Athletico

Initial Business Response / [redacted] (1000, 7, 2015/07/10) */ Contact Name and Title: [redacted] Director of Cl Contact Phone: XXXXXXXXXX Contact Email: [redacted] @athletico.com Patient [redacted] ***, was provided physical therapy services at Athletico's Evanston Center on November 11th & 20th, The rendering clinician evaluated and treated the patient per the referring physician's scriptAs a courtesy, Athletico verified (11/6/15) and verbally quoted to the patient her physical therapy benefits at her initial visitAt the time benefits were verified, the patient had a deductible which was unmetAs a result of this complaint, the patient's medical records were reviewed by the treating clinician, facility manager/clinician and the regional manager/clinician for the Evanston locationPlease note: all of the aforementioned professionals are licensed by the state of ILAfter reviewing documentation in the patient's medical record it found that services rendered were appropriate for the patients conditions In regards to Mr***'s feedback on communication, Athletico's billing system supports Mr***'s communication with the Billing Center team members and the [redacted] Manager on the following dates: 2/25/15, 3/4/15, 4/6/15, 5/14/and 6/4/ Additionally, Mr [redacted] spoke to the Facility Manager of the Evanston center on separate occasions and spoke to the Regional Manager onceBoth support that the services were rendered and appropriate per the referring physicians scriptThe remaining balance of was applied to the patient's deductible per the terms of her policy with [redacted] Athletico offers a month budget plan to those patients who request a monthly budget planMr& Mrs [redacted] can contact the Billing Center to discuss payment options at XXX-XXX-XXXX

Thank you for the opportunity to respond to this concern We take patient feedback very seriously and are committed to resolving this issue In this case, [redacted] the mother of the patient, acknowledged financial obligation of her daughter's bills when she completed and signed Athletico's Consent and Statement of Financial Responsibility FormAthletico is not in possession of a divorce settlement which may or may not dictate who is responsible for the child’s medical expensesWith that said, Athletico recommends [redacted] resolve any concerns about the responsible party with the child's fatherThis could look like the mother forwarding the patient statement to the child’s fatherAdditionally, [redacted] listed the father as a contact on the patient’s HIPAA privacy statementIf the father is in agreement with paying the account balance of $he is at liberty to contact Athletico’s Billing Center to pay the account balance in full, make a payment or set up payment arrangements and at this point he can provide his mailing address

Thank you for the opportunity to respond to this complaintWe take patient feedback very seriously. Our standard process is to verify patient benefits with the carrier as well as inform the patient to verify benefits directly with his/her insurance companyIn this case, benefit information
was verified and conveyed to the patient which included that there is a deductible on the patient's plan that the patient hadn't met yetPatient deductibles are an agreement between the patient and their health insurance plan and Athletico must hold patients responsible for their deductible

Complaint: ***
I am rejecting this response because: if this company would look back at her original records, her Father originally filled this paperwork outI was told it needed to be updatedI advised the workers that her father is the responsible party for payment but she lives with me in St LouisI was told to go ahead and update it and the person that holds the insurance is who is responsible to pay the bills He is responsible for her medical bills and have paid them in the past if you will take the time to look back at her recordsWe have been coming to your facility for years and this is the first problem I have had What if her grandparents would have brought her and filled out the paperwork, does that make them responsible? The insurance responsibilities falls on the card holder! This is what I told your staff and made it very clearThis bill will only be paid if it's sent to the proper person.
Sincerely,
*** ***

Initial Business Response /* (1000, 7, 2015/07/10) */
Contact Name and Title: [redacted] Director of Cl
Contact Phone: XXXXXXXXXX
Contact Email: [redacted]@athletico.com
Patient [redacted], was provided physical therapy services at Athletico's Evanston Center on November 11th & 20th, 2014. The...

rendering clinician evaluated and treated the patient per the referring physician's script. As a courtesy, Athletico verified (11/6/15) and verbally quoted to the patient her physical therapy benefits at her initial visit. At the time benefits were verified, the patient had a 500 deductible which was unmet. As a result of this complaint, the patient's medical records were reviewed by the treating clinician, facility manager/clinician and the regional manager/clinician for the Evanston location. Please note: all of the aforementioned professionals are licensed by the state of IL. After reviewing documentation in the patient's medical record it found that services rendered were appropriate for the patients conditions.
In regards to Mr. [redacted]'s feedback on communication, Athletico's billing system supports Mr. [redacted]'s communication with the Billing Center team members and the [redacted] Manager on the following dates: 2/25/15, 3/4/15, 4/6/15, 5/14/15 and 6/4/15.
Additionally, Mr. [redacted] spoke to the Facility Manager of the Evanston center on 2 separate occasions and spoke to the Regional Manager once. Both support that the services were rendered and appropriate per the referring physicians script. The remaining balance of 301.71 was applied to the patient's deductible per the terms of her policy with [redacted] Athletico offers a 12 month budget plan to those patients who request a monthly budget plan. Mr. & Mrs. [redacted] can contact the Billing Center to discuss payment options at XXX-XXX-XXXX.

Thank you for the opportunity to respond to this concern.  We take patient feedback very seriously and are committed to resolving this issue.  In this case, [redacted] the mother of the patient, acknowledged financial obligation of her daughter's bills when she completed and signed...

Athletico's Consent and Statement of Financial Responsibility Form. Athletico is not in possession of a divorce settlement which may or may not dictate who is responsible for the child’s medical expenses. With that said, Athletico recommends [redacted] resolve any concerns about the responsible party with the child's father. This could look like the mother forwarding the patient statement to the child’s father. Additionally, [redacted] listed the father as a contact on the patient’s HIPAA privacy statement. If the father is in agreement with paying the account balance of $481.74 he is at liberty to contact Athletico’s Billing Center to pay the account balance in full, make a payment or set up payment arrangements and at this point he can provide his mailing address.

Complaint: [redacted]
I am rejecting this response because:I was in fact told insurance was covering. I will provide a more detailed example of one of the times I was told insurance being covered is a fact. It was my third visit that I asked if I owed anything and was told $45, but then told it was a system error and that I owed nothing as insurance was covering. So your statement that I was not told is untrue. And it seems since I filed this complaint and rejected your response you sent another bill for $600+. Which raises serious questions about why I owe another $600+, because this complaint could not be resolved I sent the $751 in and now your organization is asking for another $600 all of a sudden. Either this is a billing error or there is something shady going on with Athletico. Another point is that a patient cannot ask insurance when patient does not know medical codes that you use to submit to insurance. You were asked specifically about insurance and told me yes insurance covered, I was clear that I would not do if insurance did not cover. Athletico said it did and that was only reason I agreed to do until I found out insurance was not paying and what I was told was untrue.
Sincerely,
[redacted]

Complaint: [redacted]
 
I am rejecting this response because:they lied point blank. Insurance covering had nothing to do with deductible. They rejected them entirely and would never cover this office. Again Athletico stated Insurance was covering and anything they say contrary is a smoke screen.  It is obvious their intent is to mislead and trick people.
Sincerely,
[redacted]