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St. Mary’s/Duluth Clinic double billing?

Have you ever been double billed by SMDC?

I received a bill from both St. Mary’s and the Duluth Clinic that didn’t go away after paying the clinic. My friend recently also ran into the same problem. Database glitch?

I should add the bill was exactly the same amount.

20 Comments

The Friendly Old Knifey

about 9 years ago

I've had so many issues with SMDC billing that it's not even funny. Well, it's kind of funny. For a while they thought that I was married to my mom and that my dad was our son. Weird, but funny.

TimK

about 9 years ago

I've run into the double-dipping, too. To make things even more fun, they combined my kids (with different medical histories) into one person. They even argued with me about whether or not we had two kids! Their CEO makes over $1 Million/year if that sets your mind at ease.

Barrett Chase

about 9 years ago

It's not just SMDC. St. Luke's once billed my dad for a procedure I had had done. I was 29 years old and living at a different address and we have different names. Then of course they wanted me to pay a late fee, even though the bill went to the wrong person at the wrong house.

Vera

about 9 years ago

Last year, St. Luke's neglected to bill my insurance for $1150 worth of procedures that would have been covered 100% had they submitted them to my insurance company in time.  By the time they bothered to submit the charges, 90 days had elapsed and my insurance company refused to cover the costs, claiming that they would only cover procedures within 90 days. While I was in the midst of a battle with my insurance company regarding their refusal to cover the charges, St. Luke's collection agency froze my bank account and took all the money I had to cover half of the outstanding charges.  I had 30 days to come up with the rest before they pursued wage garnishment.

I blame myself because I should have been more vigilant in tracking my medical charges.  But St. Luke's really dropped the ball.

not tony

about 9 years ago

Speaking of medical billing, after the blowup about Dave Ross making 180K I looked up some other local non-profits, and found the St. Lukes 990.

Strange makes about 500k, reasonable for someone running a 300 million organization, but some guy named John Yoon is making 2.5 mil. Stefan Konasiewicz is making 1.6 mil. Am I reading this right?  Are these guys bringing people back from the dead or what?

Return of Organization Exempt From Income Tax:
St. Luke's Hospital of Duluth

speechie

about 9 years ago

John Yoon is an opthamologist. He's a fancy eye doctor/surgeon who works in Duluth and Superior. I don't know if he's worth $2.5 million, but he's precise, has great bedside manner, and really seems to know what he's doing, which I can't say about many other doctors out there.

conrad

about 9 years ago

I have taken a lot of my past clients to Yoon and he worked very well with those individuals.  2.5 mil?  If someone thinks you are that valuable I say go ahead.  Yoon actually helps people.  Our society generally just pays off the people that are good looking or are good with a ball.

The Friendly Old Knifey

about 9 years ago

I just finally got the correct bill for a procedure I had done in August of last year. It took them that long to send it to the right insurance company. So, now I'm just going to pay the minimum $25/month.

B-man

about 9 years ago

They (health care institutions) are all crooks. Why does someone who fixes one type of persons issue make 2.5M and someone else who could arguably, help just as much makes 25K?  The fact is they can charge anything they want and what can we do about it? We could not use their services.  Yeah, that will show them.  Maybe we could demand a price list of services, like at any other establishment that charges you for its expertise.  I don't go to any other store and ask for service totally ignorant of the cost associated with it.  A maximum salary cap of 200% of the median income of the area would be a good start.  I like doctors, I hate the medical system.

E

about 9 years ago

I once tried to get a "cost breakdown" of the one-line emergency room fee of $400+. I asked about 10 times to explain the item and justify the cost. I was never given an answer other than "That is just what it says." I don't think they actually know themselves.
As for one person making $2.5M? His pay is only justified by what he makes in profit for the hospital. The hospital is paid for his procedures by the insurance companies. The insurance companies pay for the procedures by billing you ridiculous premiums. So, you, the insurance premium payer, are paying the $2.5M. Is he still worth that?

andy

about 9 years ago

In a recent bill we were charged nearly $400 for an office visit to a mid-level (nurse practitioner) at SMDC.  It was roughly  30-40min visit.  No labs, no tests, nothing special.  It included a brief description of my problem and about 3-4 drug recommendations.  When I got the bill I laughed, literally.  It was followed with a call to their business office saying the charge is excessive and out of line.  Believe it or not, they conducted an audit and agreed (holy crap!) it was coded incorrectly. An admitted mistake. So they reduced it about $45. Boy, do I feel special.  Too bad most people lack the knowledge, courage or have the access to do this.  Health care change will ultimately be driven by the consumer.  Go where they treat you well and can explain the darn bill!

Nick

about 9 years ago

Hello huitz:
I spoke with someone in our customer service department.  She asked you to please call them at 218.786.3333 or 800.985.4675 so they can help solve the situation.

Sorry for the frustration.
Nick Lansing
SMDC Health System

not tony

about 9 years ago

I guess I should stop bitching and go get one o' them opthamologist licenses. They have that at LSC right?

huitz

about 9 years ago

Thanks Nick.  It turns out that she (my friend) did in fact receive a small amount of extra care at SMDC, but added the DC amount in after she paid DC.  In my case, I did not.

For me, it went like this...  I saw a nurse (cha-ching) that immediately said I should go to SMDC and she would refer me to them as such.  I went to St. Mary's (cha-ching for same thing) and received a 20 second treatment that I could have done myself at home (minor infection, relief of pus, yuck, I know).  To quote the nurse's words (even though I did ask for a real doctor), "Well, I can't treat you, because there's nerves around there and stuff."  I kid you not.

Two bills, 'nuff said.  In all honesty, I love the west Duluth Clinic, but the problem, I think, is sort of on their end and not St. Mary's.  Either that, or whoever designed their database didn't know what the heck they were doing.

Ruthie

about 9 years ago

I at one time had a problem with the Duluth Clinic and double billing.  I had all the insurance explanation of benefits, cancelled checks and prior statements.  Despite faxing all my information multiple times and speaking to multiple supervisors there was no resolution.  I then went on line and looked up the names of the CEO and Public Relations liason and used the generic Duluth Clinic email format to send them emails.  My emails were a respectful request for intervention along with a dated history of my contact with the billing department (dates of contact and names of representatives and supervisors I spoke with). I also sent electronic copies of my documents.  Within two hours I had a call from the head of billing assuring me my issue would be resolved and within two business days the charges were reversed along with a letter of confirmation the issue had been corrected.

I have worked in the customer service field for a long time and know mistakes happen and there are unhelpful frontline employees and supervisors.  There are steps everyone can take to make sure you are getting the assistance you need when a 'mistake' happens.

Always check your statements when you get them.  Catching problems early saves a world of hurt.

Save your all your documentation.  For medical billing that means all explanation of benefits from your insurer, statements from your medical provider and cashed checks or records of on line transactions

Order your documentation in chronological order so if you have to submit it to your provider #1 You know you truly have been overbilled  (it is amazing how many times people think they are over billed when they are not) #2 They can see you have your poop in a group......they are going to look at their own documentation but if you show you have yours they know they are dealing with an intelligent consumer

Write down the date, time and first name of the representatives you speak with.  I always start out my conversation by asking for the reps first name, if they won't give it to me, I ask for a supervisor.

If you have to escalate to a supervisor, manager, etc...... Do so respectfully.  Calling people names and making negative comments about the evil capitalist system or the corrupt health care syste doesn't advance your cause.  It sets off an emotional response in the representative that begins blocking communication.

When your call is escalated get the name of the supervisor.  If they can't help and won't refer you higher start looking on line for execs in the company and submit your issue and documentation to them.  Supervisors often say, 'there is no one higher who can help you' or 'even if I were to send you higher they will tell you the same thing'.  When you hear this they are probably telling you the truth, there is no one higher in the OFFICE with the power to resolve your issue.  Go higher in the ORGANIZATION versus higher in the office.

Company email addresses usually maintain a standard format for all employees.  If the supervisors email address is [email protected] then the CEO's email address is that way.  Get that information  if you can.

What happens to your issue when the CEO gets it?  Well, most likely it will get forwarded on to a mid-level manager with the command, 'fix it'.  Which to many mid-level managers is code for 'make it go away' which equals give the customer what they want.

Hope this helps

andy

about 9 years ago

Great points Ruthie!  But unfortunately, the general public has neither the skill nor time to complete your list of suggestions.  It is the responsibility of the Health Care System to make sure bills are reflective of the care received.  There are local, state and federal guidelines as well as accepted practices within the industry.  

It's simple...I go out for a cheeseburger at McDonald's.  There is one cheeseburger in the bag.  But they charge me for two cheeseburgers, a handling fee to place the burger in the bag along with the cost of a milk shake for the kid standing next to me because he can not afford one.  I get pissed and go to Burger King.  All I wanted was a damn cheeseburger.

The fact that Nick Lansing has chimed in says he sees a problem.  Trust me, this blog is reaching the executive suite at SMDC.  Now they can hear what Duluth really thinks.

SMDC, fix it.  We want health care.  And we do not think it is our job to fix your outdated billing!

Nick

about 9 years ago

Good comments, Andy.  I agree.  Billing at any American health care provider is complex.  I don't work with billing and can't speak to the original situation.  

It should be simple.  Like you said, you want a cheeseburger so you go to MacDonald's and order a cheeseburger.  You pay the price on the screen, usually cash, eat and go home. A health care provider can't run that way.  Going with the MacDonald's comparison...

It often takes one or more trained clinical professionals to diagnose you need a cheeseburger.  Lab tests determine ketchup is needed.  Records are checked to see if you're allergic to onions.  

Let's say it's obvious that you need a cheeseburger.  A trained professional still makes your burger under sterile conditions with medical-grade equipment.  Every patty, pickle and tomato is itemized.  

We can't always tell you how much it'll cost.  It's frustrating.  We'll give you a real estimate whenever we can.  Sometimes we can't know.  Maybe your hunger doesn't respond to the mustard so the doctor has to order a different mustard before your hunger gets worse.  Your insurer pays for the bun, but NOT the sesame seeds on the bun unless we get prior approval.  (You wait for that approval, getting hungrier by the minute.)  That same insurer pays in full for the lettuce but only a percentage of the patty's cost.  Some insurers pay differently if you're served in a clinic than if you're served in a hospital.  Things like coding or in-network or out-of-network add to the complexity.

After you enjoy your burger (with or without sesame seeds), the physician has to dictate the meal prep, a transcriptionist enters the notes, Pharmacy verifies that 4 pickles were prescribed and dispensed, someone sends notes to the insurer and 30-90 days later we get paid...maybe.  

This is from my perspective in health care.  I work at SMDC but AM NOT SPEAKING ON BEHALF OF SMDC.  I'm sure someone at a health insurer has good perspective on this, too.

A mistake is a mistake no matter the cause.  We're sorry for those.  Health care and billing are heartbreakingly complex.  We wish it were as simple for you as a trip to MacDonald's. All I can say is we pay attention, keep it running smoothly for you and fix whatever needs fixing.

pbnotj

about 9 years ago

I'm probably opening a huge can of worms here but it needs to be done. Places with solid national health insurance have no billing issues because there is one payer and billing is very simple! 

I know national health insurance isn't perfect but I really envy places like Denmark and France when it comes to money issues like the one brought up here. (when it comes to getting specialized care though I think I rather be insured in the U.S.). Yes I work in healthcare and I do really understand most of the issues from both sides.

andy

about 9 years ago

Wow.  All of a sudden, I want Subway.

Sheila Rasmussen

about 8 years ago

St Marys Hospital continued billing for medications and other services for 3 days after my mother had passed away.  I have also had issues with SMDC not giving me the required insurance reduction adjustments.  They kept billing me for these charges when it is their contracted responsibility.  I had so many problems with their billing that I won't even go to one of their clinics or hospitals any more.

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