Vitality Physicians Group Practice

The business has responded Please see below:
THE CLIENT BROUGHT HIS CHILD IN TO BE SEEN AT OUR PRACTICE ON 4/**/FOR AN INITIAL INTAKEUPON CHECK-IN, THE CLIENT WAS INFORMED THAT
OUR PRACTICE WAS OUT-OF-NETWORK PER HIS INSURANCE PLANTHE CLIENT FILLED OUT THE NECESSARY PAPERWORK AND HIS CHILD WAS SEEN FOR THE APPROPRIATE AMOUNT OF TIMEAFTER THE SESSION THE CLIENT SAID HE WOULD SPEAK TO HIS SPOUSE BEFORE SCHEDULING ANOTHER APPOINTMENT DUE TO OUR PRACTICE BEING ONETWORK WITH HIS INSURANCETHE CLIENTS SPOUSE CALLED ON 4/**/TO INFORM US THAT SHE WAS NOT MADE AWARE THAT WE WERE OUT-OF-NETWORK PRIOR TO THE APPOINTMENT AND SHE SHOULD NOT BE HELD RESPONSIBLE FOR THE BALANCEIT WAS EXPLAINED TO HER THAT UPON CHECK-IN, HER SPOUSE WAS MADE AWARE THAT WE ARE OUT-OF-NETWORK & HE CHOOSE TO CONTINUE WITH THE SCHEDULED APPOINTMENT FOR HIS CHILDIT WAS ALSO EXPLAINED THAT WE BILL THE INSURANCE COMPANY A SET FEE FOR CERTAIN CPT CODESONCE WE RECEIVE AN EXPLANATION OF BENEFITS FROM THE INSURANCE COMPANY WE THEN BILL THE CLIENT ACCORDINGLYNO MONEY WAS RECEIVED FROM THIS CLIENT AT THE TIME OF SERVICE, NOR HAS THE CLIENT BEEN BILLED FOR THE SERVICE PROVIDED ON 4/**/OUR PRACTICE IS NOT RESPONSIBLE IF THE CLIENT(S) DOES NOT KNOW OR DOES NOT UNDERSTAND THE EXTENT OF THEIR OWN BENEFITSIT IS THE POLICY HOLDERS RESPONSIBILITY TO CONTACT THEIR INSURANCE COMPANY PRIOR TO THEIR SCHEDULED APPOINTMENT FOR CLARIFICATION ON COVERED SERVICES

The business has responded.  Please see below:THE CLIENT BROUGHT HIS CHILD IN TO BE SEEN AT OUR PRACTICE ON 4/**/15 FOR AN INITIAL INTAKE. UPON CHECK-IN, THE CLIENT WAS INFORMED THAT OUR PRACTICE WAS OUT-OF-NETWORK PER HIS INSURANCE PLAN. THE CLIENT FILLED OUT THE NECESSARY PAPERWORK AND HIS...

CHILD WAS SEEN FOR THE APPROPRIATE AMOUNT OF TIME. AFTER THE SESSION THE CLIENT SAID HE WOULD SPEAK TO HIS SPOUSE BEFORE SCHEDULING ANOTHER APPOINTMENT DUE TO OUR PRACTICE BEING OUT-OF NETWORK WITH HIS INSURANCE. THE CLIENTS SPOUSE CALLED ON 4/**/15 TO INFORM US THAT SHE WAS NOT MADE AWARE THAT WE WERE OUT-OF-NETWORK PRIOR TO THE APPOINTMENT AND SHE SHOULD NOT BE HELD RESPONSIBLE FOR THE BALANCE. IT WAS EXPLAINED TO HER THAT UPON CHECK-IN, HER SPOUSE WAS MADE AWARE THAT WE ARE OUT-OF-NETWORK & HE CHOOSE TO CONTINUE WITH THE SCHEDULED APPOINTMENT FOR HIS CHILD. IT WAS ALSO EXPLAINED THAT WE BILL THE INSURANCE COMPANY A SET FEE FOR CERTAIN CPT CODES. ONCE WE RECEIVE AN EXPLANATION OF BENEFITS FROM THE INSURANCE COMPANY WE THEN BILL THE CLIENT ACCORDINGLY. NO MONEY WAS RECEIVED FROM THIS CLIENT AT THE TIME OF SERVICE, NOR HAS THE CLIENT BEEN BILLED FOR THE SERVICE PROVIDED ON 4/**/15. OUR PRACTICE IS NOT RESPONSIBLE IF THE CLIENT(S) DOES NOT KNOW OR DOES NOT UNDERSTAND THE EXTENT OF THEIR OWN BENEFITS. IT IS THE POLICY HOLDERS RESPONSIBILITY TO CONTACT THEIR INSURANCE COMPANY PRIOR TO THEIR SCHEDULED APPOINTMENT FOR CLARIFICATION ON COVERED SERVICES.

Review: I took my daughter to this health group to be evaluated (intake). The office manager said nothing about a fee for the initial consultation. The total amount of time that the Social worker spent speaking with my daughter was less than 20 minutes. Subsequently, they are now trying to bill us $220 for an hour visit which never took place. Upon speaking with the [redacted] afterward, she insists that they are not obligated to disclose what their fees are until the bill is given. I have never heard of such an open ended billing procedure.Desired Settlement: If their previously undisclosed billing structure is fair at $220 per hour, then we should only have to pay 1/3 of it, since that's all the time that was actually spent providing a service.

Business

Response:

The business has responded. Please see below:THE CLIENT BROUGHT HIS CHILD IN TO BE SEEN AT OUR PRACTICE ON 4/**/15 FOR AN INITIAL INTAKE. UPON CHECK-IN, THE CLIENT WAS INFORMED THAT OUR PRACTICE WAS OUT-OF-NETWORK PER HIS INSURANCE PLAN. THE CLIENT FILLED OUT THE NECESSARY PAPERWORK AND HIS CHILD WAS SEEN FOR THE APPROPRIATE AMOUNT OF TIME. AFTER THE SESSION THE CLIENT SAID HE WOULD SPEAK TO HIS SPOUSE BEFORE SCHEDULING ANOTHER APPOINTMENT DUE TO OUR PRACTICE BEING OUT-OF NETWORK WITH HIS INSURANCE. THE CLIENTS SPOUSE CALLED ON 4/**/15 TO INFORM US THAT SHE WAS NOT MADE AWARE THAT WE WERE OUT-OF-NETWORK PRIOR TO THE APPOINTMENT AND SHE SHOULD NOT BE HELD RESPONSIBLE FOR THE BALANCE. IT WAS EXPLAINED TO HER THAT UPON CHECK-IN, HER SPOUSE WAS MADE AWARE THAT WE ARE OUT-OF-NETWORK & HE CHOOSE TO CONTINUE WITH THE SCHEDULED APPOINTMENT FOR HIS CHILD. IT WAS ALSO EXPLAINED THAT WE BILL THE INSURANCE COMPANY A SET FEE FOR CERTAIN CPT CODES. ONCE WE RECEIVE AN EXPLANATION OF BENEFITS FROM THE INSURANCE COMPANY WE THEN BILL THE CLIENT ACCORDINGLY. NO MONEY WAS RECEIVED FROM THIS CLIENT AT THE TIME OF SERVICE, NOR HAS THE CLIENT BEEN BILLED FOR THE SERVICE PROVIDED ON 4/**/15. OUR PRACTICE IS NOT RESPONSIBLE IF THE CLIENT(S) DOES NOT KNOW OR DOES NOT UNDERSTAND THE EXTENT OF THEIR OWN BENEFITS. IT IS THE POLICY HOLDERS RESPONSIBILITY TO CONTACT THEIR INSURANCE COMPANY PRIOR TO THEIR SCHEDULED APPOINTMENT FOR CLARIFICATION ON COVERED SERVICES.