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CB Hospitals and Clinics Aurora Health Care 163 N Milwaukee St, Milwaukee, WI, 53202, US
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Aurora Health Care

163 N Milwaukee St, Milwaukee, WI, 53202, US
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Aurora Health Care - Improper billing for child video visit for pink eye

Good Afternoon: Complaints Board

Back on June 6th, 2023 our daughter (Skylar G. Baral - Established Patient of Dr. Tetting) had to obtain a doctor's excuse regarding her ability to return to school, due to suspected pink eye. As such, my husband reviewed everything online within Aurora Health Care's "Live Well" website about Video Visits and the cost benefit of using this alternative method of seeking a simple medical evaluation. He then accessed the cost estimator on Aurora Health Care's "Live Well" website, which reflected a charge of only $63.00 for an Established Patient Level 1 Clinic Video Visit. As such, he went through the online process of entering all required details to initiate a simple video visit. The visit was quick, went well, and resulted in a prescription for eye ointment and a letter for her school regarding her ability to return.

On July 6th, 2023 we became aware of what was billed to my insurance. The claim (Reference #[protected]) submitted to my insurance by Aurora Health Care was Code #99202 (New Patient Level 2 Hospital) for $335.00. Upon seeing this charge, we again accessed Aurora Health Care's "Live Well" website's cost estimator and entered the #99202 code to generate the estimated charge. Aurora Health Care's "Live Well" website's reflected an amount of only $225.00, not the billed amount of $335.00. My insurance processed this claim, and shows that we are responsible for the "allowed amount" of $232.83. This is completely improper.

As such, we immediately contacted Aurora Health Care and respectfully requested that this bill be reviewed and investigated, since we felt that it was incorrectly coded and improperly charged for this type of care. Today, we received a letter from Aurora Health Care claiming that this visit was correctly coded, billed accordingly, and that no adjustments would be made.

As you will see from the attached supporting evidence, there is possible medical billing fraud taking place here, or at a minimum false estimates generated on the Aurora Health Care's "Live Well" website. Either way, an independent review board will see and have to acknowledge that this is improper and that Aurora Health Care needs to do the right thing for their patient, our daughter.

We thank you in advance for your time and consideration on this important matter.

Respectfully submitted,

Tania J. Baral (Patient's Mother)

Donald L. Baral III (Patient's Father)

Desired outcome: I respectfully request that the original "Live Well Cost Estimate" of $63.00 for this type of simple and quick video visit be applied to this claim, in lieu of the improper amount of $335.00 as billed.

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