VibrantCare Rehabilitation, Inc.

Our records indicate that VibrantCare was in touch with Mr. [redacted] on 01/25/16, 02/12/16 and 02/16/16 regarding the balance due on his account. We have also been in contact with his insurance company multiple times in an effort to get the dates of service paid. We have...

pulled his account from collections, he should be getting a letter from PMS confirming this. We are still working with his insurance company to get them to cover their portion of the bill. The insurance company assigns a patient responsibility from each EOB (explanation of benefits) that VibrantCare receives with the payment for the date of service. The patient should also receive the EOB to let them know the claim has been paid. It appears that Mr. [redacted] was to pay $12.00 for each date of service.Since we are still working with his insurance company we will remain in touch with Mr. [redacted] until the situation is resolved. I will also follow up with the Revdex.com in regards to this complaint once we hear from his insurance company about any balance that is due from them.[redacted]

I am rejecting this response because:  regardless of what they say, the person on the phone told me they offered the service and when the physical therapist said they did not, I left.   they can hide behide double talke, bottom line is the person on the phone lied.

I am rejecting this response because: I received a letter yesterday from [redacted] that my account was pulled from collections.  While I appreciate that gesture, the matter remains unresolved until Vibrant Care completely drops the matter.  All bills for co-payments, which I received from Vibrant Care, were paid in full shortly after my receiving them in the mail and I can provide detailed bank statements from 2012 that provide a full accounting. Any further outstanding bills not yet rendered are due to Vibrant Care’s own negligence.  My insurance company TRICARE requires that all claims be submitted no later than 1 year after the date the services were provided.  Given that nearly four-years have elapsed since the time of this service, Vibrant Care stands accountable for their oversight and I should not be held accountable for any further co-payments which they failed to submit in a timely manner. I request that Vibrant Care drop this matter and provide me with written acknowledgement that such action has been taken.

Mr. [redacted] was referred to physical therapy by his physician.  He was seen for his initial evaluation 02/26/14 at our South Land Park clinic. Our records show that Mr. [redacted] asked about massage therapy and we told him that massage is incorporated into the treatment but the goal was...

stretching and exercise for a home plan to relieve his symptoms. We do not have licensed massage therapists but our licensed physical therapists do use some massage during treatment.
Midway through his evaluation he told the physical therapist that he did not wish to continue the evaluation because he was only there so his insurance would pay for a massage. He stated he would not excercise or continue to come to physical therapy.
I'm sorry that Mr. [redacted] did not want the physical therapy his physican recommended for his symptoms but we are unable to refund his copayment. We did provide service to Mr. [redacted] and we billed his insurance company for the services we provided prior to his terminating the evaluation. Per our contract with his insurance company Mr. [redacted] is repsonsible for a copayment and we are obligated to collect that money.

As I stated in my original response to Mr. [redacted]'t complaint, he was referred by his physician to VibrantCare Rehabilitation for physical therapy treatment, not for massage therapy. We need to evaluate the patient which is what we did when we charged Mr. [redacted] for this co-payment and that is when Mr. [redacted] decided he wasn't interested in physical therapy, he only wanted massage therapy and wanted his insurance company to pay for it. Most insurance companies will not pay for strictly massage therapy, but they will pay for massage therapy when it is incorporated with other physical therapy procedures (stretching, excercises and ice/heat or e-stim treatment). The Physical Therapist cannot diagnose the patients symptoms so they must do what the physician requests when the patient is referred. If the evaluation had continued, the physial therapist would have developed a Plan of Care for the patient and had his referring physician sign off on the Plan of Care. We billed the insurance company for what we were able to do for Mr. [redacted] before he left mid appointment
Our records indicate that we explained that we did not do exclusively massage therapy treatments, that is was part of an overall treatment that included other things and Mr. [redacted]'s insurance company reviewed the bill, paid us for their responsibility and asked us to collect Mr. [redacted]'s responsibility which is what we did. We could not provide only massage and bill it as physical therapy or we would have been committing insurance fraud.
I'm sorry Mr. [redacted] feels he didn't get the services he requested but we provided the services his physician referred him to us for.

I am rejecting this response because:  They told me when called on the phone they offered that kind of therapy.  that is what I expected and that is what I paid for.  Tthey make it sound like was doing somekind of insurance fraud and resent that.   the truth is was not told the truth.

Review: I have medical coverage from [redacted] through Medicare and since April 2013 I received acard from [redacted] Are [redacted] (Medicaid) to make effective the payment of co-payments. Following an order from my Primary doctor I was referred to Vibrant Care for therapy that began on 8/13/2013 and I attended two times per week during some week in August 2013. from the beginning of the therapy Vibrant Care accepted (they made photocopies) of the card for payment ($20.00 per therapy session). In March 2014 they started sending the bill to my house making me responsible for a debt that at no moment I was responsible for.Desired Settlement: I consider that the company, Vibrant Care lied to me from the beginning assuring me that they were receiving the payment letting me continue the therapy and making me believe that Medicaid was paying and making me responsible of an amount that I cannot pay for they were interested for their business and at the end provide a bill that I never thought I would be responsible for. It is not fair that now they make me responsible for the sum of $403.47 for if I knew of this since the start, I would have not continued with the therapy

Business

Response:

Thank you for bringing Ms. [redacted]'s concerns to my attention. We want each of our patients to have a positive experience when they come to VibrantCare for physical therapy treatment.

It looks like Ms. [redacted] went to our clinic in Glendale AZ for 8 visits between 08/13/13 and 09/19/13 visits then went to our clinic on [redacted] for 14 visits from 09/23/13 to 11/19/13. Ms. [redacted] provided VibrantCare with her insurance cards and as a courtesy we verified those benefits with her Medicare replacement plan through [redacted] (Medicare Advantage) and her secondary insurance [redacted]. Her [redacted] plan requires a $20.00 copayment and her [redacted] plan pays for any coinsurance or deductible, it specifically does not cover copayments. Coinsurance is different than a copayment. For example a true Medicare plan pays 80% and requires a coinsurance of 20% from the policy holder.

Ms. [redacted] chose to purchase the [redacted] Medicare Replacement plan and also this particular Medicaid plan [redacted]. We verified with [redacted] at [redacted] that that particular plan only covers coinsurance and deductible amounts.

VibrantCare received an Explanation of Benefits (EOB) each time we received a payment or denial from both insurance companies. I believe it is every insurance company's policy to also send an EOB to the patient. This EOB will show the patient the payment the insurance company made on their behalf as well as any money assigned as patient responsibility by the insurance company.

When VibrantCare does insurance verification, as a courtesy to the patient, we are told that the verfification does not guarantee payment. Payment eligibility is only determined once the actual claim for services rendered is received by the insurance company. Our records don't indicate that Ms. [redacted] ever inquired about insurance payments until after the services were rendered. Ms. [redacted] should have received the EOB's telling her that [redacted] required the $20.00 copayment and that [redacted]) did not cover copayments. All of her dates of service were submitted to [redacted] and to [redacted]. There is nothing more we can do to make the insurance company pay the bill.

We would be happy to set up a reasonable payment plan for Ms. [redacted] but we are contractually unable to write off this balance. It is ultimately the patients responsibility to know the financial obligations they have under the plans they purchase.

Consumer

Response:

Consumer states that her complaint issues have been resolved. She has received a letter confirming the modified billing adjustments made by the company.

Review: During 2012, approximately three-and-a-half years ago, I received physical therapy treatment from this company. Authorization for payment for services was covered through my medical insurance, [redacted].

During January 2016, I received a Demand for Payment letter from [redacted]), a bill collection agency, regarding unpaid bill/s from Vibrant Care for unpaid services during 2012. The problem with this is twofold:

1) Since completion of my treatment in 2012, I never received further bills from Vibrant Care for any outstanding co-payments, which would have been my responsible part of any bill, per the agreement [redacted], a Federal insurer, established with Vibrant Care.

2) Vibrant Care is actually violating their agreement with the insurance company as, per [redacted]'s written policy; "claims for current treatment must be filed within 365 days of the date of service."

During the course of two phone conversations with [redacted], Vibrant Care's California State Account representative, I was advised that there has been “glitches” in account records that may have resulted in forwarding of my past billing to the collection agency. During those two calls I requested [redacted] send me a letter to clarify this matter and to contact [redacted] to remove my account from the collection process. She assured me she would comply, but as of today, no action has been taken.

I have several p

Your company never notified me, either via written bill or verbally, that I had outstanding fees. Had I been notified by your company, I would have promptly paid any outstanding fees.

As of today, I have not heard back from either [redacted] or any other party from Vibrant Care. Since January 25th I also left two voicemails at her number without reply.Desired Settlement: Vibrant Care do the following:

1) Contact [redacted] and have my name and account removed from the collection process.

2) Ensure prompt removal of any delinquency that may have been reported by either Vibrant Care, and/or [redacted], to any credit reporting agency.

3) That that be removed as a party on this matter. Any outstanding fees to be collected should be taken up with [redacted] or taken on as a loss by Vibrant Care due to misfiling. Notify me in writing once complete.

Business

Response:

Our records indicate that VibrantCare was in touch with Mr. [redacted] on 01/25/16, 02/12/16 and 02/16/16 regarding the balance due on his account. We have also been in contact with his insurance company multiple times in an effort to get the dates of service paid. We have pulled his account from collections, he should be getting a letter from PMS confirming this. We are still working with his insurance company to get them to cover their portion of the bill. The insurance company assigns a patient responsibility from each EOB (explanation of benefits) that VibrantCare receives with the payment for the date of service. The patient should also receive the EOB to let them know the claim has been paid. It appears that Mr. [redacted] was to pay $12.00 for each date of service.Since we are still working with his insurance company we will remain in touch with Mr. [redacted] until the situation is resolved. I will also follow up with the Revdex.com in regards to this complaint once we hear from his insurance company about any balance that is due from them.[redacted]

Consumer

Response:

I am rejecting this response because: I received a letter yesterday from [redacted] that my account was pulled from collections. While I appreciate that gesture, the matter remains unresolved until Vibrant Care completely drops the matter. All bills for co-payments, which I received from Vibrant Care, were paid in full shortly after my receiving them in the mail and I can provide detailed bank statements from 2012 that provide a full accounting. Any further outstanding bills not yet rendered are due to Vibrant Care’s own negligence. My insurance company TRICARE requires that all claims be submitted no later than 1 year after the date the services were provided. Given that nearly four-years have elapsed since the time of this service, Vibrant Care stands accountable for their oversight and I should not be held accountable for any further co-payments which they failed to submit in a timely manner. I request that Vibrant Care drop this matter and provide me with written acknowledgement that such action has been taken.

Business

Response:

Mr. [redacted] came to VibrantCare’s Pinole clinic between 09/12/2012 and 12/10/12 and was treated for two different diagnosis codes. From the beginning of his treatment VibrantCare has been in contact with [redacted] insurance regarding his treatment. VibrantCare has been working with [redacted] to make sure they pay the insurance portion due for services rendered. VibrantCare billed all charges timely and collected the portion of the services that [redacted] assigned to Mr. [redacted] as patient responsibility. VibrantCare will always work with our patient’s insurance companies to collect the insurance portion due. As I have stated in previous responses to Mr. [redacted]’s Revdex.com complaint his account was sent to collection because the insurance company did not pay for some of the services rendered. There are records in our accounts that indicate that VibrantCare was in contact with Mr. [redacted] over the years trying to resolve the outstanding balance due. When he contacted us after he received a letter from [redacted] we pulled the account from [redacted] and appealed the insurance denials with [redacted]. All of the patient responsibility has been applied to the account and Mr. [redacted] has been sent letters indicating the account was pulled from [redacted] and that at this time there is no patient responsibility for services rendered. If [redacted] pays the denied charges and assigns a patient responsibility then Mr. [redacted] will be notified from [redacted] via an EOB what that patient responsibility is. Our [redacted] supervisor has the account and is following up with the insurance company regularly until this is resolved. Both of Mr. [redacted]’s accounts have been updated to reflect the address and telephone number Mr. [redacted] has on his letters so we can keep in touch if anything changes. This matter will be finally resolved once we hear back from [redacted] regarding the appeal we have made on the claims that they did not pay.

Consumer

Response:

I am rejecting this response because:While the respondent claims to have been in touch with me, I still have yet to receive any written documentation from their company. Therefore, Vibrant Care has still not complied with my request to provide me, directly from their company, written acknowledgement that I fulfilled my patient obligation and have no further responsibility on my part for collection of payment for past services. Whatever bills for outstanding services remain is between [redacted] and VibrantCare. If I do not receive this letter from VibrantCare within 7 days I will file a Letter of Grievance with [redacted]. Regards, [redacted]

Review: I was told I would receive a specific type of care on the phone and when I arrived and paid my co-pay I was told that type of treatment was not offered and when I tried to get my money back, I was told that was not possible.Desired Settlement: I would like my co-pay of $15 back.

Business

Response:

Mr. [redacted] was referred to physical therapy by his physician. He was seen for his initial evaluation 02/26/14 at our South Land Park clinic. Our records show that Mr. [redacted] asked about massage therapy and we told him that massage is incorporated into the treatment but the goal was stretching and exercise for a home plan to relieve his symptoms. We do not have licensed massage therapists but our licensed physical therapists do use some massage during treatment.

Midway through his evaluation he told the physical therapist that he did not wish to continue the evaluation because he was only there so his insurance would pay for a massage. He stated he would not excercise or continue to come to physical therapy.

I'm sorry that Mr. [redacted] did not want the physical therapy his physican recommended for his symptoms but we are unable to refund his copayment. We did provide service to Mr. [redacted] and we billed his insurance company for the services we provided prior to his terminating the evaluation. Per our contract with his insurance company Mr. [redacted] is repsonsible for a copayment and we are obligated to collect that money.

Consumer

Response:

I am rejecting this response because: They told me when called on the phone they offered that kind of therapy. that is what I expected and that is what I paid for. Tthey make it sound like was doing somekind of insurance fraud and resent that. the truth is was not told the truth.

Business

Response:

As I stated in my original response to Mr. [redacted]'t complaint, he was referred by his physician to VibrantCare Rehabilitation for physical therapy treatment, not for massage therapy. We need to evaluate the patient which is what we did when we charged Mr. [redacted] for this co-payment and that is when Mr. [redacted] decided he wasn't interested in physical therapy, he only wanted massage therapy and wanted his insurance company to pay for it. Most insurance companies will not pay for strictly massage therapy, but they will pay for massage therapy when it is incorporated with other physical therapy procedures (stretching, excercises and ice/heat or e-stim treatment). The Physical Therapist cannot diagnose the patients symptoms so they must do what the physician requests when the patient is referred. If the evaluation had continued, the physial therapist would have developed a Plan of Care for the patient and had his referring physician sign off on the Plan of Care. We billed the insurance company for what we were able to do for Mr. [redacted] before he left mid appointment

Our records indicate that we explained that we did not do exclusively massage therapy treatments, that is was part of an overall treatment that included other things and Mr. [redacted]'s insurance company reviewed the bill, paid us for their responsibility and asked us to collect Mr. [redacted]'s responsibility which is what we did. We could not provide only massage and bill it as physical therapy or we would have been committing insurance fraud.

I'm sorry Mr. [redacted] feels he didn't get the services he requested but we provided the services his physician referred him to us for.

Consumer

Response:

I am rejecting this response because: regardless of what they say, the person on the phone told me they offered the service and when the physical therapist said they did not, I left. they can hide behide double talke, bottom line is the person on the phone lied.