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Aurora Health Care review: Aurora Grafton hospital billing department

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10:45 am EST
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My mom was in Aurora Grafton Hospital from October 23rd, 2023, to November 3rd, 2023. She was moved to Hospice on November 3rd, 2023 - November 8th, 2023, in Aurora Grafton Hospital. On December 13th I receive a letter in the mail from DCM (Collection Agency) for two amounts $470.00 and $227.50. Aurora also sent a bill to the house for $227.50 that I paid, and Aurora cashed the check on December 11th, 2023. I told DCM that I paid this bill and DCM had to contact Aurora to get the $227.50 claim removed from DCM. I called Aurora Grafton Hospital on December 14th, 2023, and asked to speak to the billing department. There I find out that Aurora has FAILED to submit either of these two claims to Medicare. They tell me it will be taken care of. I get another letter from DCM in the mail about the $470.00 bill this time telling me that the claim was for a head CT on October 23rd, 2023. I called Medicare to see if they received these claims and they confirmed they did NOT. Then I called Aurora Grafton Hospital and asked to speak to their billing department on December 27, 2023. AGAIN, I'm told the NEITHER claim was submitted to Medicare. Now DCM files a claim against my mother's estate and I'm contacted by my attorney. I called Medicare AGAIN and they confirm NEITHER claim was submitted. I call Medicare on January 11th, 2024, and they confirm they received the claim for the head CT for $470. They tell me they will send me the EOB in the mail. I call Aurora Grafton Billing Department AGAIN on January 15th, 2024, and AGAIN the claim for $227.50 WAS NOT SUBMITTED. Now my lawyer says he's sending Aurora a letter demanding they submit all claims to Medicare. I call Medicare on January 23rd, 2024, and they confirm the claim for $227.50 has STILL NOT BEEN SUBMITTTED, and they confirmed that the claim for the Head CT for $470.00 was approved and paid and sent on to her supplementary insurance to pick up the remainder. I call Aurora Grafton Hospital AGAIN on January 23rd, 2024, and go through the entire detail AGAIN. I also let them know that my lawyer has sent Aurora a letter telling them ALL claims MUST be submitted to Medicare and ANY over payment MUST be returned. I get placed on hold and now I get transferred to someone else (yeah because they know a lawyer is involved). She confirms that the claim for 227.50 has NOT been submitted but it has been in the queue since January 3rd, 2024, and it can take 30 to 45 days to be submitted. Funny how when they didn't have a payment the $470.00 claim could be submitted much quicker. Then I ask her WHY this is taking so long. Get this the billing department DIDN'T LOOK AT THE DATE OF SERVICE. Medicare won't pay for these when the patient is in Hospice. The claim for the Head CT for $470.00 happened ON THE DAY SHE WAS ADMITTTED. The claim that I paid for $227.50 happened on December 30th, 2023. Before she was moved to Hospice on November 3rd, 2023. I also told them they need to contact DCM because they have a claim on my mother's estate, and she says oh someone will. Yeah right, I've asked the billing department to contact DCM on December 14th, 2023, on December 27th, 2023, on January 15th, 2024, and DCM has still not been contacted. All they tell me is all we can do is put a note that you want DCM contacted. I've notified my lawyer that the Head CT claim for $470.00 has been approved and paid and sent on to her secondary insurance to pick up the remainder. My lawyer said he will keep an eye out for this and will see if DCM will contact him. He did tell me that he will need to file an objection to this claim on March 8th, 2024. If he does, he has to go to court. If that happens, Aurora should have to pay for my lawyer's time and the court fees since they have already received payment and refused (obviously since they refused to do it after I requested on December 14, 2023, December 27, 2023, and January 15, 2024). I SHOULD NOT HAVE TO PAY FOR AURORA'S BILLING DEPARTMENT'S INCOMPITANCE. My Mom has been gone for over 2 months (almost 3 on February 8th) and I'm STILL fighting the billing department to do their job.

Desired outcome: I want the claim for the psychiatrist with a date of service October 30th, 2023, to be submitted to Medicare. If Medicare pays and submits the claim to the supplementary insurance to pay. I want Aurora to return my $227.50.

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Update by Sherri Fleener
Jan 25, 2024 2:19 pm EST

I also want Aurora to contact DCM about the $470 claim for the head CT that Medicare has confirmed has been approved and paid to remove the claim against my mom's estate.

Update by Sherri Fleener
Jan 25, 2024 2:24 pm EST

I want to make a correction...The claim that I paid for $227.50 happened on October 30th, 2023. Before she was moved to Hospice on November 3rd, 2023.

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