Complaints

This profile includes complaints for Lima Memorial Health System's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Lima Memorial Health System

  1001 Bellefontaine Ave. Lima, OH 45804-2899

  
• 

  Lima Memorial Health System

  525 N. Eastown Rd. Lima, OH 45807

  

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:11/04/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I went to Dr **** ******* office to get a callous trimmed from my left foot. The doctors office billed me for the service and I also received a bill from the hospital. I did not realize that they could bill me for a treatment room that you are taken into directly from the receptionist desk. Was just wondering if this is true disclosure of charges or if it is illegal.

  Business Response

  Date: 11/26/2024

  The individual named in this complaint was informed and he acknowledged there would be 2 claims; 1 for the hospital, and 1 for the provider as part of provider-based billing. This is also posted on our website and confirmed claims were accurate.

  ******************************:

  Provider-Based Billing
  Provider-Based Billing
  Lima Memorial Health Systems (LMHS) physician offices are provider-based clinics. Receiving care from our providers at our clinics will result in a professional or physician charge and a facility charge for services and / or procedures. This will be reflected on statements you receive for provided services.
  Patients are advised to review their insurance benefits or contact their insurance provider to determine what their policy will cover and identify any out-of-pocket expenses. 
  If you have further questions regarding provider-based billing,please reach out to our Patient Accounts representatives at ************.
  FAQs
  What does provider-based mean?
  Provider-based refers to the billing process for services provided in a hospital outpatient clinic or location. It means that hospitals have met specific ******** regulations to have their outpatient physician office and clinics classified as provider based. Most large hospital systems are classified as provider based by ********, which results in uniform billing.
  Why provider-based billing? 
  Provider-based billing is used across the **** by many healthcare systems and improves the quality of care for patients. Patients benefit because all hospital outpatient departments are subject to strict quality standards and are monitored by ********************* The **************** accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization's commitment to meeting certain performance standards. 
  Does provider-based billing apply to me if Im not covered by ********?
  Yes, provider-based billing applies to all patients, not just those covered by *********
  How does this affect my bill?
  With the provider-based billing model you may receive two (2)bills; one represents the facility or hospital charge, and one represents the professional or physician charge. The total charges are intended to equal the one charge that would be incurred at a non-provider-based clinic for an office visit.
  Does this mean I will pay more for services?
  Depending on your insurance coverage, it is possible benefits may differ for certain services and procedures at our provider-based clinics.We recommend you review your insurance benefits or contact your insurance provider to determine what your policy will pay and what out-of-pocket expenses you may incur.
  Does this affect my co-pays, out-of-pocket expenses or deductibles?
  Depending on your specific insurance benefits, additional out-of-pocket expenses may be incurred by provider-based billing.
  My insurance policy states that I will now owe my deductible or a co-insurance if my laboratory and / or radiology tests are done in the physicians office. Does that apply?
  Your laboratory tests are processed as a hospital outpatient test at ****, so your insurance company may apply your outpatient deductible and co-insurance. Check with your insurance carrier or policy manual to see how your deductible and co-insurance will be applied. 
  Where can I call with my questions or concerns?
  LMHS understands that navigating healthcare may be difficult; if patients have questions about their bills, payment options, payment plans,financial assistance or insurance, they can call our Patient Accounts team at ************ Monday Friday during the hours of 8 am 5 p.m., and a representative will be available to answer your call.
  What if I have ******** or ******** as a secondary insurance coverage?
  Coinsurance and deductibles may be covered by a secondary insurance. Check your benefits or contact your insurance company for details. 
  How does provider-based billing affect me if I have ********?
  The hospital services, physician and clinical professional services will be charged to ********. If you have secondary or supplemental insurance, we will submit any balance to that insurance plan. If your secondary insurance does not cover the balance or if you do not have secondary or supplemental insurance, the balance will be billed to you.
  How does provider-based billing affect me if I am not covered by ********?
  Your insurance company may handle provider-based charges different from ********.  ************** companies may apply these charges to your annual deductible and coinsurance. To find out what will be covered,contact your insurance company.
  If I am unable to make a full payment immediately, can I set up a payment plan?
  Yes. Please contact our Patient Accounts team at ************.We would be happy to assist you.
  What can I do if I am having difficulty paying for healthcare services?
  **** understands patients may have concerns regarding the cost of healthcare and treatments. Weve expanded our financial assistance program to help offset the out-of-pocket expenses patients may incur. Patients can apply for financial assistance by completing applications available in our physician offices, Lima Memorial Hospital or on our hospital website at **********************************. 
  Our financial assistance program is available for medically necessary care if you are a resident in our hospitals service area. Our hospital service area is defined as the following counties: *****, ********,*******, ******, ******, *****, ******, Paulding, ****** and Van ************** assistance is based on patients household size and income. 
  Our Patient Accounts team is available to help provide information regarding our financial assistance program in person at our main hospital or by phone at ************.

• Initial Complaint

  Date:08/09/2023

  Type:Customer Service Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I had two procedures done at Lima Memorial (4/4/22 and 11/16/22). I've been working with them for approximately a year and submitting financial assistance applications. I've submitted everything they've requested. Unfortunately, I was unaware that you had to submit multiple applications for one date of service at one facility - they call them the "hospital side" and the "physicians side". Nobody told me there were two different applications until 7/19/23. When I found out, they sent me the "other" application to fill out. I received it on 7/24/23 and submitted it back to them the same day. I was then told by ******* ***** that because it's been over a year since the first statement was sent, that they cannot accept my application. How am I supposed to know all of these different applications if they don't tell me? I called and asked for applications, and then filled out everything that I was sent. I even explained to her that I was never told, was only ever sent one application, I submitted it last year and was approved, and never received another bill since - so had I known, they would've received the other on time. She said there's nothing she can do. I called customer service - they agreed that an exception should be made and asked that a supervisor call me back (not *******). Yesterday, I received a voicemail from ******* stating that she received the inquiry and as she stated previously, there's nothing that can be done since I didn't submit it within a year (even though I DID submit an application w/in the timeframe). I've included copies of emails from this year, showing that I've been keeping up on all of this, and was never told until recently. I don't understand how they can act this way. In addition, I don't understand why they make this so difficult! Why can't they accept one application and send it to both sides? This is ridiculous!

  Business Response

  Date: 09/05/2023

  [BBB Transcription via Phone]

  The matter has been resolved. 

  Customer Answer

  Date: 09/05/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ****** *********

• Initial Complaint

  Date:02/22/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Have received bills from Lima Memorial Health System in regards to charging for the room(s) being used when seeing a Doctor ($21.00 to $34.00) or Laboratory ($58.00) who is associated with the hospital, even though I didn't go to the hospital for services. Was informed by one person in billing that they started doing this in January '22 with no explanation as to why and by another person in billing that didn't know when this started or why. I feel that we are being double charged for seeing a Doctor or Laboratory that is affiliated with the hospital, since we are being charged by the Doctor for services or the Laboratory where we get blood work done in the first place. "Feel that we should be able to then charge the Hospital, Doctor's Office or Lab a fee, because of the precious time out of our day to see them for things, along with the gas to get there and the fee for the check or card being used to pay them. There have been times when I have waited for almost an hour to see a Doctor. Or when we get a bill for using a room that we would have to be in just to see the Doctor or get Labs done in the first place. Which takes time to write out the check, the stamp and the envelope, since they don't send one to use to pay the bill." How is that the Hospital can double dip this way, especially since they have never done this before. They are already getting money from the individuals that go see these Doctors and Laboratories, because I'm sure that they have to pay a rent to the hospital for the use of the office space. It's bad enough what the Doctors and Laboratories charge for services, even with having insurance, (which we have to pay for) without the Hospitals charging an additional fee for the use of a room, which Insurance Companies will not pay for. Found this out after receiving bills for my wife from hospital for this, then I receive statements that insurance wants info. So we called to find out what's what. Found that they usually add to original bill.

  Business Response

  Date: 02/28/2023

  From: **** ****** <************************>
  Date: Tue, Feb 28, 2023 at 1:23 PM
  Subject: ID ********
  To: ***************** <*****************>
  
  
  Ms ********,
  
   
  
  Due to HIPAA laws, we can not respond to this inquiry.
  
   
  
  Please let me know if there is any additional questions
  
   
  
  Thank you
  
   
  
   
  
  **** ******
  
  Chief Compliance & Privacy Officer, Risk Management