East Coast Orthotic & Prosthetic Corp.

Dear [redacted] ,I am responding to complaint ID [redacted] The patient is claiming that she was never informed by the company that she would owe anything Both the practitioner and the customer service representative stated that they never told the patient that she wouldn't owe anything I have attached a document that is time and date stampedThe document shows that our customer service representative verified the patient's benefits and shows she had active coverage and was covered at 80%The patient owes $in coinsurance to East Coast Orthotic & Prosthetic Corp We are contracted with the patient's insurance company to charge her for her coinsuranceThis is a legal obligation It is ultimately the responsibility of the patient to understand the details of her health insurance plan

There has been a misunderstanding between East Coast Orthotic & Prosthetic Corp. (ECOP) and the patient, based on a miscommunication with [redacted], the company that makes the knee brace requested by the patient.  That miscommunication has now been resolved and ECOP has communicated with...

the patient that the correct brace will be provided to her.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me and the matter has been resolved.
Sincerely,
[redacted]

Dear [redacted],I am responding to complaint ID [redacted].  The patient is claiming that she was never informed by the company that she would owe anything.  Both the practitioner and the customer service representative stated that they never told the patient that she wouldn't owe anything....

 I have attached a document that is time and date stamped. The document shows that our customer service representative verified the patient's benefits and shows she had active coverage and was covered at 80%. The patient owes $559.09 in coinsurance to East Coast Orthotic & Prosthetic Corp.  We are contracted with the patient's insurance company to charge her for her coinsurance. This is a legal obligation.  It is ultimately the responsibility of the patient to understand the details of her health insurance plan.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

[Your Answer Here]
The document attached by East Coast Orthotic & Prosthetic Corp shows that they had verified patient's coverage with the health insurance company at 80%, but it doesn't prove that they had notified me that I will owe them a hefty co-pay of  $559.09. East Coast Orthotic & Prosthetic Corp's staff never notified me that I will have to make a co-payment. The Orthotist lead me to believe that I will not be charged for anything by saying that I will be fine since I have a private insurance. "Fine" doesn't mean that I will owe 20% of the cost of night braces. Please provide me with a copy of any and all financial responsibility agreement signed by me.
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

[Your Answer Here]
Even though the business provided the copy of a form which I signed saying that I am responsible for any payment not paid by my insurance, but they never specifically told me how much the co-payment will be. They kept saying you are good most likely your insurance covers it because its a private insurance. If it was a small amount that would have been fine but sending me a co-payment bill of $559 is not fair. They should have given me an idea before I got the foot brace from them. This co-payment needs to be removed. 
 
 
 
 
Sincerely,
[redacted]

Dear [redacted],It is our practice to inform all patients that they are responsible for all applicable insurance deductibles and coinsurance.  In fact the patient product agreement and proof of delivery that was signed by [redacted] on 12-**-14 specifically states that "I understand that all costs for products/services not paid by my insurance carrier will become my responsibility."  Furthermore, the company is prohibited from not collecting such amounts from its patients. I have attached the signed patient product agreement and proof of delivery.

Review: I was told by the orthotist at the doctors office that my insurance will cover the braces and that I won't have to pay anything. About 4 weeks later after picking up the night braces for my toddler, I received a statement from East Coast Orthotic and prosthetic Corp that I owe them $559.09. A day later I received a statement from my insurance company stating that after all the discount they have paid $2,236.31 to East Coat Orthotic and Prosthetic Corp and my responsibility is to pay $559.09. It is not fair for me to pay that huge bill as I was not informed beforehand that I will be billed for that amount, instead the orthotist kept insisting that I will be "fine" because I have a private insurance. After talking to East Coast Orthotics and Prosthetic Corp's customer service representative about my statement, not only she was very rude but she wasn't helpful at all. She said no matter what I have to pay the balance to them and I can go file whatever complain I want to file against them.Desired Settlement: Since the insurance company has already paid East Coast Orthotic and Prosthetic Corp $2,236.31, I shouldn't have to pay anything especially when I wasn't informed in advance of such co-payment.

Business

Response:

Dear [redacted],I am responding to complaint ID [redacted]. The patient is claiming that she was never informed by the company that she would owe anything. Both the practitioner and the customer service representative stated that they never told the patient that she wouldn't owe anything. I have attached a document that is time and date stamped. The document shows that our customer service representative verified the patient's benefits and shows she had active coverage and was covered at 80%. The patient owes $559.09 in coinsurance to East Coast Orthotic & Prosthetic Corp. We are contracted with the patient's insurance company to charge her for her coinsurance. This is a legal obligation. It is ultimately the responsibility of the patient to understand the details of her health insurance plan.