I spoke to someone's in OH.
Initial dispute, I did it online and in a couple of days I got a call. Can't recall if that person had an accent. They initially credited my account.
After about 6 weeks, I got the call from this woman in OH, whose position is that they were authorized to charge my card after keying in my card number in their terminal but not getting my consent or signature to charge almost $2200 at inflated DCC rate.
She said I would have to produce a credit slip from the hospital or else my account would be charged back the amount they had credited during the dispute case.
Of course the hospital had this money all this time, almost 2 months, and I'd left the country so I had no recourse, since they were ignoring my emails.
But this Chase agent is giving a lot more weight to my securing a credit slip from the merchant than the merchant proving that I agreed to the transaction by producing a signed receipt.