Advantage Physical Therapy

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved] Complaint: [redacted] I am rejecting this response because: I am not sure Advantage Physical Therapy is understanding my issue with this My point by bring up the examples of billing issues was to illustrate that I was confused by the billing from Advantage Physical Therapy not to use those examples to dispute any charges I repeatedly asked for one statement showing everything that was invoiced and paid so I could make sure I owned this amount I did not get this until the date I made full payment and did not feel I should be required to pay until I was sure of what I owned My request is to be credited for the penalty because I do not feel the billing was explained adequately to me Even on the day I made full payment the person handling the billing gave me multiple different amounts to pay because she was confused How can I be expeceted to know the amount when the company themselves did not have a firm grasp on the amount To declare that the consumer has some sort of leverage over the business in these cases assumes that the consumer is not concerend about thier credit rating The fact that a business could have a negative impact on my credit rating and threatened to do this forced me to pay this unwarranted penatly Regards, [redacted]

July 30, To Whom It May Concern.Advantage Physical Therapy received the original complaint notice from the Revdex.com on Friday June 27" 2014, We had responded to this complaint on Thursday July 3" We received a response on Friday July 11" The ID associated with this complaint is We received notice that our response to this patient was rejected, because she states she was billed more than her contractual patient responsibility and that her payments were not reflected on billing statements she received, She also states that she asked the therapists to not perform services that were not covered.Regarding the issue of being billed more than her Copayment, she was never billed more than her $Copay per visit, because her claims all processed through her insurance carrier with her contractual $copayment and we only ever billed her for this amount per her insurance contractAt visits x $= the total amount of her bills which was $No claims denied or were rejected from the insurance company, and all services that were expected to, have paidThere is only ever one service that is performed and is denied by all carriers and is a contractual write off when denied, we are legally obligated to bill this service as we perform it, however because we know it is not a payable code it gets written off and is never billed to the patientThe patient's bills and statements from Advantage reflected paymentsHer first bill was on 7/31/in the amount of $and her first payment of $on 8/11/was reflected because her next two bills were on 9/21/for $and on 10/9/for $based on claims processed and then she had an additional payment on 10/30/for $and her next - statement was on 10/31/for $based on claims processedHer next payment on 11/4/for $and her next statement was sent 12/7/for $On each statement the patient received she had Specific dates of Service that had balances, once she made a payment on those dates of service those dates were removed from the statement because they were paidWe understand that the patient may have not understood that was the reflection of the payments, and weapologize for not being able to provide the exact receipt that she wanted at the timeHowever when we explain the patient responsibility portion on a patient's first visit, it is also explained that it is due at time of service per the contract the patient holds with their insurance companyAs far as requesting to not perform services that are not covered, our Therapists and Staff are not aware of what will deny with the insurance carriers prior to performing each ServiceEven when we Verify CPT codes and Diagnosis codes with the insurance carrier, they say that claims are based on medical necessity and appropriatenessWe perform services that are medically necessary to get each patient better, and the insurance companies have the final determination to pay or deny claims.We do not feel as a business that we hold any advantage over anyone, in fact we feel that the patients hold the advantage over ourselves because they the foundation to our businessWe not only pride ourselves on the excellent patient care, but in the accuracy and efficiency of billing processesWe recognize and accept negative experiences, and we continue to change and improve our processes so that no one has an experience such as this oneAgain we sincerely apologize for being unable to timely provide the itemized receipt the patient had requested, However we kept the patient informed of the transition of billing systems, and as a courtesy notified the patient of their patient responsibility with their insurance contractWe were patient with repayment of her patient responsibility just as she had been patient with us with receiving her requested information, however we had still seen this patient in the year and only now in are we seeing repayment of her services performedWe incurred Costs as a business to attempt to collect the monies owed to us based on her Contractual obligations with her insurance, and thus when no response was made by any means (i.ephone, mail, email, or in person) we turned her account over to Collections which per our financial policies incurs a penalty feeAgain, we feel that the proper resolution has already been made by the bill with penalty included being paid.Sincerely, Lisa CCEO Advantage Physical Therapy Associates

July 03, 2014To Whom It May Concern:Advantage Physical Therapy received the complaint notice from the Revdex.com on Friday June 27th The ID associated with this complaint is ***The patient this complaint comes from had visits with our office between the dates of 7/5/and
12/14/As a courtesy to all of our patients, we perform benefit verifications to let patients know what their expected expenses should be when they are seen in our officesShe was given a "benefit letter” at the start of treatment which explains her patient responsibility due to us per her insurance contract, this letter was signed by the patient to understand that she has a $patient responsibility per visit, and a visit maximum per yearThis equates to a total of $patient responsibility for her full course of treatment, since she had visitsThe Patient made payments throughout her course of treatment as follows: $paid on 8/11/12, $on 10/30/12, $on 11/4/These payments were reflected against the balance due, however a balance still accrued because the patient was attending therapy while statements were being received, and making minimal paymentsThe Patient had statements sent on the following dates with the following amounts due:7/31/$Due9/21/$Due10/9/$Due10/31/$Due12/7/$Due12/12/$Due 1/14/$Due 2/20/#Due 4/12/$Due6/3/$Due7/3/$Due 4/8/FINAL NOTICE SENT $Due 6/9/SENT ACCOUNT TO COLLECTIONSThe patient attended visits at a $copay per visit which equals $1050, minus the payments of $70, $70, and $105, this equals $805, which was the remaining balance on her account and was reflected on the statement sent on 1/14/and each one sent thereafterThe Patient neglected to pay, make payments, or contact our office after her discharge from our clinic on 12/14/12, no attempt to set up a payment plan for her remaining patient responsibility was madeA total of eleven statements and one final notice were sent to this patient at her current address where she resides, and only three payments were received while the patient was actively being seen in the officeA total six statements were sent to the patient after her discharge with the amount due of $were mailed to patient, the last of these six statements was her final noticeThis notice clearly states there is an outstanding balance and that no attempt at payment or contact from her was forthcoming, therefore her account will be considered for collections unlessfull payment was made within days of that letterThat letter was mailed 4/8/and her account was not turned over to collections until 6/9/to allow enough time to make contact with our office to arrange paymentAnd because no contact or payment was made, her account was turned over to our Collections agency on 6/9/The 30% surcharge is the penalty added to a patients account balance once it has been turned into a collections agency due to legal fees and overhead CostsWhen the patient received a letter on 6/23/from the collections agency she promptly made contact with our office to have the 30% removed and to pay their balance in fullHowever, because the account was already in collections the legal fees/overhead fees had already been applied, and therefore we offered a courtesy discount from the 30% surcharge to a 25% surchargeWe feel that the 5% discount of the surcharge was more than courteous on our part because the balance remained unpaid since December of cost our company significant amounts in overhead and suppliesThe patient has paid their balance infull with the 25% surcharge added, and we feel that this was the proper recourse and resolution to this situationWe greatly appreciate this patient taking the time to constructively criticize our processes, however we have worked very diligently to smooth our transition between billing softwareWe understand her frustration with a delay in information, however she did receive Statements from Advantage that clearly and accurately stated what her patient responsibility was for each visit and she also receives Explanation of Benefits (EOB's) from her insurance showing what was billed by Advantage to her insurance Company, what was paid by insurance, and what She owes to AdvantageIf the patient made an attempt to contact Advantage prior to going to Collections, we would have offered the many payment options we make available to all our patients to resolve an outstanding balanceHowever, her balance of $remained unpaid and no contact was made on her part since her last payment on 11/4/and that is why her account had to be turned over to CollectionsAgain, we greatly appreciate the criticism from all parties as it will only prove to better our Company and improve our processes, and in this case we feel the proper resolution has already been reachedTherefore in order to hopefully come to a resolve, we will maintain the 25% surcharge,Thank you for your time and consideration in this matter and please feel free to contact our office with any questions or Concerns regarding this matter, or to request additional documentation.Sincerely, Lisa C
CEO Advantage Physical Therapy Associates

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved] Complaint: [redacted]I am rejecting this response because:
I do not dispute the fact that I was informed of the Co Pays and the max number of visits.  The first issue I have is I was not billed only $35 per visit, the first visits had services denied by the insurance company as non covered which appeared to be over and above the $35. The second issue is my payments were not reflected on the billing statements I recieved.  I asked the therapists to not perform services that were not covered as soon as I got the EOB (Explanation of Benefits) from the Insurance Company and I informed them I could not make additional payments until I got a bill showing my past payments were applied.  Still to this day I have never recieved a bill showing all my payments being applied.  On my most recent request I recieved two print outs out of two systems showing the three payments but I just got that last month.   I understand that changing billing systems is a difficult transition but really all I wanted to do was have one statement showing what I paid, what the insurance company paid and what I owe and to date I have not gotten that.  I have paid the bill plus the so called late fee only under threat of a negative report on my credit rating.  The response given to the Revdex.com is even more confusing to me as the total they proport I owed plus a 25% fee would come to $1,312.50 and yet they have billed me $1,287 in total includeing the fee.  This is the issue here thier numbers never quite make sense to me and I can not get an explanation. 
Businesses hold the advantage in this relationship and can send someone off to a collection agency without adequate billing.  I hope that Advantage Physical Therapy understands that thier success depends upon how they treat thier patients/customers.  Word of mouth advertising within the community is an important way to gain business and while at this point I have not said anything negative to anyone who has asked me about PT services because the treatment I recieved was good.  If the compnay insists upon billing me this late fee all the billing issues I have had, I cannot continue to do be silent about what I feel the company has put me through.  Regards,[redacted]

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved] Complaint: [redacted]I am rejecting this response because:
I am not sure Advantage Physical Therapy is understanding my issue with this.  My point by bring up the examples of billing issues was to illustrate that I was confused by the billing from Advantage Physical Therapy not to use those examples to dispute any charges.  I repeatedly asked for one statement showing everything that was invoiced and paid so I could make sure I owned this amount.  I did not get this until the date I made full payment and did not feel I should be required to pay until I was sure of what I owned.  My request is to be credited for the penalty because I do not feel the billing was explained adequately to me.  Even on the day I made full payment the person handling the billing gave me multiple different amounts to pay because she was confused.  How can I be expeceted to know the amount when the company themselves did not have a firm grasp on the amount. 
To declare that the consumer has some sort of leverage over the business in these cases assumes that the consumer is not concerend about thier credit rating.  The fact that a business could have a negative impact on my credit rating and threatened to do this forced me to pay this unwarranted penatly.  Regards,[redacted]

July 30, 2014
To Whom It May Concern.Advantage Physical Therapy received the original complaint notice from the Revdex.com on Friday June 27" 2014, We had responded to this complaint on Thursday July 3" 2014. We received a response on Friday July 11" 2014. The ID associated with this complaint is 10104052. We received notice that our response to this patient was rejected, because she states she was billed more than her contractual patient responsibility and that her payments were not reflected on billing statements she received, She also states that she asked the therapists to not perform services that were not covered.Regarding the issue of being billed more than her Copayment, she was never billed more than her $35 Copay per visit, because her claims all processed through her insurance carrier with her contractual $35 copayment and we only ever billed her for this amount per her insurance contract. At 30 visits x $35 = the total amount of her bills which was $1050. No claims denied or were rejected from the insurance company, and all services that were expected to, have paid. There is only ever one service that is performed and is denied by all carriers and is a contractual write off when denied, we are legally obligated to bill this service as we perform it, however because we know it is not a payable code it gets written off and is never billed to the patient. The patient's bills and statements from Advantage reflected payments. Her first bill was on 7/31/12 in the amount of $70 and her first payment of $70 on 8/11/12 was reflected because her next two bills were on 9/21/12 for $175 and on 10/9/12 for $70 based on claims processed and then she had an additional payment on 10/30/12 for $70 and her next - statement was on 10/31/12 for $175 based on claims processed. Her next payment on 11/4/12 for $105 and her next statement was sent 12/7/12 for $70. On each statement the patient received she had Specific dates of Service that had balances, once she made a payment on those dates of service those dates were removed from the statement because they were paid. We understand that the patient may have not understood that was the reflection of the payments, and weapologize for not being able to provide the exact receipt that she wanted at the time. However when we explain the patient responsibility portion on a patient's first visit, it is also explained that it is due at time of service per the contract the patient holds with their insurance company.
As far as requesting to not perform services that are not covered, our Therapists and Staff are not aware of what will deny with the insurance carriers prior to performing each Service. Even when we Verify CPT codes and Diagnosis codes with the insurance carrier, they say that claims are based on medical necessity and appropriateness. We perform services that are medically necessary to get each patient better, and the insurance companies have the final determination to pay or deny claims.We do not feel as a business that we hold any advantage over anyone, in fact we feel that the patients hold the advantage over ourselves because they the foundation to our business. We not only pride ourselves on the excellent patient care, but in the accuracy and efficiency of billing processes. We recognize and accept negative experiences, and we continue to change and improve our processes so that no one has an experience such as this one. Again we sincerely apologize for being unable to timely provide the itemized receipt the patient had requested, However we kept the patient informed of the transition of billing systems, and as a courtesy notified the patient of their patient responsibility with their insurance contract. We were patient with repayment of her patient responsibility just as she had been patient with us with receiving her requested information, however we had still seen this patient in the year 2012 and only now in 2014 are we seeing repayment of her services performed. We incurred Costs as a business to attempt to collect the monies owed to us based on her Contractual obligations with her insurance, and thus when no response was made by any means (i.e. phone, mail, email, or in person) we turned her account over to Collections which per our financial policies incurs a penalty fee. Again, we feel that the proper resolution has already been made by the bill with penalty included being paid.Sincerely,
Lisa CCEO Advantage Physical Therapy Associates