Active Chiropractic, Inc

Revdex.com:
I have reviewed the offer and/or response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
[Provide details of why you are not satisfied with this resolution.]
Regards,
Response to Dr. G[redacted]- October 20, 2016            I’ve read
Dr. G[redacted]’s response and I don’t believe it comes even close to addressing my
complaint.            The issue
is rather simple.  This is a matter of
contract law.  When I called Dr. G[redacted]’s
office to schedule a chiropractic visit with Dr. G[redacted], a chiropractor, I asked
whether the chiropractic services (spinal manipulation) would be covered by
[redacted].  I was told “yes” by his
receptionist.  That constituted a
specific contract.  On the day as my
appointment, I was told to pay $182 out-of-pocket.  I asked whether the services would be
reimbursed by [redacted] and was told that although [redacted] would be billed,
[redacted] would not reimburse me.  I was
told to speak to the billing service which made the situation abundantly
clear.  My visit would be billed to
[redacted] under Codes that the doctor and his staff knew were not reimbursable.  These included: “Office Visit,” “Supportive
Therapies,” and “Education.”  [redacted] would
not be billed for the only service from a chiropractor it reimbursed, which was
spinal manipulation.  This was pure
scam.  It would be as if you arranged for
your teenage son to have guitar lessons and instead he was provided with drum
lessons!  I did not ask Dr. G[redacted] to
provide any bogus service to me but chiropractic services that were covered by
[redacted].  If he was not prepared to do
so, he should have told me so and I would have cancelled the appointment.  To make it clear, the services that would be
billed to [redacted] were not only services I had not requested but services that
I did not need.  I did not require
“Education” about my back injury as I am currently meeting every other week
with my surgeon for that very purpose.  I
did not require supportive therapies, since I had completed one year and a half
of physical therapy with a licensed therapist and ceased these appointments
because I was no longer profiting from physical therapy.  As to “Office Visit,” I don’t know what that is!
– I assume that all of Dr. G[redacted]’s appointments are held in an office.  In his response, Dr. G[redacted] claims that the
form I signed gave him permission to provide any service he wished to provide
and be compensated for it by me if it wasn’t covered by insurance. Dr. G[redacted]’s
intention which was confirmed by his billing office was to submit a claim to
[redacted] knowing that the claim would be submitted under Codes that were not
reimbursable and for services that were not needed or requested.            To conclude
and restate:  this was a scam.  I asked whether my visit with Dr. G[redacted] for
chiropractic service would be reimbursed by [redacted] and was told “Yes.”  I knew from reviewing [redacted] regulations
that chiropractic services were only covered providing they were chiropractic
services (spinal manipulation).  Other
services like x-rays are not covered by [redacted].  Nor were the services like “Education” and
“Supportive Therapies,” under which Dr. G[redacted] planned to bill [redacted].  After the appointment, I was told that
[redacted] would not cover the appointment because Dr. G[redacted] planned to submit to
[redacted] charges for the three services he allegedly provided to me knowing
full well that these services would not be reimbursed by [redacted].  In fact, Dr. G[redacted]’s office assistant asked
for the $182 immediately following my appointment because she knew that these
charges would not be submitted to [redacted] under reimbursable Codes.  Again, back to contract law.  Dr. G[redacted] knowingly violated his contract
with me to provide [redacted]-reimbursable chiropractic services.  This was not a situation like the kind Dr.
G[redacted] described in his rebuttal letter, where a doctor submits charges to an
insurance company in the expectation of receiving payment from the insurance
company and then to everyone’s surprise, the services were not covered.  Dr. G[redacted] entered into a contract to provide
[redacted]-reimbursable services which he had no intention of providing and
billing to [redacted].  His receptionist
asked for the $182 in payment because she knew in advance that [redacted] would
not pay for this visit.  Dr. G[redacted] violated
his contract with me to provide [redacted]-reimbursable services and therefore
owes me full reimbursement for the $182 which was illegally taken from me under
false pretenses.  Dr. G[redacted]’s violation
of the contract to provide [redacted]-reimbursable chiropractic services to me
absolved me of any obligation to pay for unwanted, unneeded services of Dr.
G[redacted]’s own choosing.

Re: Revdex.com Case Number [redacted]Dear Sir or Madam:Thank you for your most recent correspondence concerning [redacted]. This letter serves as Active Chiropractic’s response to your inquiry. Please advise if you require further information. We look forward to your resolution of this matter.[redacted]...

("Patient”) visited our office for chiropractic treatment on 10/04/2016. As part of the intake process, Patient completed standard paperwork detailing personal information and medical history. We are unable to attach this paperwork as it is protected under HIPAA. However, page 4 of our paperwork requires electronic acceptance of the following terms:I certify that I'm the patient or legal guardian listed above I have read/understand the included information and certify it to be true and accurate to the best of my knowledge I consent to the collection and use of the above information to this office of chiropractic. I authorize this office and its staff to examine and treat my condition as the doctors see fit. I hereby authorize the doctor to release all information necessary to any insurance company, attorney or adjuster for the purpose of claim reimbursement of charges incurred by me I grant the use of my signed statement of authorization with my signature for required insurance submissions. I understand and agree that all services rendered to me will be charged to me, and I’m responsible for timely payment of such services. I understand and agree that health/accident insurance policies are an arrangement between an insurance carrier and myself. I understand that fees for professional services will becomes immediately due upon suspension of termination of my care or treatment.Patient accepted these terms on 9/30/16 at 3:34 PM.It would appear from Patient's communication with Active Chiropractic and subsequent letter to the Revdex.com, that Patient's insurance provider(s) did not cover the charges for treatment. Additionally, Patient does not wish to be personally responsible for the charges.Patient has asked Active Chiropractic to refund the charges for treatment. Waiver or refund of charges for treatment is commonly referred to by the courts as insurance fraud, and is considered felonious illegal activity. Additionally, acquiescing to Patient's request would compromise Active Chiropractic's standing with the American Chiropractic Association.Our position is that the fees generated from Patient's treatments remain due and Patient is not entitled to a refund.Regards,Dr. Robert G[redacted]