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:10/24/2022

  Type:Service or Repair 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 sought physical therapy services from this company, beginning on 8/12/2022. At that time I was told that each session would cost $100 and I paid this amount at the time of service each time. I had ten sessions with a provider. At no time during the course of treatment was I informed that I was responsible for more than the $100 per session. Treatment concluded with the final session on 9/29/2022, which I paid for as usual. I recently received a bill (dated 10/14/22) from Redbird stating a balance due of $824.92. Since I had paid the session fee at each session, I assumed it was a mistake and called the company to straighten it out. The billing department employee stated that there was nothing they can do, that it would be illegal for them to cancel the bill (untrue) and that she planned to send it to collections. I know companies are not legally required to send bills to collections. I stated that I would not have attended a single session, had I known that each session would be $185, rather than the $100 they quoted me. Or even if they had billed me sooner, I would have understood how much I was being charged, before accruing a bill of over $800. I asked why they did not send me a bill for any of the sessions sooner and the employee stated that it was my insurance company's fault for taking too long to process the claims. I called my insurance company, and was told they had processed the claims within 1-2 weeks of receiving them. I just can't believe that it would be legal for someone to walk into a clinic, be quoted a service fee, pay it promptly and then have the company turn around and randomly bill the patient for a previously unspecified, unmentioned, and un-agreed upon amount.

  Business Response

  Date: 10/25/2022

  ****************** came to our clinic on 8/12/22 for his initial appointment, at which time his insurance benefits were verified using our online verification platform. At this time, it was indicated to ****************** his benefits, per PacificSource and his contractual agreement with the insurance company, were a $2,800 deductible in which he had met $906.67. It was explained that he would be required to satisfy the remaining portion of his $2,8000 deductible before his 30% coinsurance would apply. During this conversation, the front office staff explained that ****************** would be responsible for 100% of the allowable charges and then explained about our clinic policy pertaining to deductible collection. 

  
  At Redbird, we collect $100 per appointment to go towards the patient's total bill, this is not guaranteed to be the total amount due per appointment. This policy helps to alleviate large outstanding balances for both the patient and the business. I understand the patient believes he was misled with this information, and I did apologize for the confusion regarding this policy.

  
  Upon speaking to ******************, he informed me he believed he was paying a flat rate because his insurance deductible was so high. I then took the time to explain our Self Pay rate to assure him we would not have offered to charge him a flat rate of $100 per appointment. Our Self Pay rate is $175 for the initial appointment and $125 for follow up appointments. This rate is typically used for those who come to get services from our clinic who *** not have insurance benefits. For a variety of reasons, when billing insurance, we are unable to give a patient an exact quote of how much each date of service will cost. The length of the appointment, the *** codes being billed and at what frequency, the plan of care and what this details. All of these factors are subject to change depending on the progress and/or lack thereof of each individual patient, therefore the cost of each appointment *** vary. 

  
  In regards to ********************** request to write off his balance of $824.92 and it being illegal, as he mentioned in his complaint. It was explained that as of 10/24/22, after the processing of all dates of service at our clinic, the patient now only requires $68.41 to satisfy his deductible, at which time he will begin to receive services at his benefit rate. If our clinic was to write off his balance, we would be ensuring to Pacific Source, which both he and our clinic hold a contract with, that he did in fact satisfy his deductible. At this time Pacific Source would begin to pay more for his services. Illegal or not, this is considered to be insurance fraud and we take that very seriously. We will not knowing commit healthcare claims fraud and this was expressed with condolences to *******************  Call reference number cheylauna102522 from 10/25/22 with Pacific source states that we are not obligated to adjust any of his balance. The conversation with ********** at Pacific Source was had by our billing manager, *********************** and she is happy to walk through the details of the conversation with the representative. She can be reached at ************.

  
  Our electronic records have been attached for further proof of our timely billing. Our company sends statements out on or around the 15th of each month. ****************** was first seen on 8/12/22 and we sent him his first statement on 9/14/22. Parts of this statement have been concealed to protect the privacy of the patient. I have also attached portions of the *** (electronic remittance advice) from Pacific Source which show the dates in which the insurance company processed the dates of service. Majority were processed after 9/14/22 and billed to the patient on 10/14/22. I have also attached the backside of the patient registration form where ****************** signed and initialed our policy around payments and monthly statements. 
  During the conversation with ******************, it was evident that there would not be a compromise, conversations regarding a payment plan, or any resolution other than us writing off his complete and total bill. This was made clear when ****************** indicated to the billing team that Redbird would not get another ***** out of him. At this time, we explained our company policy for non payment, which does ultimately lead to the intervention of a collections agency. 

  
  As expressed to ******************, we are very sorry for any misunderstanding or perhaps miscommunication that *** have occurred. We understand getting a surprise bill is not ideal and it was clear that  ****************** was very upset. We did our best to explain in full detail the process of insurance billing and help to alleviate any confusion around the charges. At the time of the conversation on 10/24/22 we did offer ****************** a payment plan option in which he responded by informing us that he will not be paying any of his bill.