Coco's Beauty Salon

Ms [redacted] was seen at our office for physical therapy of the described months At the time of the visit her benefits were explained to her which were at the time a $2,ind deductible/$family deductible after which she would be covered at 80% She also had %out of pocket She had a HRA account of a balance of -$ She was aware of her balance and attempted to pay her balance using her flex card on June 3, which was declined and she was going to call the next month once she had money in the account to pay the balance which she never did We maintained her flex credit card account on file September my office left her a message that we needed to hear from her otherwise her account would be sent to collections September she was sent to the collections agency In December 28, we finally heard back from her as she was providing her Medicaid number that could be billed which she forgot to provide to the office The Medicaid timely filing had expired at that time and we could not bill the Medicaid I received a letter pertaining to her domestic violence in Octand attempted to call her legal representative she provided to me without response Spoke to Ms [redacted] over the phone telling her that there was nothing I could do once in collections and she was aware of her balance from the beginning plus the attempt to pay the balance using her flex spending account which we never heard back from her She expressed that she was trying to buy a house and was concerned about her credit rating being effected I again told her that once it is collections there was nothing more that I can do plus her history She had called several other times trying to resolve the issue at which time we told her to call the collections agency to pay the bill I again trying calling her back at her request leaving her a voice message on her phone in Dec telling her she is expected to pay the balance and hope she does and there is nothing that can be done once in collections She has had a lot going on in however there are responsibilities that need to maintained to prevent conditions like this from arising I can not maintain a busy by offering free treatment as it appears she was hoping to receive I have not been paid by her insurance because of her deductible and out of pocket benefits

Complaint: ***
I am rejecting this response because: the information is un-true and inaccurate. At the time of my visit, not before, nor after, were my benefits EVER explained to me by anyone at this office The only time they were explained to me was when I called my insurance previous to my first appointment I asked the lady up front every single time I was there if there was a co-pay or any amount due, to which she checked her computer and said no, nothing was due and "don't worry - you'll be billed"I was never aware of a balance and called to make sure before I moved, I only gave the girl up front my HRA card number in case there was ever a balance, not because there was a balance. The reason the HRA account was -was because by the time I finally got a call from the collections agency, I called the Droffice to give them my HRA card number again but my insurance company had changed, of course there were no funds a month later, I'm sure the doctor understands how insurance works and HRA's, once the insurance is expired, so are the funds! I could have submitted claims up to days later, had I known there was a balance! I never "forgot" to call his office about a Medicaid number, I didn't know there was a balance on my account, because no one called until it was waaay past the time insurance could be run through. I received Medicaid to help cover the medical cost incurred with the domestic violence situation, which was backdated and would have covered these visits. After I received a call from your collections agency, I called my Medicaid case worker, who directed me to contact your office and ask you to do a "special filing" asking for an exception to the "timely filing", to which she would approve and help push through. I spoke with the lady at the front office several times about this and asked her to relay the message to the Dr The lady up front called me back a few times and her and I discussed this, each time, she would agree with my about the Medicaid being filed and but it being too late, and saying that she would call me backI felt as if the info was not being conveyed clearly, so I called to make an appointment to meet in person with the Dr. I was told by his staff up front that unless I pay a co-pay and use my current insurance OR pay an office visit fee (with no insurance), that he would not see me. I can confirm that at no time were any messages received by any of my legal representation, not only did they work closely with me with my medical bills but they were always in close contact with me. There were several people working on my case but the Adams County DA gave me her personal cell phone number (which was provided to the Dr.) and a direct line to her office. I have owned a home since I was 18, the last time I bought a home was in 2011. At no time was a home purchase ever mentioned. The only reason I didn't want a mark on my credit report is because I don't think this was handled fairly! Several attempts were made to get this taken care of, the last time I talked to the Drhe said he would "see what he could do" and would call me back. I have not since heard from him...only months later from his collections agency. At no time was I hoping to receive free treatment and, in fact, I feel as though I have tried to pay you several times only to be told that I should wait, or there was nothing due, or that you could not or would not submit another claim as per the instructions of my case worker at Medicaid. My hope for you as a provider would have been that you and your office staff work with me to get the insurance billed and that that be a priority over picking lilacs across the street. I think my responsibilities were more than met with the communication with your office once I was aware of the situation. If the receptionist would have taken my payment on any of the multiple times I offered at my office visits - this wouldn't have happenedIf I had received a call about a balance prior to September, the HRA card could have been run throughOR a manual claim filedIf you had filed a Medicaid claim (which was requested but never done) it could have been paid through thatThere are a lot of missed opportunities here. I have had to pay this out of pocket because you and your staff would not help process through the channels that were available. This is what my complaint is about, not me complaining that I had to pay for something that was rightfully due, there is no question there, but the way it was handled; or more accurately not handled.
Sincerely,
*** ***

Ms*** was seen at our office for physical therapy of the described months. At the time of the visit her benefits were explained to her which were at the time a $2,ind deductible/$family deductible after which she would be covered at 80%. She also had %out of
pocket. She had a HRA account of a balance of -$669.90. She was aware of her balance and attempted to pay her balance using her flex card on June 3, which was declined and she was going to call the next month once she had money in the account to pay the balance which she never did. We maintained her flex credit card account on file. September my office left her a message that we needed to hear from her otherwise her account would be sent to collections. September she was sent to the collections agency. In December 28, we finally heard back from her as she was providing her Medicaid number that could be billed which she forgot to provide to the office. The Medicaid timely filing had expired at that time and we could not bill the Medicaid. I received a letter pertaining to her domestic violence in Octand attempted to call her legal representative she provided to me without response. Spoke to Ms*** over the phone telling her that there was nothing I could do once in collections and she was aware of her balance from the beginning plus the attempt to pay the balance using her flex spending account which we never heard back from her. She expressed that she was trying to buy a house and was concerned about her credit rating being effected. I again told her that once it is collections there was nothing more that I can do plus her history. She had called several other times trying to resolve the issue at which time we told her to call the collections agency to pay the bill. I again trying calling her back at her request leaving her a voice message on her phone in Dec30 telling her she is expected to pay the balance and hope she does and there is nothing that can be done once in collections. She has had a lot going on in however there are responsibilities that need to maintained to prevent conditions like this from arising. I can not maintain a busy by offering free treatment as it appears she was hoping to receive. I have not been paid by her insurance because of her deductible and out of pocket benefits

I am glad you checked your insurance before coming here, most people don't. Given that you should have known that you didn't have a co-pay but a deductible that had to be met and there would be money owed. It is for this reason the front office had told you that you will be billed at a later date once the explanation of benefits were received from your insurance company which takes approximately to days from the dates which you were seen. Once your deductible is met you would be covered by 80%, 20% would be your responsibiilty. You had not be much of your deductible therefore would be paying for your visit which is what you would have heard when you called your insurance company. We provide to our patients as a benefit an explanation of their benefits for physical therapy. You provide your flex spending account in June, months after you were seen last to pay your bill however there wasn't any money in your account. From our understanding, you were going to call us once there was money available but we never heard from you until we were forced to send you to collections. This prompted you to call us and I had spoken to you informing you that I could not remove you from the collections which I could not do once it is in process and given your history of lack of response to both statements being sent and messages being left. There was ample time from June till September for you to respond and get the account settled. I do not like sending people to collections but is necessity when people try avoiding paying there bill. The question I ask is why did you not ever try to contact use from June till September when you knew there was an outstanding balance? We can only contact you with the information provided to use by you regarding phone number and address. If you didn't receive it, there is nothing we can do. You may think I never call your legal representative but I did and I did leave a message without response. I also left a message in Dec telling you that there was nothing I can do once you are in collections. Your last visit here was April 29. You were seen for visits. We received your first EOB on May at which time statements were being sent out to you. First response by you was June to pay with your flex account which didn't clear. We didn't hear from you till Oct when you were sent to collections. What happened to you between June and September? From June through the Month of September statements were being mailed to you without response. You did not leave me other options