Elite Physical Therapy Group LLC

[redacted] made this complaint to me personally through email.? I am the owner of Elite Physical Therapy and did not work with [redacted] as a patient so I gathered all the information I could on the situation to address it appropriately.? This is what I learned:? [redacted] reports that he was told by our staff that he did not have a co-pay with his insuranceI cannot confirm or deny this with any confidence as Lori, whom he states is the person who told him he had no co-pays, no longer works for Elite Physical TherapyI then reviewed [redacted] file in our system and found his Insurance Verification form.? This is a form we fill out after checking the patient's insurance benefits.? Our staff records the patient's insurance benefit on the sheet and then reviews the information with the patient at their first visit.? We did this with [redacted] as his signature is on the form that we have.? This form states clearly that he has a $co-pay.? Again, [redacted] signed this form acknowledging that he had read and understood itSince I was not present at his first visit, I cannot confirm any conversation that he may have had with Lori.? All I can do is look at the facts that we have, and his signature on the insurance verification tells me he was given the information about his co-pay.? Unfortunately the co-pay was not collected at the time of service In effort to resolve the situation amicably our company contacted his insurance company (Sound Path) twice and asked them if we could be allowed to reduce his co-pay's since he was frustrated about the situation.? We received the same response after both phone calls:? We are not allowed to reduce the copay's.? If we did, it would be a violation of our contract with Sound PathWe are not able to see Sound Path patients if we lose our contract with them, therefore reducing the co-pays was not an option.? We explained this to ***, but he was not understanding.? He continued to assert that we needed to own the mistake and fix it in his favor.? He could not see our need to honor our contract with his insurance companyAgain, the only facts in my possession are a copy of his insurance verification with HIS signature on itAll my efforts to reduce his bill were simply made to appease his frustration and try to repair a relationship with him.? The facts in my possession did not support his position.? However, we reached out once more and told him that we would accept his offer of paying $dollars in total if he would contact his insurance company and get them to approve in writing or via phone call to us that we could reduce his? co-pay? bill without violating our contract? He did so and his insurance company told us we could not reduce his bill but we could waive his co-pays.? Therefore we honored his request to allow him to pay only $in total and we waived the remainder of his bill I am surprised that he would make a complaint after we did all we could in meeting his terms and expectations.? If I could offer any parting advice, I would suggest that he be proactive about checking his own insurance benefits.? As a subscriber, he is responsible to know his own coverage and it's limitations.? Every health care organization in existence will check insurance benefits as a courtesy to their patients, but health care organizations are not responsible to know the subscribers coverage better than the insurance company or the patientWe are disappointed to lose [redacted] as a patient, but we honestly did all that we could in? meeting his expectations short of violating? our contract with? Sound Path, which we simply could not do? Kind Regards

To Whom It May Concern, Thank you for reaching out to us regarding this patient's concernsWe appreciate your recognition that there are two sides to every story, and are happy to let you know our process and steps with this accountWe understand from a patient's perspective how complicated and confusing medical billing can be and would love to do anything we can to help make the process and billing clearerFor this patient specifically, we received the medical insurance information from her mother and did a benefit check before treatment was providedAt her first appointment, her mother was presented a form that explained all benefit information that was disclosed to us, which indicated that they had a $1,deductible and none of it had been metOur company requires an initial payment of $for all visits that will apply to a deductible to lessen the bill that the patient receives later onUnfortunately, we do not have the ability know beforehand the exact amount that the insurance will allocate to the deductible for the visitThe patient's mother signed a form stating all of this and indicating that we should bill her insuranceWe do not have record of her requesting to be a self pay patientAll visits were billed to the patient's health insurance agency per this formAt the conclusion of care the patient's mother received a statement for the remaining balance owing for the insurance visits that had processedAt this time, the patient's mother called our office and stated she would not be paying it, and hung up on our billerWithin the next billing cycle, the remaining visits processed through her insurance company and the rest of her balance was added to her statement We sent out two additional statementsWe did not receive any response or paymentWe then sent the patient's mother a final notice stating the date she would be sent to collections and whyWe did not receive any responseWe did not at any point change the CPT codes that were sent to the insurance agencyAll CPT codes that we bill are charged at the same rate and are determined by what treatment our therapist provides during the appointmentThe amount that we are reimbursed is then determined by the established fee schedule of the insurance company and the specific plan the patient hasThe entirety of the balance in question matches the explanation of benefits (EOB) we received from her insurance agency.After being sent to collections, the patient's mother lodged a very similar complaint on our Yelp pageWe immediately responded that we would like to work with her to resolve the situation, and asked her to call our billing officeWe called our collection agency to withdraw her account, and have held it out of collections as a courtesyWe have not received any responseUnfortunately, it would be a violation of our contract with her insurance company not to collect her remaining balance in fullHowever, we would be happy to discuss options with the patient's mother that will bring this matter to a mutually beneficial closeThank you for your time and considerationPlease let us know if there is any other information that you need

[redacted] made this complaint to me personally through email I am the owner of Elite Physical Therapy and did not work with [redacted] as a patient so I gathered all the information I could on the situation to address it appropriately This is what I learned: [redacted] reports that he was told by our staff that he did not have a co-pay with his insuranceI cannot confirm or deny this with any confidence as Lori, whom he states is the person who told him he had no co-pays, no longer works for Elite Physical TherapyI then reviewed [redacted] file in our system and found his Insurance Verification form This is a form we fill out after checking the patient's insurance benefits Our staff records the patient's insurance benefit on the sheet and then reviews the information with the patient at their first visit We did this with [redacted] as his signature is on the form that we have This form states clearly that he has a $co-pay Again, [redacted] signed this form acknowledging that he had read and understood itSince I was not present at his first visit, I cannot confirm any conversation that he may have had with Lori All I can do is look at the facts that we have, and his signature on the insurance verification tells me he was given the information about his co-pay Unfortunately the co-pay was not collected at the time of service In effort to resolve the situation amicably our company contacted his insurance company (Sound Path) twice and asked them if we could be allowed to reduce his co-pay's since he was frustrated about the situation We received the same response after both phone calls: We are not allowed to reduce the copay's If we did, it would be a violation of our contract with Sound PathWe are not able to see Sound Path patients if we lose our contract with them, therefore reducing the co-pays was not an option We explained this to ***, but he was not understanding He continued to assert that we needed to own the mistake and fix it in his favor He could not see our need to honor our contract with his insurance companyAgain, the only facts in my possession are a copy of his insurance verification with HIS signature on itAll my efforts to reduce his bill were simply made to appease his frustration and try to repair a relationship with him The facts in my possession did not support his position However, we reached out once more and told him that we would accept his offer of paying $dollars in total if he would contact his insurance company and get them to approve in writing or via phone call to us that we could reduce his co-pay bill without violating our contract He did so and his insurance company told us we could not reduce his bill but we could waive his co-pays Therefore we honored his request to allow him to pay only $in total and we waived the remainder of his bill I am surprised that he would make a complaint after we did all we could in meeting his terms and expectations If I could offer any parting advice, I would suggest that he be proactive about checking his own insurance benefits As a subscriber, he is responsible to know his own coverage and it's limitations Every health care organization in existence will check insurance benefits as a courtesy to their patients, but health care organizations are not responsible to know the subscribers coverage better than the insurance company or the patientWe are disappointed to lose [redacted] as a patient, but we honestly did all that we could in meeting his expectations short of violating our contract with Sound Path, which we simply could not do Kind Regards

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 meSincerely, [redacted]

To Whom It May Concern, Thank you for reaching out to us regarding this patient's concernsWe appreciate your recognition that there are two sides to every story, and are happy to let you know our process and steps with this accountWe understand from a patient's perspective how complicated
and confusing medical billing can be and would love to do anything we can to help make the process and billing clearer. For this patient specifically, we received the medical insurance information from her mother and did a benefit check before treatment was providedAt her first appointment, her mother was presented a form that explained all benefit information that was disclosed to us, which indicated that they had a $1,deductible and none of it had been metOur company requires an initial payment of $for all visits that will apply to a deductible to lessen the bill that the patient receives later onUnfortunately, we do not have the ability know beforehand the exact amount that the insurance will allocate to the deductible for the visitThe patient's mother signed a form stating all of this and indicating that we should bill her insuranceWe do not have record of her requesting to be a self pay patientAll visits were billed to the patient's health insurance agency per this form. At the conclusion of care the patient's mother received a statement for the remaining balance owing for the insurance visits that had processedAt this time, the patient's mother called our office and stated she would not be paying it, and hung up on our billerWithin the next billing cycle, the remaining visits processed through her insurance company and the rest of her balance was added to her statement. We sent out two additional statementsWe did not receive any response or paymentWe then sent the patient's mother a final notice stating the date she would be sent to collections and whyWe did not receive any response. We did not at any point change the CPT codes that were sent to the insurance agencyAll CPT codes that we bill are charged at the same rate and are determined by what treatment our therapist provides during the appointmentThe amount that we are reimbursed is then determined by the established fee schedule of the insurance company and the specific plan the patient hasThe entirety of the balance in question matches the explanation of benefits (EOB) we received from her insurance agency.After being sent to collections, the patient's mother lodged a very similar complaint on our Yelp pageWe immediately responded that we would like to work with her to resolve the situation, and asked her to call our billing officeWe called our collection agency to withdraw her account, and have held it out of collections as a courtesyWe have not received any responseUnfortunately, it would be a violation of our contract with her insurance company not to collect her remaining balance in fullHowever, we would be happy to discuss options with the patient's mother that will bring this matter to a mutually beneficial close. Thank you for your time and considerationPlease let us know if there is any other information that you need.

*** *** made this complaint to me personally through email. I am the owner of Elite Physical Therapy and did not work with *** as a patient so I gathered all the information I could on the situation to address it appropriately. This is what I learned: *** reports that he was
told by our staff that he did not have a co-pay with his insuranceI cannot confirm or deny this with any confidence as Lori, whom he states is the person who told him he had no co-pays, no longer works for Elite Physical TherapyI then reviewed *** file in our system and found his Insurance Verification form. This is a form we fill out after checking the patient's insurance benefits. Our staff records the patient's insurance benefit on the sheet and then reviews the information with the patient at their first visit. We did this with *** as his signature is on the form that we have. This form states clearly that he has a $co-pay. Again, *** signed this form acknowledging that he had read and understood itSince I was not present at his first visit, I cannot confirm any conversation that he may have had with Lori. All I can do is look at the facts that we have, and his signature on the insurance verification tells me he was given the information about his co-pay. Unfortunately the co-pay was not collected at the time of service
In effort to resolve the situation amicably our company contacted his insurance company (Sound Path) twice and asked them if we could be allowed to reduce his co-pay's since he was frustrated about the situation. We received the same response after both phone calls: We are not allowed to reduce the copay's. If we did, it would be a violation of our contract with Sound PathWe are not able to see Sound Path patients if we lose our contract with them, therefore reducing the co-pays was not an option. We explained this to ***, but he was not understanding. He continued to assert that we needed to own the mistake and fix it in his favor. He could not see our need to honor our contract with his insurance companyAgain, the only facts in my possession are a copy of his insurance verification with HIS signature on itAll my efforts to reduce his bill were simply made to appease his frustration and try to repair a relationship with him. The facts in my possession did not support his position. However, we reached out once more and told him that we would accept his offer of paying $dollars in total if he would contact his insurance company and get them to approve in writing or via phone call to us that we could reduce his co-pay bill without violating our contract He did so and his insurance company told us we could not reduce his bill but we could waive his co-pays. Therefore we honored his request to allow him to pay only $in total and we waived the remainder of his bill
I am surprised that he would make a complaint after we did all we could in meeting his terms and expectations. If I could offer any parting advice, I would suggest that he be proactive about checking his own insurance benefits. As a subscriber, he is responsible to know his own coverage and it's limitations. Every health care organization in existence will check insurance benefits as a courtesy to their patients, but health care organizations are not responsible to know the subscribers coverage better than the insurance company or the patientWe are disappointed to lose *** as a patient, but we honestly did all that we could in meeting his expectations short of violating our contract with Sound Path, which we simply could not do
Kind Regards

Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to meSincerely, *** ***

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. Sincerely, [redacted]

To Whom It May Concern, Thank you for reaching out to us regarding this patient's concerns. We appreciate your recognition that there are two sides to every story, and are happy to let you know our process and steps with this account. We understand from a patient's perspective how complicated...

and confusing medical billing can be and would love to do anything we can to help make the process and billing clearer. For this patient specifically, we received the medical insurance information from her mother and did a benefit check before treatment was provided. At her first appointment, her mother was presented a form that explained all benefit information that was disclosed to us, which indicated that they had a $1,000 deductible and none of it had been met. Our company requires an initial payment of $85.00 for all visits that will apply to a deductible to lessen the bill that the patient receives later on. Unfortunately, we do not have the ability know beforehand the exact amount that the insurance will allocate to the deductible for the visit. The patient's mother signed a form stating all of this and indicating that we should bill her insurance. We do not have record of her requesting to be a self pay patient. All visits were billed to the patient's health insurance agency per this form. At the conclusion of care the patient's mother received a statement for the remaining balance owing for the insurance visits that had processed. At this time, the patient's mother called our office and stated she would not be paying it, and hung up on our biller. Within the next billing cycle, the remaining visits processed through her insurance company and the rest of her balance was added to her statement.  We sent out two additional statements. We did not receive any response or payment. We then sent the patient's mother a final notice stating the date she would be sent to collections and why. We did not receive any response. We did not at any point change the CPT codes that were sent to the insurance agency. All CPT codes that we bill are charged at the same rate and are determined by what treatment our therapist provides during the appointment. The amount that we are reimbursed is then determined by the established fee schedule of the insurance company and the specific plan the patient has. The entirety of the balance in question matches the explanation of benefits (EOB) we received from her insurance agency.After being sent to collections, the patient's mother lodged a very similar complaint on our Yelp page. We immediately responded that we would like to work with her to resolve the situation, and asked her to call our billing office. We called our collection agency to withdraw her account, and have held it out of collections as a courtesy. We have not received any response. Unfortunately, it would be a violation of our contract with her insurance company not to collect her remaining balance in full. However, we would be happy to discuss options with the patient's mother that will bring this matter to a mutually beneficial close. Thank you for your time and consideration. Please let us know if there is any other information that you need.

[redacted] made this complaint to me personally through email.  I am the owner of Elite Physical Therapy and did not work with [redacted] as a patient so I gathered all the information I could on the situation to address it appropriately.  This is what I learned:  [redacted] reports that he was...

told by our staff that he did not have a co-pay with his insurance. I cannot confirm or deny this with any confidence as Lori, whom he states is the person who told him he had no co-pays, no longer works for Elite Physical Therapy. I then reviewed [redacted] file in our system and found his Insurance Verification form.  This is a form we fill out after checking the patient's insurance benefits.  Our staff records the patient's insurance benefit on the sheet and then reviews the information with the patient at their first visit.  We did this with [redacted] as his signature is on the form that we have.  This form states clearly that he has a $40 co-pay.  Again, [redacted] signed this form acknowledging that he had read and understood it. Since I was not present at his first visit, I cannot confirm any conversation that he may have had with Lori.  All I can do is look at the facts that we have, and his signature on the insurance verification tells me he was given the information about his co-pay.  Unfortunately the co-pay was not collected at the time of service.
In effort to resolve the situation amicably our company contacted his insurance company (Sound Path) twice and asked them if we could be allowed to reduce his co-pay's since he was frustrated about the situation.  We received the same response after both phone calls:  We are not allowed to reduce the copay's.  If we did, it would be a violation of our contract with Sound Path. We are not able to see Sound Path patients if we lose our contract with them, therefore reducing the co-pays was not an option.  We explained this to [redacted], but he was not understanding.  He continued to assert that we needed to own the mistake and fix it in his favor.  He could not see our need to honor our contract with his insurance company. Again, the only facts in my possession are a copy of his insurance verification with HIS signature on it. All my efforts to reduce his bill were simply made to appease his frustration and try to repair a relationship with him.  The facts in my possession did not support his position.  However, we reached out once more and told him that we would accept his offer of paying $240 dollars in total if he would contact his insurance company and get them to approve in writing or via phone call to us that we could reduce his co-pay bill without violating our contract.  He did so and his insurance company told us we could not reduce his bill but we could waive his co-pays.  Therefore we honored his request to allow him to pay only $240 in total and we waived the remainder of his bill.
I am surprised that he would make a complaint after we did all we could in meeting his terms and expectations.  If I could offer any parting advice, I would suggest that he be proactive about checking his own insurance benefits.  As a subscriber, he is responsible to know his own coverage and it's limitations.  Every health care organization in existence will check insurance benefits as a courtesy to their patients, but health care organizations are not responsible to know the subscribers coverage better than the insurance company or the patient. We are disappointed to lose [redacted] as a patient, but we honestly did all that we could in meeting his expectations short of violating our contract with Sound Path, which we simply could not do.  
Kind Regards