Complaints

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• Initial Complaint

  Date:09/12/2022

  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.

  Visited and received treatments dates 5/26/22 to 6/9/22. I applied for **** ****** and was approved for $ 4500. Dr V*** got the 4500 before treatments. I found out and discontinued the services. I also paid $200 towards their fee for the care credit( care credit does not charge Dr.) I filed a dispute and he had to pay back care credit $3750. I have **** **** **** ***** that verified that Diagnosos codes and procedure codes were covered except for code S9090.which is his special decompression table. **** **** denied charges because he did not have notes on my chart. I received a bill for 1550 . When called secretary I was told I had a 2000 out of pocket expense(I DO NOT) I am plan administer . I need him to bill **** ***** with correct notes which he will not do. My copay for the 6 visits would be $240. He is in network. I already paid $ on a bogus bill for care credit. I need help with this please. I feel as though this is such a big scam and as a nurse I should have known better. His bill to me was $1550 so less the 750 care credit paid him it should of reflected on bill which it was not.nor was the $200 I paid . Please help!

  Business Response

  Date: 09/28/2022

  I am contacting you in response to complaint ID: ********, referred to as, **** ******** *, dated 09-12-2022. 

  **** ******** * presented to my office for Initial examination and consultation on 04-28-2022, at which time an appropriate diagnosis was formulated, based on the history, including previously failed treatment procedures, examination, and imaging findings. I concluded that a Course of Non Surgical Spinal Decompression would be appropriate for **** ******** * condition. (All equipment is FDA clear to treat such conditions) 

  **** ******** *'s Insurance benefits were verified and showed $1,000.00 Deductible with a 3,000.00 out of pocket expense. See Exhibit 1 
  **** ******** * returned for Report of Findings and treatment options. **** ******** was informed about her $1,000.00 Deductible and $3,000.00 out of the pocket expense. **** ******** was informed that her insurance plan required an Authorization for any type of procedure. We requested on Authorization with the appropriate CPT codes, MRI Reports, codes, but received a denial. See Exhibit 4 
  No Insurance coverage was available, regardless of the codes used. All submitted coding is appropriate and in accordance with Correct Procedure Terminology (CPT) and International Classification of Disease coding (ICD 10) See Exhibit 5 All treatment procedures were explained in detail. **** ******** agreed to treatment and signed the enclosed contract. See Exhibit 2 
  **** ******** was also informed about the Total price of the treatment - $6,000.00, and was given the option of prepayment, at the discounted rate of 25%. **** ******** applied for **** ****** in the amount of $4,500.00 and chose the one year, no interest if paid in full option. She was informed that there will be a charge to our office, in the amount of $445.50, **** ******** agreed to those charges and asked if she can make payments until charges were paid in full. She paid $200.00 towards the interest charge of $445.50 See Exhibit 3 

  **** ******** *. filed a dispute with **** ****** alleging non -receipt of services, **** ****** adjudicated that there would be no charge back to my business, and that the rules of the agreement were upheld. See exhibit 7. 

  As stated on the contract, **** ******** was informed that she can terminate it at any time, but she will be fully responsible for the charges that accrued since the start of the treatment. A refund was issued in the amount of $3,750.00 on 07-13- 2022. See exhibit 8 
  

  **** *********s Medical claims were submitted twice to her insurance carrier on 08-25-2022 and then again on 09-06-2022. The claims were denied. See Exhibit 6. 
  Given the above data I, feel that I have demonstrated the excellent level of goodwill and standards that are synonymous with my practice. 
  If you have any other questions, please feel free to call us at ###-###-####. 
  

  Regards, 
  Emanuel V*** D.C.