Illinois AG Office to Investigate Questionable Billing at Cottage Hospital: ‘Something Doesn’t Seem Right’
Galesburg area residents have recently been receiving medical bills with a recognizable logo. The logo features a striped cross accompanied by a small heart, symbolizing Galesburg Cottage Hospital.
The staff at Cottage Hospital signs off with a heartfelt “thank you.”
Cottage Hospital, unfortunately, lacks a dedicated staff.
On January 8, 2022, the hospital located at Kellogg and Losey streets ceased operations due to patient care violations, which led to the loss of its Medicaid and Medicare participation.
The hospital’s license was revoked by the Illinois Department of Public Health two months later.
OSF HealthCare purchased the building a month later.
However, the medical bills from Cottage Hospital are still being sent out, even after several years.
Vince Marolla was taken aback when he discovered the Cottage logo in his mailbox a few weeks ago.
The envelope, postmarked in Pontiac, Mich., bore the striking red print on its exterior.
Marolla expressed her astonishment when she discovered three bills upon opening the package. What caught her off guard even more was the fact that these bills were dated back to August 2021. She was puzzled because there was no information provided on the bills regarding the services they were for.
Marolla was shocked to see the charges on the bills, which amounted to over $17,000 for three different days of outpatient services. However, after taking into account the necessary adjustments and insurance payments, Marolla’s bill was reduced to around $2,200.
Marolla became suspicious when he noticed that two of the bills he owed had a suspiciously even amount of exactly $500 each.
“It wouldn’t make any logical sense,” he stated, questioning the feasibility of such an amount. He further elaborated, “After factoring in insurance and payments, it just doesn’t add up.”
Marolla contacted his insurance company to address the situation, only to find out that they had no record of the claims.
Marolla is concerned that other individuals who have also received the bills may not be as cautious as he is and could potentially be exploited.
“There’s a generation of people who receive a bill like this, take a glance at it, write a check, and send it off,” he explained. “When you receive a bill, it appears to be official, and you don’t think twice about it. You simply pay it.”
Upon examining Marolla’s three bills and a recent outpatient services bill received by another local resident in September 2021, TSPR discovered additional red flags.
There are a few notable aspects that catch the eye.
I received the bills in November, even though the statement date on them is May 1, 2023.
The address indicated on the envelope and the bill is 142 S. Johnson St. in Pontiac, Michigan. However, it is worth noting that there is no 142 S. Johnson St. in Pontiac. Nevertheless, there is a 142 S. Johnson Ave.
The address belongs to an apartment building that is located right next to Pontiac General Hospital.
The Sharma family, who acquired Cottage Hospital as SBJ Group of Austin, Texas in 2020, now owns Pontiac General Hospital.
The phone number featured on the bills bears an Austin, Texas, area code. It is also the same number provided on Cottage Hospital’s website, serving as the designated contact for individuals seeking to obtain medical records or patient statements.
Unfortunately, there is no response to the inquiry.
The call gets disconnected after a message stating that the mailbox is full.
Billing problems
Insurance companies impose timely filing limits on providers. These limits can range from 90 to 365 days. In order to receive payment, providers must adhere to these limits and file claims within the specified timeframe.
Marolla saw this as yet another warning sign.
According to documents obtained by TSPR, Cottage Hospital faced billing issues in August and September of 2021 due to problems with the electronic health record system implemented by CEO Sanjay Sharma earlier that year. As a result, patients were not being billed during this period.
According to a report from the Department of Health and Human Services dated November 19, 2021, investigators were informed by Cottage’s registered nurse abstractor that the system did not allow employees to extract data.
“We are only able to obtain limited information, such as the number of admissions, but nothing more,” explained the RN abstractor. “We couldn’t even generate billing codes from the electronic health record. Additionally, all the coders were let go.”
According to the report, Cottage Hospital experienced a significant turnover in its workforce, with a total of 118 employees either resigning or being terminated within the past six months.
State Representative Dan Swanson, a Republican from Alpha, has been receiving numerous complaints from his constituents regarding the receipt of similar medical bills in their mailboxes.
“There’s something off about this,” remarked Swanson. “Even though Cottage Hospital shut down in January 2022, they are only just now being billed.”
Swanson contacted a representative from the office of Illinois Attorney General Kwame Raoul.
According to Swanson, the AG’s office reviewed the matter and concluded that the most effective way for people to address their concerns is by filing a Health Care complaint. This would enable the office to conduct a thorough investigation into the issue.
If you have received a statement or bill from Galesburg Cottage Hospital, you have the option to file a complaint online. You can reach out to the Illinois Attorney General Health Care Bureau hotline at (877) 305-5145 to address any concerns or issues you may have.
According to Swanson, it is important to include a copy of the documentation you received when filing a complaint. The staff of the Attorney General’s office will review the complaint and, if necessary, contact the hospital to mediate the claim.
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