A Mission for Michael Inc

We cannot respond to the complaint because to do so, would be a violation of The Health Insurance Portability and Accountability Act of (HIPAA)We did not treat your complainantHowever, she did sign a contract as the Payor and in that contract acknowledged that no part paid to AMFM, was
refundableShe was provided with a copy of that contract and can provide it to youWe cannot provide it to you as to do so would violate HIPAAIf you can provide us with a signed release of confidentiality for records from the patient, we can then adequately respond

Thank you for providing the Authorization for Release of Health Information apparently executed by *** ***. First, at no time did I, nor anyone else on behalf of A Mission for ***, hereafter AMFM, ever tell anyone, let alone *** ***, that AMFM is a primary psychiatric, secondary substance abuse facilityPlease reference the attached contract (Agreement for Payment for Treatment) signed by both *** *** and *** *** wherein it is clearly indicates that AMFM treats people who suffer from co-occurring disorders and/or have a dependency on alcohol and/or drugs. Representatives from AMFM spoke to the hospital while *** was there on several occasions*** *** picked up and flew home *** without telling anyone at AMFM. *** was admitted to AMFM on March 8, He left Against Medical Advice from the facility twice and was returned by Police Officers twiceAlthough requested, the police would not take *** to the hospital for psychiatric stabilizationRather, our Psychiatrist, Dr*** ***, committed *** on March 11, for assessment, evaluation, crisis intervention and placement at *** ***, Laguna BeachThe Application for Assessment Order is attached as well. We were in contact with the social workers, the behavioral unit and *** *** from March 11, - March 16, Our Program Director, *** ***, visited *** in person at *** *** on March 16, Please see note from *** ***:
"1pm
Program Director dropped off all personal belongings of *** *** at MHLB including, medications, clothes and cigarettes as requested by MHLB and *** ***
*** had sent text message re same earlier
*** has been determined inappropriate for treatment at AMFM at this time due to his current high mental health acuity and his leaving treatment AMA twice while at AMFMTwice he was picked up by police while putting himself and others in ***ger by wandering on the freeway and twice crossing it on foot. It is believed he is still in need of a higher level of careWe recommend treatment at *** *** in Riverside or a similar environmentAfter at least two weeks of stabilization and compliance in taking medications, AMFM is willing to reassess him at that time for return to treatment here."Unbeknownst to AMFM, *** *** picked up *** and flew him home on March 17, This was only discovered by AMFM by my phone call to *** *** on March 17, and via my conversation with ***'s social workerShe let me know that *** was gone. As to *** ***'s request for a refund, AMFM attempted to bill ***'s insurance and all claims have been deniedThey are currently being sent back for reviewThe Agreement for Payment for Treatment is clear that any fees at the published rate for billing $per day, or $10,for the days that *** was here are due and payable. Although *** *** paid $5,000, she also issued a check for $3,as additional payment toward the fees, which was returned to her as a good faith gestureAMFM, under the Agreement for Payment, is due more money, but we are not seeking that. I presume this clarifies any misunderstanding that *** *** previously had

No response can be given since no additional information was provided about why the resolution was rejected.

We have fully addressed the allegations made by the complainant and stand by our previous responseWe will not respond furtherHowever, we have now received an Explanation of Benefits from the insurance company indicating they have paid 50% of the billed amount which amounts to $4,We have previously provided a copy of the contract whereby the insured is responsible for the coinsurance of 50% or a corresponding amount of $4,In addition, the patient and the complainant executed an Agreement for Sober Living which called for payment of $and was non-refundable. Attached is a copy of the Sober Living Agreement and the Explanation of Benefits. As can be seen, the total amount owed is $6,for which we have been paid $5,There remains due and owing of $1,We will not be responding to any further requests for a refund as there is no refund due.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Regards,
*** ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Regards,
*** ***

We have fully addressed the allegations made by the complainant and stand by our previous responseWe will not respond furtherHowever, we have now received an Explanation of Benefits from the insurance company indicating they have paid 50% of the billed amount which amounts to $4,We have previously provided a copy of the contract whereby the insured is responsible for the coinsurance of 50% or a corresponding amount of $4,In addition, the patient and the complainant executed an Agreement for Sober Living which called for payment of $and was non-refundable.
Attached is a copy of the Sober Living Agreement and the Explanation of Benefits.
As can be seen, the total amount owed is $6,for which we have been paid $5,There remains due and owing of $1,We will not be responding to any further requests for a refund as there is no refund due

We cannot respond to the complaint because to do so, would be a violation of The Health Insurance Portability and Accountability Act of (HIPAA)We did not treat your complainantHowever, she did sign a contract as the Payor and in that contract acknowledged that no part paid to AMFM, was
refundableShe was provided with a copy of that contract and can provide it to youWe cannot provide it to you as to do so would violate HIPAAIf you can provide us with a signed release of confidentiality for records from the patient, we can then adequately respond.

Thank you for providing the Authorization for Release of Health Information apparently executed by *** ***.? First, at no time did I, nor anyone else on behalf of A Mission for ***, hereafter AMFM, ever tell anyone, let alone *** ***, that AMFM is a primary psychiatric, secondary substance abuse facilityPlease reference the attached contract (Agreement for Payment for Treatment) signed by both *** *** and *** *** wherein it is clearly indicates that AMFM treats people who suffer from co-occurring disorders and/or have a dependency on alcohol and/or drugs.? Representatives from AMFM spoke to the hospital while *** was there on several occasions*** *** picked up and flew home *** without telling anyone at AMFM.? *** was admitted to AMFM on March 8, He left Against Medical Advice from the facility twice and was returned by Police Officers twiceAlthough requested, the police would not take *** to the hospital for psychiatric stabilizationRather, our Psychiatrist, Dr*** ***, committed *** on March 11, for assessment, evaluation, crisis intervention and placement at *** ***, Laguna BeachThe Application for Assessment Order is attached as well.? We were in contact with the social workers, the behavioral unit and *** *** from March 11, - March 16, Our Program Director, *** ***, visited *** in person at *** *** on March 16, Please see note from *** ***:
"1pm
Program Director dropped off all personal belongings of *** *** at MHLB including, medications, clothes and cigarettes as requested by MHLB and *** ***
*** had sent text message re same earlier
*** has been determined inappropriate for treatment at AMFM at this time due to his current high mental health acuity and his leaving treatment AMA twice while at AMFMTwice he was picked up by police while putting himself and others in ***ger by wandering on the freeway and twice crossing it on foot.? It is believed he is still in need of a higher level of careWe recommend treatment at *** *** in Riverside or a similar environmentAfter at least two weeks of stabilization and compliance in taking medications, AMFM is willing to reassess him at that time for return to treatment here."Unbeknownst to AMFM, *** *** picked up *** and flew him home on March 17, This was only discovered by AMFM by my phone call to *** *** on March 17, and via my conversation with ***'s social workerShe let me know that *** was gone.? As to *** ***'s request for a refund, AMFM attempted to bill ***'s insurance and all claims have been deniedThey are currently being sent back for reviewThe Agreement for Payment for Treatment is clear that any fees at the published rate for billing $per day, or $10,for the days that *** was here are due and payable.? Although *** *** paid $5,000, she also issued a check for $3,as additional payment toward the fees, which was returned to her as a good faith gestureAMFM, under the Agreement for Payment, is due more money, but we are not seeking that.? I presume this clarifies any misunderstanding that *** *** previously had.?

We have fully addressed the allegations made by the complainant and stand by our previous response. We will not respond further. However, we have now received an Explanation of Benefits from the insurance company indicating they have paid 50% of the billed amount which amounts to $4,390.00. We have previously provided a copy of the contract whereby the insured is responsible for the coinsurance of 50% or a corresponding amount of $4,390.00. In addition, the patient and the complainant executed an Agreement for Sober Living which called for payment of $2500 and was non-refundable.  Attached is a copy of the Sober Living Agreement and the Explanation of Benefits.  As can be seen, the total amount owed is $6,890.00 for which we have been paid $5,000. There remains due and owing of $1,890.00. We will not be responding to any further requests for a refund as there is no refund due.

In response to A Mission for Michael’s previous statement to the Revdex.com sent May 18th claiming they were not aware ** left Mission Hospital…
I sent [redacted] a text on March 15, 7:50 p.m. (which I have a printed copy of, as well as EVERY SINGLE text, email and phone call log) that’s been exchanged between myself and AMFM regarding these activities) stating “I was very concerned and confused about the plan for **,” since Mission Hospital planned to release him on the 15th and I had heard nothing from AMFM. I did not receive a reply back from [redacted].
On March 16th Mission Hospital called again. I have a statement and recorded voicemail from the social worker assigned to **, [redacted], stating “I still have not received a return phone call from AMFM, nor has anyone come to ‘assess’ **,” during the 5 days he was there (even though AMFM’s response claims they did visit with **). [redacted] said ** was being released at 4 p.m. I finally reached [redacted] via his cell phone on March 16 who informed me AMFM would not take ** back. I had no time to find any alternative facility. I purchased a ticket for a flight. ** flew home that evening.
FACT: I did not fly to California to pick up my son. I was at work, in Washington State, teaching elementary students. I could not afford to fly, due to the amount spent for this process, nor did I have enough time to get a flight down soon enough before ** was released from Mission Hospital. What is factual is [redacted], the social worker at Mission Hospital, called me on March 15th stating ** was stable and able to be released to the care of AMFM. However, they had been unable to contact AMFM. The hospital said they were no longer allowed to keep ** in the psych ward and legally were not allowed to release him without a plan. Since they couldn’t contact anyone at AMFM, and knowing the circumstances of me having no money, the social worker ([redacted]) they said they would pay for a taxi and send ** to the airport. I begged the social worker to continue to attempt to contact AMFM and please not release **. The social worker called back a few hours later stating the doctor would approve ** one more night, but needed to be released in the morning.
Fact: I was told by [redacted], as well as [redacted]s from referral source, AMFM was primary psychiatric. Supporting documentation include an email I sent prior to contracting with AMFM where I requested a primary psychiatric facility, as well as a phone call I made to my insurance company onMarch 3rd inquiring about the coverage for a primary psychiatric facility. I was concerned with the amount of money AMFM was charging. I simply didn’t even the full amount.  My insurance company stated there was no primary psychiatric In-Network and if they received documentation ** needed that higher level of care, they would “contract out” with AMFM and pay more. I immediately called [redacted] telling her “Good news. My insurance company will pay more.” [redacted] quickly replied “Don’t call your insurance. That’s my job. That’s what I’m hired for. You’ve been through enough. Just worry about getting ** down here and I’ll take care of the insurance. Let’s not worry about the higher level of care documentation. We’ll just accept the money we quoted you and what your insurance provides for out of network.” Interesting [redacted] never made that call to my insurance seeking more money. Perhaps because AMFM isn’t a primary psychiatric facility and they would have been denied any payment? Even more interesting is that my insurance company was NEVER billed by AMFM until the day after receiving my Revdex.com complaint; 1 ½ months after ** was denied re-admittance to AMFM. Yet AMFM claims they were denied payment from United Health Care and they are in the process of appealing it? According to United Health Care, AMFM was issued a check for $4390 on May 18th, AMFM was never denied a claim, and nothing was ever appealed. FACT: I was told by both [redacted] and [redacted] that AMFM was a primary psychiatric facility.
It would not make any sense for me to spend every dollar I have, including borrowing money from family and friends, to send ** to a drug and alcohol facility. I could have stayed in Washington State. ** had been in 3 psych wards in the last year, he was currently in a psych ward from running back and forth across the freeway, and he had just been rejected from 2 drug and alcohol treatment facilities once they received **’s medical records because ** needed a higher level of care. I was told by AMFM I was sending ** to a primary psychiatric facility.
Regarding the claim [redacted] visited ** on March 16, if [redacted] did visit ** on this date, it was after I had been told AMFM would not take ** back. I have an email from [redacted] stating “When the hospital lets me know it’s getting close to discharge time, I will gather the necessary medical records and send staff to go meet with [redacted] for an evaluation. We will keep you posted on all of this.”  THIS NEVER HAPPENED. And nowhere in that email did it mention ** needed two weeks of stabilization. If [redacted] “saw” ** on March 16, it must have been only to return his belongings.
Regarding the claim AMFM didn’t know ** left the hospital? In addition to the text I sent [redacted] on March 15, I have a text that I sent [redacted] on March 16, 12:46 p.m. stating “** is being released this morning. Can you bring his items to the hospital?” In addition I have a return text from [redacted] at 2:17 p.m. stating “everything has been dropped off an hour ago.”
Regarding the claim ** was returned twice by the police for “wandering on the freeway.” This is false. The first time ** went missing he was located in a nearby shopping complex and had not shown a cause for the police to be concerned. I was the only one in contact with the police on both occasions, as AMFM chose to not call the police even though they knew ** was extremely mentally unstable and in an unfamiliar location out of state. AMFM had **’s wallet and driver’s license in a locked safe; ** had no ID on him, nor a jacket. AMFM did not find it necessary to report him missing (per text and phone conversation with [redacted] on March 8). In fact, the [redacted]a Point Sheriff, who had ** in the back of her patrol car for over 2 hours, was unable to find any contact information for AMFM (including an after-hours number), and was in disbelief AMFM did not call and report ** missing.
There does not appear to be a misunderstanding on my part. There seems to be some inconsistencies, misstated information on the part of AMFM and a treatment facility that was not equipped to help my son (even though they had all his medical records and saw how unstable he was before arriving at their office, and assured me they could help. Even to the point of [redacted] recommending I either hire a company or fly down with ** directly due to the fact that he’s a “flight risk.”
My request has not waivered. I want a full refund so I can place my son into a facility that can better meet his needs.

I am attaching a release of information from [redacted].
Please let me know if I need to provide anything else.
Sincerely,
[redacted]

In response to A Mission for Michael’s previous statement to the Revdex.com sent May 18th claiming they were not aware ** left Mission Hospital…I sent [redacted] a text on March 15, 7:50 p.m. (which I have a printed copy of, as well as EVERY SINGLE text, email and phone call log) that’s been exchanged between myself and AMFM regarding these activities) stating “I was very concerned and confused about the plan for **,” since Mission Hospital planned to release him on the 15th and I had heard nothing from AMFM. I did not receive a reply back from [redacted].On March 16th Mission Hospital called again. I have a statement and recorded voicemail from the social worker assigned to **, [redacted], stating “I still have not received a return phone call from AMFM, nor has anyone come to ‘assess’ **,” during the 5 days he was there (even though AMFM’s response claims they did visit with **). [redacted] said ** was being released at 4 p.m. I finally reached [redacted] via his cell phone on March 16 who informed me AMFM would not take ** back. I had no time to find any alternative facility. I purchased a ticket for a flight. ** flew home that evening.FACT: I did not fly to California to pick up my son. I was at work, in Washington State, teaching elementary students. I could not afford to fly, due to the amount spent for this process, nor did I have enough time to get a flight down soon enough before ** was released from Mission Hospital. What is factual is [redacted], the social worker at Mission Hospital, called me on March 15th stating ** was stable and able to be released to the care of AMFM. However, they had been unable to contact AMFM. The hospital said they were no longer allowed to keep ** in the psych ward and legally were not allowed to release him without a plan. Since they couldn’t contact anyone at AMFM, and knowing the circumstances of me having no money, the social worker ([redacted]) they said they would pay for a taxi and send ** to the airport. I begged the social worker to continue to attempt to contact AMFM and please not release **. The social worker called back a few hours later stating the doctor would approve ** one more night, but needed to be released in the morning.Fact: I was told by [redacted], as well as [redacted]s from referral source, AMFM was primary psychiatric. Supporting documentation include an email I sent prior to contracting with AMFM where I requested a primary psychiatric facility, as well as a phone call I made to my insurance company onMarch 3rd inquiring about the coverage for a primary psychiatric facility. I was concerned with the amount of money AMFM was charging. I simply didn’t even the full amount.  My insurance company stated there was no primary psychiatric In-Network and if they received documentation ** needed that higher level of care, they would “contract out” with AMFM and pay more. I immediately called [redacted] telling her “Good news. My insurance company will pay more.” [redacted] quickly replied “Don’t call your insurance. That’s my job. That’s what I’m hired for. You’ve been through enough. Just worry about getting ** down here and I’ll take care of the insurance. Let’s not worry about the higher level of care documentation. We’ll just accept the money we quoted you and what your insurance provides for out of network.” Interesting [redacted] never made that call to my insurance seeking more money. Perhaps because AMFM isn’t a primary psychiatric facility and they would have been denied any payment? Even more interesting is that my insurance company was NEVER billed by AMFM until the day after receiving my Revdex.com complaint; 1 ½ months after ** was denied re-admittance to AMFM. Yet AMFM claims they were denied payment from United Health Care and they are in the process of appealing it? According to United Health Care, AMFM was issued a check for $4390 on May 18th, AMFM was never denied a claim, and nothing was ever appealed. FACT: I was told by both [redacted] and [redacted] that AMFM was a primary psychiatric facility.It would not make any sense for me to spend every dollar I have, including borrowing money from family and friends, to send ** to a drug and alcohol facility. I could have stayed in Washington State. ** had been in 3 psych wards in the last year, he was currently in a psych ward from running back and forth across the freeway, and he had just been rejected from 2 drug and alcohol treatment facilities once they received **’s medical records because ** needed a higher level of care. I was told by AMFM I was sending ** to a primary psychiatric facility.Regarding the claim [redacted] visited ** on March 16, if [redacted] did visit ** on this date, it was after I had been told AMFM would not take ** back. I have an email from [redacted] stating “When the hospital lets me know it’s getting close to discharge time, I will gather the necessary medical records and send staff to go meet with [redacted] for an evaluation. We will keep you posted on all of this.”  THIS NEVER HAPPENED. And nowhere in that email did it mention ** needed two weeks of stabilization. If [redacted] “saw” ** on March 16, it must have been only to return his belongings.Regarding the claim AMFM didn’t know ** left the hospital? In addition to the text I sent [redacted] on March 15, I have a text that I sent [redacted] on March 16, 12:46 p.m. stating “** is being released this morning. Can you bring his items to the hospital?” In addition I have a return text from [redacted] at 2:17 p.m. stating “everything has been dropped off an hour ago.”Regarding the claim ** was returned twice by the police for “wandering on the freeway.” This is false. The first time ** went missing he was located in a nearby shopping complex and had not shown a cause for the police to be concerned. I was the only one in contact with the police on both occasions, as AMFM chose to not call the police even though they knew ** was extremely mentally unstable and in an unfamiliar location out of state. AMFM had **’s wallet and driver’s license in a locked safe; ** had no ID on him, nor a jacket. AMFM did not find it necessary to report him missing (per text and phone conversation with [redacted] on March 8). In fact, the [redacted]a Point Sheriff, who had ** in the back of her patrol car for over 2 hours, was unable to find any contact information for AMFM (including an after-hours number), and was in disbelief AMFM did not call and report ** missing.There does not appear to be a misunderstanding on my part. There seems to be some inconsistencies, misstated information on the part of AMFM and a treatment facility that was not equipped to help my son (even though they had all his medical records and saw how unstable he was before arriving at their office, and assured me they could help. Even to the point of [redacted] recommending I either hire a company or fly down with ** directly due to the fact that he’s a “flight risk.”My request has not waivered. I want a full refund so I can place my son into a facility that can better meet his needs.

Thank you for providing the Authorization for Release of Health Information apparently executed by [redacted]. 
First, at no time did I, nor anyone else on behalf of A Mission for [redacted], hereafter AMFM, ever tell anyone, let alone [redacted], that AMFM is a primary psychiatric, secondary substance abuse facility. Please reference the attached contract (Agreement for Payment for Treatment) signed by both [redacted] and [redacted] wherein it is clearly indicates that AMFM treats people who suffer from co-occurring disorders and/or have a dependency on alcohol and/or drugs. 
Representatives from AMFM spoke to the hospital while [redacted] was there on several occasions. [redacted] picked up and flew home [redacted] without telling anyone at AMFM. 
[redacted] was admitted to AMFM on March 8, 2016. He left Against Medical Advice from the facility twice and was returned by Police Officers twice. Although requested, the police would not take [redacted] to the hospital for psychiatric stabilization. Rather, our Psychiatrist, Dr. [redacted], committed [redacted] on March 11, 2016 for assessment, evaluation, crisis intervention and placement at [redacted], Laguna Beach. The Application for Assessment Order is attached as well. 
We were in contact with the social workers, the behavioral unit and [redacted] from March 11, 2016 - March 16, 2016. Our Program Director, [redacted], visited [redacted] in person at [redacted] on March 16, 2016. Please see note from [redacted]:
"1pm 3.16.16
Program Director dropped off all personal belongings of [redacted] at MHLB including, medications, clothes and cigarettes as requested by MHLB and [redacted].
[redacted] had sent text message re same earlier.
[redacted] has been determined inappropriate for treatment at AMFM at this time due to his current high mental health acuity and his leaving treatment AMA twice while at AMFM. Twice he was picked up by police while putting himself and others in [redacted]ger by wandering on the freeway and twice crossing it on foot.  It is believed he is still in need of a higher level of care. We recommend treatment at [redacted] in Riverside or a similar environment. After at least two weeks of stabilization and compliance in taking medications, AMFM is willing to reassess him at that time for return to treatment here."
Unbeknownst to AMFM, [redacted] picked up [redacted] and flew him home on March 17, 2016. This was only discovered by AMFM by my phone call to [redacted] on March 17, 2016 and via my conversation with [redacted]'s social worker. She let me know that [redacted] was gone. 
As to [redacted]'s request for a refund, AMFM attempted to bill [redacted]'s insurance and all claims have been denied. They are currently being sent back for review. The Agreement for Payment for Treatment is clear that any fees at the published rate for billing $2695 per day, or $10,780 for the 4 days that [redacted] was here are due and payable. 
Although [redacted] paid $5,000, she also issued a check for $3,000 as additional payment toward the fees, which was returned to her as a good faith gesture. AMFM, under the Agreement for Payment, is due more money, but we are not seeking that. 
I presume this clarifies any misunderstanding that [redacted] previously had.

I am attaching a release of information from [redacted].Please let me know if I need to provide anything else.Sincerely,[redacted]