Complaints

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• Initial Complaint

  Date:07/27/2022

  Type:Billing 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.

  My son, *******************, went to two appointments with ********************************* at Creekside Counseling and Wellness last year, one on 7/28/2021, and the other on 12/2/2021. I provided his insurance information at both (we were covered by United Healthcare). We were not charged a copay either time, and no problems with insurance were mentioned.In late February of this year, I was sent a bill for $70 for "copays." I called and spoke to a receptionist on 3/4/2021, and I paid the $70. Again, no mention was made of insurance issues or me owing anything beyond the $70.Earlier this month, I received an invoice dated 6/26/2022, for $230. It states that insurance was denied on 5/19/2022 (10 months and 5 months, respectively, after my son's appointments). The insurance company they had tried to bill was UMR. Again, I had United Healthcare in 2021, and I had provided that information to them.I called the office several times and sent an email. None were returned. Then I got a certified letter on 7/20/2022, threatening to send me to collections and informing me that UMR has confirmed that I was not insured by them in 2021. That is exactly what I have been telling them, as my insurance was through United Healthcare. So, again, I called and emailed, and again have received no response. Additionally, I have spoken with two different United Healthcare representatives who confirmed that my son did have coverage, and that there should not have been any copay. So, if Creekside had billed correctly, I should not have had to pay the $70 in copays, so actually, they owe me a refund. Unfortunately they refuse to communicate with me in any way, aside from the threatening letter.

  Business Response

  Date: 08/12/2022

  I am responding to your letter from 07/27/22. I had called on Feb 28^th, 2022 and left a message for mom (********************) saying that UMR Insurance was denying claims to the policy being termed. ******************** said insurance was active, so we sent claims again for DOS 07/28/21 and 12/2/21. Insurance denied both claims again. We had no idea that United Healthcare was the new insurance. I have attached the insurance cards provided to us. There were no emails or voicemails regarding a switch to United Healthcare until this latest communication. We had done all we could do, so we balance billed the patient account. Finally, on July 19^th, 2022, we sent her a letter saying regretfully, we would need to turn the account over to collections in 30 days if no payment was received on the account. We had given ******************* 6 months to get us the correct insurance information. On August 1^st, I received a call from United Healthcare asking me to submit these claims to them. This was the first time we received correct information regarding the policy of the patient. I sent claims within the hour to United Healthcare on August 1, 2022. I spoke with ******************* in March of 2022 to ask for her copays for those two dates of service. The $70 was the only payment we have received for the dates of service in question. ******************** has left numerous, threatening messages on our voicemail and our email. I have attached the latest thread of emails, where Ms. ********* thoughts are unfiltered and unfair. She has also been verbally abusive to our staff.

  We thank you for your time! If theres anything else we can do to get this resolved, please let me know.

  Thanks again,

  *********************************

  Practice Manager

  Customer Answer

  Date: 08/12/2022

  This response is full of lies, which is not surprising because:1. When my son was still going to this facility for psychiatric services, we had issue after issue. Our UHC information was provided at both appointments, the one in July and the one in December. Staff members failed to convey messages properly multiple times, prescriptions were called in to the wrong pharmacy more than once, and two meds were called in to two separate pharmacies at one point. I asked an important question about his meds and it took about 5 calls back and forth before the question was finally answered, and the lady I spoke with lied, saying she had given the info at a previous appointment (when it had not been an issue at that time, so it hadn't even been asked).2. I received no voicemail on 2/28.3. I called on 3/4 to pay the copays (which I should not have owed, had they billed the insurance company I had provided. No mention whatsoever was made to me about insurance issues. At this point it was 9 months after his first appointment, and 3 months after the second one. Why was it not billed to insurance before that?4. I received the first $230 bill in June, and only after I had left, I believe, 6 voicemails and emailed twice, I got no response at all, but then got a letter threatening to send me to collections.5. I called and emailed again several times with no response, and each time I (again) provided the proper insurance info. No one called, no one emailed me back, until apparently my complaints to various places must have started rolling in.6. The insurance info she is saying I provided had only been provided in 2019, when that was the appropriate insurance. I'm guessing they were too lazy and/or incompetent to put in the new insurance info when I gave it to them... once at each appointment.I could go on, but the gist is, they are incompetent and lie frequently to cover their incompetence. Last week, I finally got one email about the situation, and still haven't heard a resolution. They owe me $70.Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 
  
  [Provide details of why you are not satisfied with this resolution.]
  
  Regards,
  
  *************************
  

  Business Response

  Date: 08/31/2022

  United Healthcare was billed on July 28, 2022.  We received a response on August 15, 2022 from United Healthcare that the claims were being processed and that the policy in effect for 2021 did not require a copay.  We promptly generated a refund check for the 2 collected copays.  On August 16, 2022 a refund check for $70 was sent via certified mail.  That check was cashed on August 22.  The account balance for this individual is $0 with no pending charges.  Please consider this matter resolved.

  Thank you for your time!

   

  Megan ******, CPNP, PMHS