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:02/13/2023

  Type:Order 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.

  I had three office visits to *********** on 10/23/19, 1/11/20, and 3/5/20. My insurance, *****, was accepted each time I visited, and I never received a bill from them at the times of each visit. In the summer of 2022, I received a bill from ************** office that was blank, other than the fact that I owed them $395. When I called, I was told I owed *********** $395 for the visits in question because the insurance company never paid them for the claims they submitted in 2019 and 2020. When I contacted ***** however, they said they had no record of claims from ************* office ever being submitted at the time of each visit. Per multiple phone conversations, their records indicated only one claim was submitted for all three visits in 2022, which was after the 27 month period Aetna allows for submitting claims, so ***** would not assist. I was also on a three way call with ***** and ************* office and when the office was asked by ***** to submit the original claims as proof, they failed to provide the original claims and only resubmitted the bulk claim for all three visits they made in 2022. I have since received monthly bills from ************** office (and attached one as an example), and have recently been threatened that they would submit to collections. I will pay the $395 but I want to be reimbursed, as my insurance was accepted at the time of each visit and its not my fault that they failed to submit any of the claims in a timely matter.

  Business Response

  Date: 02/20/2023

       In response to this complaint, we have reached out the the patient and his insurance carrier. It was verified that INDEED his carrier did have the claims and did not process his claims. We were able the document the inquiry reference # from ***** for the patient to verify himself. It was verified that his original insurance group was closed then he was re-instated with another group number. We had the insurance carrier reprocess the claims in question. He was informed if there are any credit due to him, he would be reimbursed after the insurance payments have been processed. He has since agreed to retract this complaint.
  

       As for any invoices not be being sent, it is our office policy to send outstanding accounts receivables every month so that any and all questions can be addressed in a timely manner. Final bills were sent due to the fact that we have had zero contact with the patient and/or the insurance company for claims that exceeded 2 years. The patient was satisfied our handling of this matter and has reached out the insurance company who initiated this misunderstanding.