Complaints

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• Initial Complaint

  Date:08/10/2022

  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.

  TRPN or Three Rivers Provider Network is scamming providers into participation with their network. On 8/9/22, we received a check from TRPN Direct Pay. It was formatted exactly like an insurance remittance payment from an insurance company. At the top it had a box stating "for claim payment questions call ************." At the bottom, was a check in the amount of $15. TRPN Direct Pay poses as an insurance payment, scamming the recipient into an unsolicited provider network contract with deposit of the mailed $15 check. TRPN Direct Pay mailed a check for $15 in a format mimicking a typical insurance payment. Only in the fine print on the second page(I have attached a copy of the second page) does it say that depositing the check enrolls the recipient into an unsolicited provider network with terms and agreements that our providers would never willingly accept. TRPN is targeting health care providers who have limited time to study fine print under the assumption of a valid insurance payment. This deceitful practice needs to stop.
  

  Business Response

  Date: 09/07/2022

  Business Response /* (1000, 5, 2022/08/11) */
  The use of restricted endorsement check to reach a binding agreement has a long and wide application across the United States. In fact, the administrative trustees that accept and sign deposits every day for these agreements use similar forms of agreements for their own business practices. Hence, there is no better-informed executor accepting the form of these agreements and endorsing these same checks at an institutional level.
  
  Furthermore, the agreement allows for 90 business days grace period in the event that an error has been made in cashing the restricted endorsement check or the provider has had second thoughts about network participation. The terms of payment even more defend the amounts cashed as binding since the network provider rates of reimbursements are based on a multiple of an already established and mandated state or federal fee schedule.
  
  We are happy to assist the State in reviewing the provider's charge master along with all collections for services rendered by this provider in order to demonstrate whether or not this provider is meeting the State regulations and guidelines.
  
  
  Consumer Response /* (3000, 7, 2022/08/16) */
  (The consumer indicated he/she DID NOT accept the response from the business.)
  The 90 days grace period is a way for this business to justify the forced contract even in the event of an error. If this check is cashed and not "caught" as a contract, the provider is locked into a contract that they would never have signed in the first place. In 90 days, it is unlikely a new patient with this insurance plan would come in the office to be seen and billed out. I have never seen a contract with a fee schedule as unacceptable as this contract is. This company should be forced to mark these checks and this "contract" so that it is very clear to any level of staff that are processing checks, depositing checks, etc. If the company is doing nothing wrong, it should not be done in a deceitful way.
  
  
  Business Response /* (4000, 9, 2022/08/17) */
  Please note, that my response stated 90 business days, not 90 days. Just want to correct the complainants oversight or misunderstanding.
  
  We have thousands of providers who have received the information, read the agreement attached, called or emailed if they had any questions or concerns, cashed our participation payment and are satisfied with the membership direction and reimbursement as result.
  
  All it takes is a simple phone call or email if a provider is unhappy or signed up inadvertently and a member of our excellent Provider Relations department can assist.