Alliance Hand & Physical Therapy

Complaint: 10360355
I am rejecting this response because:The company’s response is a gross misrepresentation of the truth. Again, as evident in the company’s response, they are stressing their perceived policies while skewing the facts. I paid the company hundreds of dollars for services, so $would not impact me in anyway. This is not about the money, it is; however, about the principle of honest and fair business practice. While this is not a valid charge, I paid the $38.75, so they can stop framing this as me refusing the pay, and focus on the real problem, which is their illegal bait and switch policy. I called this a bait and switch policy because, in my opinion, based on the facts, this company is engaged in a bait and switch operation. I was told one price, paid said price, and now being charged an additional amount for services, which were already paid for in full. Additional Facts:With my insurance policy, I do not have a co-payment, which is what a patient would normally pay at the time of the appointment What I have is a deductible, and Allianceshould not have charged me anything until after billing Aetna, and have Aetna respond with the patient’s portion of that bill. Alliance led me to believe the charges are thestandard payments for patients with deductibles that are not covered by the insurance company. Alliance was very specific in how much I am required to pay for each visit prior to service, and those charges are as follows: $for the first visit, and $for subsequent visits. I paid the $for the initial visit, and paid $for all subsequent visits. My primary reason for reporting this to Revdex.com is so Alliance can review, and correct their policy of misleading their customers when it comes to pricings. I strongly believe that I should not be responsible for the additional charge because that was not part of our verbal agreement. In addition, I was not given a fair opportunity when comparing prices with Alliance’scompetitors. If this is standard practice for Alliance to mislead their customers on pricing, I hope this Revdex.com reporting deter them from continuing this practice However, if it is not the intent of the company to mislead their customers on pricing, I certainly do hope this report will motivate them to review their policies on dealing with customers with deductible and properly train their employees on communicating pricing to paying customers.
Regards,
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It is the policy of Alliance Hand and Physical Therapy to verify and advise patients of their insurance benefits before treatment is rendered.  Mr. [redacted] was advised of the plan deductible. He agreed to make payments towards this deductible. Mr. [redacted] was advised actual benefit...

determination c[redacted]ot be made until the claim has been reviewed by the insurance company. We have confirmation of this communication with Mr. [redacted]’s signature.  Alliance staff is unable to answer any specific billing questions until the “Explanation of Benefits” is received from the insurance company.  On December 10, 2014, Mr. [redacted] called regarding the bill he received for $38.75. Mr. [redacted] was advised this balance represented the remaining deductible balance based on Aetna’s “Explanation of Benefits”. He was further advised to review his Aetna explanation of benefits to confirm this balance. Mr. [redacted] refused to pay and requested to speak with a supervisor. [redacted], the Lead Administrator of the office [redacted] treated at returned Mr. [redacted]’s call since she originally explained the benefits to Mr. [redacted]. During this call Mr. [redacted] again refused to pay. On December 29, 2014, Mr. [redacted] called again and spoke with [redacted] (supervisor) regarding the bill he received for $38.75. [redacted] explained the balance to him and he refused to pay and hung up the phone. Mr. [redacted] also contacted [redacted] via e-mail on December 30, 2014 and was advised all bills were submitted to Aetna for processing.  Aetna has processed all claims and the remaining balance reflects their determination.  All payments he made have been applied to the account. $38.75 is the remaining balance due which Aetna processed toward the deductible. Alliance Hand and Physical Therapy is contracted with Aetna to provide services to their insurers. As per our contract with Aetna, we are only allowed to charge patients for what Aetna allows on their explanation of benefits. This balance is valid, and Mr. [redacted] is responsible.

Review: Services rendered to my 15 year old son | Case Code 04521-01

I made an appointment for services, and during this process the Alliance representative contacted my insurance company regarding payments and deductibles. The Alliance representative then informed me that my deductible was not met and I needed to pay upfront for my services. I asked to still put the claim through the insurance company, so the amount paid can go towards my deductible and she said she will. As requested of me, I paid upfront for their services, and now I’m being billed for $38.75.

I called Alliance and was told the insurance did not pay for the services and the $38.75 charge represent the remainder of my portion that I need to pay. I told the rep that I paid for the services prior and they told me that it was not enough. I asked to speak to a supervisor, and was told they were not available now, but someone will call me back. No one called back, so I called again after receiving the second bill, and was told the same thing as before. Asked to speak to a supervisor again and was told the same thing. Just like before no one call back. I called a third time, today (12/29/14) and spoke to supervisor [redacted] M.

Explained my situation to [redacted] and all she did was try to discount what I was saying by explaining their policies and procedures. She refused to investigate what I was saying, which leaves me no choice, but to file this complaint. [redacted]'s actions led me to believe this was standard practice for them to mislead customers by tell them one price and changing more after the services.

To sum-up, I was charged one price for services and after the services rendered, I am unknowingly charged more.Desired Settlement: The desired outcome is for Alliance to adjust my bill to $0 because I have already paid for the services rendered. The company should stop telling customers a cheaper price for services and changing more because it is unfair business practice.

Business

Response:

It is the policy of Alliance Hand and Physical Therapy to verify and advise patients of their insurance benefits before treatment is rendered. Mr. [redacted] was advised of the plan deductible. He agreed to make payments towards this deductible. Mr. [redacted] was advised actual benefit determination c[redacted]ot be made until the claim has been reviewed by the insurance company. We have confirmation of this communication with Mr. [redacted]’s signature. Alliance staff is unable to answer any specific billing questions until the “Explanation of Benefits” is received from the insurance company. On December 10, 2014, Mr. [redacted] called regarding the bill he received for $38.75. Mr. [redacted] was advised this balance represented the remaining deductible balance based on Aetna’s “Explanation of Benefits”. He was further advised to review his Aetna explanation of benefits to confirm this balance. Mr. [redacted] refused to pay and requested to speak with a supervisor. [redacted], the Lead Administrator of the office [redacted] treated at returned Mr. [redacted]’s call since she originally explained the benefits to Mr. [redacted]. During this call Mr. [redacted] again refused to pay. On December 29, 2014, Mr. [redacted] called again and spoke with [redacted] (supervisor) regarding the bill he received for $38.75. [redacted] explained the balance to him and he refused to pay and hung up the phone. Mr. [redacted] also contacted [redacted] via e-mail on December 30, 2014 and was advised all bills were submitted to Aetna for processing. Aetna has processed all claims and the remaining balance reflects their determination. All payments he made have been applied to the account. $38.75 is the remaining balance due which Aetna processed toward the deductible. Alliance Hand and Physical Therapy is contracted with Aetna to provide services to their insurers. As per our contract with Aetna, we are only allowed to charge patients for what Aetna allows on their explanation of benefits. This balance is valid, and Mr. [redacted] is responsible.

Consumer

Response:

Review: 10360355

I am rejecting this response because:The company’s response is a gross misrepresentation of the truth. Again, as evident in the company’s response, they are stressing their perceived policies while skewing the facts. I paid the company hundreds of dollars for services, so $38.75 would not impact me in anyway. This is not about the money, it is; however, about the principle of honest and fair business practice. While this is not a valid charge, I paid the $38.75, so they can stop framing this as me refusing the pay, and focus on the real problem, which is their illegal bait and switch policy. I called this a bait and switch policy because, in my opinion, based on the facts, this company is engaged in a bait and switch operation. I was told one price, paid said price, and now being charged an additional amount for services, which were already paid for in full. Additional Facts:With my insurance policy, I do not have a co-payment, which is what a patient would normally pay at the time of the appointment. What I have is a deductible, and Allianceshould not have charged me anything until after billing Aetna, and have Aetna respond with the patient’s portion of that bill. Alliance led me to believe the charges are thestandard payments for patients with deductibles that are not covered by the insurance company. Alliance was very specific in how much I am required to pay for each visit prior to service, and those charges are as follows: $75 for the first visit, and $65 for subsequent visits. I paid the $75 for the initial visit, and paid $65 for all subsequent visits. My primary reason for reporting this to Revdex.com is so Alliance can review, and correct their policy of misleading their customers when it comes to pricings. I strongly believe that I should not be responsible for the additional charge because that was not part of our verbal agreement. In addition, I was not given a fair opportunity when comparing prices with Alliance’scompetitors. If this is standard practice for Alliance to mislead their customers on pricing, I hope this Revdex.com reporting deter them from continuing this practice. However, if it is not the intent of the company to mislead their customers on pricing, I certainly do hope this report will motivate them to review their policies on dealing with customers with deductible and properly train their employees on communicating pricing to paying customers.

Regards,