Complaints

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• Initial Complaint

  Date:08/23/2024

  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.

  On June 21st at my appointment I paid the balance that was sent to me via mail, of $447.98. After making that payment I checked my insurance to see if the claim was sent for the date of service they were billing me the full fee for. And it had not, when I was told that I then called the office back and they told me to call billing, so I did. I told billing that the claim was never sent and I paid for that at the office and would like to have that refunded back to me, especially since they are in network with my insurance and everything is covered at 100%. They told me they would send a request back to the office. Two weeks later I called to follow up and the office again told me to call billing, ******* said that bc I had an outstanding claim they can not give me a refund. Which I was not told that in the beginning. Had I known that I would not have scheduled anymore appointments for my family or myself. I was finally able to get a partial refund, and have been trying to get the remainder and each time I call I keep getting the run around. Then on 8/8/2024 the office manager called me and told me it would be mailed out today. I have yet to get any check, I called to check on it bc I only live 15 min away and they told me I have to wait at least 30 days to see if it will arrive.

  Business Response

  Date: 09/03/2024

   Dear *****,

   

  Thank you for your inquiry. Ms. ****** has been a patient of the practice as of April 2024. Since her initial visit, Ms. ******s has visited the practice five times with the practice submitting charges to her insurance company totaling $1824. Ms. ******s has an annual deductible of $5600. Ms. ******s had not yet satisfied her deductible at her initial visits, The practice asked that she pay for visits totaling $477.91. Ms. ******s paid the referenced amount. Ms. ******s called the office on numerous occasions asking that the $477.91 be refunded to her while the claim was being adjudicated with her insurance company.

  The practice made an initial refund payment to her on July 26th totaling $206.91. It was explained to her that the practice was waiting for the insurance company to play the claim before a refund for the balance could be considered. Ms. ******* continued her calls to the practice after receiving her initial refund.  On August 9th a second check was sent to Ms. ******s in the amount $273 which completed payment the balance Ms. ******s had paid to the practice. 

  The practice had contracted with a new outside medical ****** earlier in the year. After reviewing previous years of billing records, it was determined that there were disregarded bills in cases where deductibles had not been met. It was suggested that patients make payments at the time of service if deductibles had not been met to avoid this issue. The outside billing team who fielded calls from Ms. ******s mentioned their unpleasant exchanges with Ms. ******s. 

  The practice determined all parties would be served by refunding the total payment.