reduce the amounts due with our partnered collection service, Quick Collect. We encourage you to reach out to them directly to settle your balances.
  
  Once again, we apologize for any confusion or inconvenience you have experienced. Please feel free to reach out to me directly if you have any further questions or concerns.

  All the best,

  Sage

  ZoomCare Patient Relations

  *****************************************

  Customer response

  05/02/2024

   
  Complaint: 21551384
  
  Hi Sage, 
  
  Thank you for your response. I have read through your clarification and would like to provide a few notes of my own. You state that your benefits team was unable to provide an out-of pocket estimate, but this is not true. The billing specialist that spoke to me at the clinic provided me with an estimate of eighty dollars, which I have paid.
  
  As for the amounts due, the "visit" to the *************************** on 2/1/24 consisted of a zoom call of less than (10) minutes in which they informed me that they could provide no services and that I needed to visit the in person clinic. Charging ****** (or even the reduced 104) $ for a phone call in which they provided no medical support or expertise is not acceptable.
  
  The billing specialist that I spoke to at the ******************* ************ assured me that the out-of-pocket cost would be no more than eighty dollars. I repeatedly asked her to confirm the cost, which she did. I have paid the amount that was explained to me at the time of the visit. Billing me for 1,400$ puts ZoomCare in clear violation of the No Surprises Act, which states that medical bills may not exceed four hundred dollars difference from the estimate provided, which was eighty dollars.
  
  I have submitted a formal complaint to the ************ of ******* Examiners for predatory billing practices and unless the Quick Collect attempts to contact me cease and desist effective immediately, I will pursue legal action.
  
  Thank you,
  ********
  

  Business response

  05/16/2024

  Hi ********,

  Thank you for your response and for sharing your concerns with us. We understand how important it is to have clarity regarding medical billing, and we appreciate the opportunity to address your concerns.

  Regarding your recent correspondence, I would like to provide some further clarification based on the information available in your records:

  - Insurance ********: Our front desk associates provide information based on the details available from the insurance provider at the time of your visit. Unfortunately, during your visit, our benefits team was unable to verify your benefits fully, and thus, we could not provide a definitive estimate of your out-of-pocket costs. While I was not present during this exchange, there is no record in our system of a confirmed $80 estimate, and we did not collect $80 from you as stated. Our records show an adjustment of $81.92 made by your insurance for your video visit, and a $12 payment collected for medication, which is not covered by insurance benefits.

  - Good Faith ******** and No Surprises Act: The Good Faith ******** requirements apply to patients who do not have insurance or are self-pay, which does not include your situation as you are insured. The No Surprises Act is designed to protect patients from unexpected bills from out-of-network providers or facilities. Since ZoomCare is an in-network provider for your insurance, this regulation does not apply to your case.

  - Charges for Services: Your bill reflects the costs as determined by your insurance plan, which includes a deductible that your insurance requires you to pay. We provided a financial accommodation to assist with these costs, which reduced the amounts you owe. This accommodation was extended as a courtesy, and we are obligated to collect the remaining balance as per your insurance plan's terms.

  We regret any frustration or confusion you have experienced. Based on the information provided, there is nothing further we can do to adjust the amounts due.

  Thank you for bringing this matter to our attention. Should you have any further questions, please do not hesitate to contact me directly.

  All the best,

  Sage

  ZoomCare Patient Relations

  *****************************************

• Initial Complaint

  02/13/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I visited Zoom Care clinics for 5 urgent care visits in January 2023 at the ***********, ********, and Beaumont location in the Portland area. 3 urgent care visits, one for labs, and one for an ultrasound. During these urgent care visits, I was told that my health care insurance was in network and that my ** pay was sufficient. If there was any more payment required, I was supposed to be notified via mail and the online patient portal. During that time frame, I checked the online patient portal and looked for my medical bills to populate, but nothing populated. I never received any notification of billing in the mail either. I was assured that if anything was owed it would be in the patient portal. Today 2/12/24, I get notified that I have a **urt order attempting to be delivered to my old address by a **llection agency. The **llection agency, Quick Collect, informed me that I did in fact owe and the total is $1,164.98. I in turned **ntacted Zoom Care where I spoke with the patient advocate specialist named ***** who informed me that the patient portal was experiencing "technical difficulties" and "was not reflecting balances owed by patients." She told me that Zoom Care did not need to notify patients that the billing portal was not working and that the bills were already sent to **llections and nothing **uld be done. She told me Zoom care attempted to mail invoices and it was my fault that I never received any bills via mail. I now over $1,100 and Zoom Care is taking no responsibility for their failure to inform their patients that their online billing system was not working. Had I been informed, I **uld have paid as they were due but I was not given the opportunity by their **nscious and blatant lack of **mmunication.

  Customer response

  02/14/2024

  The fact that I was not notified within 120 days of the billing service shows that Zoom Care violated the No Surprises Act. I was told that I was in network and subsequently charged for out of network pricing. 

  Business response

  02/21/2024

  Dear *******,

  Thank you for bringing your concerns regarding billing discrepancies to our attention. We have conducted a thorough investigation into the matter and appreciate your patience throughout this process. Here is a detailed explanation based on our findings:

  Our records indicate that you visited several of our ZoomCare clinics for services on various dates in January and March of 2023. For each of these visits, we diligently attempted to notify you of any outstanding balances through mailed billing statements. These statements were sent to you on the following dates:

  - Date of Service (DOS) 01/30/23
  Statement (Stmt) #1 mailed 4/25/23 for $218.08
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  - DOS 3/20/23
  Stmt #1 mailed 4/25/23 for $218.08
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  - DOS 3/22/23
  Stmt #1 mailed 4/25/23 for $229.68
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  - DOS 03/24/23 (x2 visits)
  Stmt #1 mailed 4/25/23 for $149.44
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  Stmt #1 mailed 4/25/23 for $232.38
  Stmt #2 mailed 5/25/23
  Stmt #3 Final mailed 6/16/23
  

  Additionally, we attempted to reach out to you via phone call on September 12, 2023, with a voicemail left requesting a return call. Unfortunately, we did not receive a response from you despite our attempts to reach out.

  We understand the challenges you faced with accessing billing information through our online patient portal and apologize for any inconvenience caused. Our team is here to assist you, and we encourage proactive communication if you encounter any difficulties or have questions about your billing matters.

  It's important to note that your insurer typically sends Explanation of Benefits (EOB) for each processed claim, which should have included information about any outstanding balances, in addition to our attempts. Moving forward, Quick Collect will be managing the collection process. We advise you to communicate directly with them to resolve the outstanding balance, as we have exhausted our options on our end.

  We understand your frustration and regret any inconvenience caused. Please feel free to contact us if you require further assistance or clarification at ************.

  Best regards,

  Sage

  ZoomCare Patient Relations

  Customer response

  02/21/2024

   
  Complaint: 21285009
  
  I am rejecting this response because I was charged and billed successfully for the amount of $226.00 with the card on file on 2/16/23 with no issues. Your billing services state that "If actual charges or payments are different than your estimate, you will be notified, and your card will be charged." The card on file was working for it to be charged on 2/16/23 and I received no notices that there were any outstanding charges. There was no attempt made by Zoom Care to charge the card on file as your billing service states and therefore, I am not responsible for Zoom Care's inability to bill successfully and follow through on their billing instructions. If my card was charged which was successfully billed in February as dictated by the billing department standards and practices prior to April, May or June, there would have been no need for mailed statements that were unsuccessfully delivered. The bills should have been charged as it was on 2/16/23. I have not seen any printed receipts that I was contacted other than what Zoom care has stated and therefore do not believe that any letters were sent to the address on file as they were never received. If this continues, I will seek legal counsel on how to process this further as this is a failure on Zoom Care's billing part by not following through with their own stated billing practices and I am not responsible for their billing failures. 
  
  Sincerely,
  
  ***************************

  Customer response

  02/21/2024

  I have followed up and shown proof that Zoom Care's online billing service was working properly and I was subsequently notified of my adjusted medical bill. I also have shown proof that I received an email notifying me of billing adjustment for $226.00 and email proof that I successfully paid $226.00 as shown in the billing adjustment. Also in the email, it is clearly stated that "Zoom Care will bill the card on file within 24 hours." I will also follow up with making a complaint with CMS and DCBS as this is not Zoom Care's first time being reported and found guilty for fraudulent practices. 

  Customer response

  02/23/2024

  Zoom care not responding to the information provided shows that they willing did not bill the card on file. Zoom care failed to follow their billing promise as shown in the attached documents either. Choosing to not reply shows their avoidance in admitting guilt in resolving the problem and trying to place it on the patient. 

• Initial Complaint

  01/10/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  This company is a scam. I should have listened to my husband and my instincts and not continued to receive service here based upon convenience. On 09/26/2023, I was seen at ZoomCare Super as a referral after I was seen at the ******* location for horrible stomach pains that weren't getting better. The ******* location said they could not do anything for me, so I paid $91.36 to that clinic for a statement saying they couldn't help. Upon my arrival, the Super location told me it would cost me no more than $750 (uninsured rate) even though I had insurance (Providence Connect). At the end of my visit, they returned with a summary of my visit and services performed, with the total cost of my visit being $578.71. They stated they would just bill my insurance for this and I could go on my way since I was feeling horribly and the visit took a long time. Come to find out, ZoomCare billed my insurance provider multiple times, with disallowed amounts. Today, when I opened my mail, all of a sudden I had a "past due" invoice from ZoomCare dated 12/28/2023. I had not received ONE BILL since the date of my service on 09/26/2023 for any emergency-related services for that date. I called Providence and they said unfortunately, since the provider is out-of-network, they can bill for disallowed amounts and make the patient responsible even though you have a max out of pocket (I already reached the limit before this) and coinsurance. Providence said usually all providers bill under standard codes, but this was not the usual practice. How can you have insurance and want to use the insurance, but the cost to use the insurance is more than having no insurance for the same services? This does not add up. This is a way for Zoom to collect additional money and chalk it up to, well this is the contracted amount with insurance. No, no it's not. I would have insisted on paying the $578.71 on 09/26/2023, if I knew my bill's total would be twice that amount 3 months later.

• Initial Complaint

  12/23/2023

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  Zoomcare claims that "*ZoomCare does not currently accept *************************************** or the ****** Health Plan. We are unable to provide care if you are covered under any of these plans." (Zoomcare website, ************************ even specify on their app that this policy includes those who pay out of pocket. I cannot understand how this isn't illegal discrimination. Not being able to accept state coverage is one thing; refusing care to those with state coverage is completely another. To me, this is major discrimination. Zoomcare must be forced to explain why this policy is in place. And furthermore, the state should step in to legally prevent these kinds of exclusionary policies.

  Business response

  01/09/2024

  Dear ***,

  Thank you for reaching out and expressing your concerns regarding ZoomCare's insurance policies. We understand the importance of addressing such matters, and we appreciate the opportunity to provide clarification.

  At ZoomCare, compliance with healthcare regulations is of utmost priority, and we carefully evaluate the applicability of various insurance plans, including *************************************** and the ****** Health Plan. Currently, ********************** is not registered to accept ******** patients, which impacts our ability to provide care to individuals covered under these specific plans. Our policies are in alignment with the regulations imposed by ********, and they are rigorously enforced by the insurance board.

  We acknowledge the inconvenience this may cause, and we want to assure you that we are actively exploring the possibility of registering in the future to broaden our scope of service. Your feedback is invaluable to us, and it will be taken into consideration as we continue to refine our policies.

  It is essential to note that our policies are not intended to discriminate against any individual or group. Rather, they are based on compliance with the regulatory framework governing healthcare providers. We recognize the importance of transparency and will make efforts to better communicate the reasons behind our current policies.

  We appreciate your understanding and are committed to addressing concerns raised by our valued community members. If you have further questions or would like to discuss this matter in more detail, please feel free to contact us directly.

  Thank you for bringing this to our attention, and we look forward to the opportunity to serve you in the future.

  Take care,

  Sage

  ZoomCare Patient Relations

• Initial Complaint

  12/16/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Appointment for 3PM. Arrived 3:05PM. Arrived to empty lobby. After 3 minutes, I went looking for someone. Office Manager was hiding in the office, looked up at me, and said "you're too late now. I am on the phone." then looked away.A NP emerged and apologized for the office manager's conduct stating "there is nothing she can do."

  Business response

  01/04/2024

  Hi there,

  I hope this message finds you well. I want to express my sincere apologies for the negative experience you encountered during your recent visit to ZoomCare. We deeply regret any inconvenience caused by the delay in being seen.

  At ZoomCare, we take pride in our commitment to providing efficient and timely care, and we understand the importance of each patient's time. Our five-minute grace ****** is designed to keep our clinics running on schedule, and I'm truly sorry that this was not the experience you had.

  I want to assure you that we take your feedback very seriously. Your insights help us identify areas for improvement, and we certainly never like to miss an opportunity to be there when our patients need us. The experience you described does not align with the standards we set for our team, and I appreciate you bringing it to our attention.

  Please know that your feedback has been reported as necessary, and it will be used to weigh in on ongoing discussions about improvements to our organization. We are committed to ensuring that incidents like these are addressed and that our patients feel valued and respected during every interaction.

  If there's anything specific you'd like us to address or if you have additional details you'd like to share, please feel free to reach out to us directly at ****************************************** Your experience matters to us, and we are dedicated to providing Beyond Better care.

  Thank you for your understanding, and I appreciate the opportunity to address your concerns.

  Best regards,

  Sage

  ZoomCare Patient Relations

*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. ↩