Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:06/12/2024

  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.

  I started seeing ****** (I was her first patient) in November. She told me I would receive checks in the mail from my insurance to give to her. I stopped seeing ****** in Dec due to a NPs malpractice in her office. ****** emailed me in Apr requesting $******, because I had cashed the checks that were supposed to be from her. I made an honest mistake here & cashed some of her checks (directed to me though) bc these checks look like my regular claim checks. ****** works with me with a payment plan for the 722, split into 4 payments. About 4 weeks later out of the blue ****** tells me I owe her ********. Her email earlier in the month made it seem like I no longer owed her money (why would she tell me I owed ****** ************** her emails payment 1/4 if I actually owed more). I asked her if she would be willing to do a payment plan again & she told me I could give her 2000 that & then 2000 next week. I told her this is unrealistic for a 23 year old, so then she charged my Amex $5,136.09. I am still, as of today, totally confused where this figure came from. I called Amex & claimed fraud, as I didnt authorize the **************** told me she doesnt keep cards on file. She then told me she would send me to court/collections. Im trying to work a payment plan out with her, Im trying to send her the additional checks Ive received from my *************** refuses to communicate with me. Im not contesting that I have accidentally cashed some checks. I do not believe Ive cashed $5,106 worth in medical claims though & I have yet to been provided proof saying otherwise.

  Business Response

  Date: 06/28/2024

  Customer ID# ********
  ***********************
  
  ***************,

  
  Thank you for bringing this matter to my attention. I appreciate the opportunity to address this issue and defend my ************* based medical practice, Sinar Treatments.

  
  *********************** is a past patient in my office, a 23 year old Underwriter for FundFi, currently residing in ************* independently that currently owes my company $4,787.81. The dispute on this BBB complaint states $822.66, actual total is $4,787.81. Upon seeing this patient for the first visit on 10/26/2023, I had her sign a contract created by my attorney stating that her insurance company would send checks for my services to her address and it was her responsibility to bring the checks. The agreement states failure to bring in said checks would result in a charge on a patients credit card for the entire balance on the account. She provided her credit card information on this agreement. ***** signed and dated this agreement without hesitation. See attached for agreement. She proceeded to come into my office and see 3 different providers: a chiropractor, acupuncturist and nurse practitioner. She was seen personally by me for a total of 10 visits. 

  
  My office received no payment for any services rendered for this patient from dates 10/26/2023 to 11/22/2023. ***** was instructed to sign the checks once she received them and return them to my office without cashing them as payment. She was billed for multiple acupuncture treatments, totaling $722.66. She did receive the insurance payments and proceeded to cash those checks. After discussing the matter with her, I believed it was an honest mistake on her part. I made an agreement with her, in good faith, to make 4 payments of $180.67 which I had to take a loss on in credit card fees. In written email communication, I proceeded to let her know, once again, that she would receive more checks for chiropractic services and to not cash them, but to send them into my office. 

  
  The total amount reimbursed by ****** insurance company, ********** Blue Shield for chiropractic services rendered at Sinar Treatments was $4,787.81, and once again, she proceeded to cash those checks without making the necessary payment. Unfortunately, as a business owner, there was not much I could do at this point. There came a time when I did have the need to charge her **************** card. ***** then reported the charge as fraudulent, after receiving multiple services in my office without sending payment from ********** Blue Shield. Since I did not have an imprint of her card, **************** accepted her charges against me as fraud. They did not pay me. This has been very frustrating for me. You will also find a letter from my ****** attached, who verified with *****'s insurance company that the checks had been cashed.

  
  My office has not received payment for chiropractic or pain management services at this point. This patients last visit was on 11/22/2023 and I am still fighting to receive payment 8 months later. I have had to seek legal counsel regarding this matter in order to escalate it further. This patient claims they have not received an invoice detailing what is owed, yet she has attached all of the invoices to her complaint. See attached for individualized invoices detailing what amounts were sent to ***** with dates and proof that it was mailed to her Brooklyn address, ****************************** 

  
  Additionally, there was no malpractice lawsuit that took place in my office between ***** or any provider in my practice, past or present. No insurance company pays patients to be members of their policy, so there should be no confusion on this patient receiving regular claim checks. ***** is not a college student, she is a full time Underwriter at a bank who can afford to live in *************. ********** Blue Shield is the only insurance company that I take that sends claim checks directly to patients, as per their policy. It is a policy no provider will ever understand and unfortunately, results in cases like this.

  
  I have had to seek legal counsel regarding this matter because no matter what communication ***** is given or how many free passes she is offered, she continues to take advantage of my kindness, cash checks for services I rendered 9 months ago and cause a strain financially on my company by cashing checks from her insurance company, using the funds for personal use and trying to cut deals with medical professionals who provide care for her. This is insurance fraud. ***** knows the address of my office - she has come there many times - she could have made a payment already, but has failed to do so.
  

  
  

  Customer Answer

  Date: 06/28/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

  This is NOT insurance fraud by any means. This simply was an honest mistake. You reached out in April, many months after the checks were received. They appeared to be the exact same as the checks I receive from my therapy for paying out of pocket. I pay my therapist, send the bill to my insurance, and get a check for what is covered. The checks I received look exactly the same as the checks you sent, which is where the confusion came from. You never told me how much the checks would be for. You told me you don't keep cards on file, yet charged my card $5,106 without permission (with still no explanation where that figure comes from). I didn't receive an invoice for services rendered until after you charged my card that mystery number after repeated requests. 

  And I am a college student ******. Its been over 8 months since you've seen me as a patient, things change. And I pay $800 a month in rent on the outskirts of ********. Yes I can afford to live in the city by pinching my pennies. I am in NO WAY denying that I owe you some amount of money and that there were services rendered. I am saying once again I do not have $4,800 lying around and would need some flexibility with a payment plan (more flexibility than ***** this week ***** next week), and that I am still unsure where the approx $5,100 charge came from. The only reason why this has escalated is because of your actions (specifically charging my card a random figure behind my back over a holiday) and your refusal to work with me on a realistic payment plan. I have provided a payment plan that I believed to be fair for the both of us, and you did not respond, so I'm unsure what you mean by I could have made a payment but refuse to do so. This is why I reached out to the BBB, because you refused to reach out to me. I am honestly unsure what you mean by "free passes" and would appreciate some elaboration. Working with me on a payment plan is not a "free pass", but I was truly appreciative for that, and I am still confused as to why we cannot work together on a payment plan. I am still open to that option if you are.

  The reason you have been waiting 8 months for payment is because you didn't reach out until April telling me how much I owe, and when you did, you made it seem like I only owed the initial $781. Once you told me I owed over $4,800.00, yes I was extremely upset and confused, especially when you would not work with me on a payment plan. I in no way "took advantage of your kindness". The way you are portraying this is unfair and is leaving out very important details. I truly do apologize for the financial burden you are bearing, certainly you could understand how that would be exacerbated even more for a financially independent 23 year old college student. Once again, this was truly an honest mistake made on my end and I do not want either of us in this situation.

  If you would like to work on a payment plan, please let me know. 

  In order for the BBB to appropriately process your response, you MUST answer the question above.

  
  Sincerely,
  
  ***********************
  
  
  
  
   
  

  Customer Answer

  Date: 07/08/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me and the matter has been resolved. We've agreed to a payment plan. Just to be clear, I in no way did any form of insurance fraud. 
  
  Sincerely,
  
  ***********************