Focus Physical Therapy

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]

I am responding to the recent complaint (ID [redacted]) we received regarding the care of the complainant.
I understand as stated in the complaint letter that a HIPPA release was signed and accepted and that with the complainant's permission I can legally discuss the facts of this complaint.  If...

this is not the case, please stop reading at this time and destroy this document.
From what is written in the complaint, the complainant is complaining about a breach of contract, a refusal to fix a problem and defamation of character and slander.  These claims are untrue and unfounded, and represent neither accuracy in our business practices nor in the details of this specific claim.
Here is the summary of the complainant's history with our clinic.  The complainant was referred twice over the course of 5 months, initially in April of 2010 for a worker's compensation claim related to plantar fasciitis, and secondly, in October 2010 for injuries sustained in a motor vehicle accident.  These alleged complaints relate to the first episode of care, which was administered by her worker's compensation coverage and paid in full.  These are the pertinent facts as they relate to the complainant's claims of fraudulent claims, breach of contract and other allegations:
Episode One:
1.  The complainant was seen for an evaluation of her left plantar fasciitis, with seven subsequent treatments.  During her care, she was referred by another provider, possible her primary physician, to an orthotist for prescription of custom orthotics.  Based on her claim information, this orthotist may have been with [redacted], which is not owned by us.  Throughout her case, our therapist's notes state that her worker's compensation coverage and prescription of orthotics was delayed and then ultimately denied by her worker's compensation insurance for custom orthotics.  We were not responsible or involved with the referral for custom orthotics, the justification for their use, their coverage by her workers compensation insurance, or any subsequent matters related to custom orthotics.
2.  Standard treatments for plantar fasciitis were performed and documented in her notes, including a trial of tape to support the arch or her foot and a trial of an over the counter insole, of which we carry a demonstration pack in the clinic.
3.  Partly into her case, our therapist sized her with a demonstration model of Superfeet brand over-the-counter insoles as a less expensive alternative to custom orthotics, which at that time we were told were delayed but not completely out of the picture.  The demonstration set of Superfeet insoles are single insoles on a ring, one of each type in the same size.  This initial trial was performed by our therapist who no longer works in the state, and I am unable to verify additional details.  The following note and one other note later in the month during visits with another therapist **, [redacted] state the complainant reported 50% improvement from her use of the OTC insole, and later that her feet felt better in them.  Aside from these two recorded subjective statements, there is no other mention of OTC insoles, and treatments consisted of other interventions which are all standard in the are of plantar fasciitis.
4.  An analysis  of the complainant's billing for the date of service where OTC insoles were trialed and subsequent dates of service show appropriate billing for treatment rendered as stated in the notes, including one 15 minute unit of Therapeutic Activities which would cover trialing, assessment of an insole and educating the complainant on the use of an OTC Insole.  Therapists do not provide Insoles, and no billing far any such insoles appears in her case.  Standard procedures would be to assess the potential benefit of OTC insoles if custom prescribed insoles are not forthcoming, and leave it up to the patient to choose to purchase them in their size as they see fit from a 3rd party.
5.  Superfeet insoles are readily available from sporting good, camping, shoe and specialty running shoe stores, as well as online and cost approximately $35-$40.
6.  At the time of her last visit for this problem, the complainant stated she felt OTC insoles were helping, and she had hired a lawyer to fight for her custom orthotics.
7.  Our clinic does not manufacture, prescribe, fit or bill for custom orthotics, and in this case the referral to an orthotist was made by another Independent provider, not our group.  Our group was also not asked to justify custom orthotics  or to account for them in the case in any way.  Any complaint related to custom orthotics or to harm caused by the lack of custom orthotics should be directed at the parties responsible.
Episode Two
8.  The complainant returned to our clinic for an unrelated second episode of care in October 2010 for treatment of neck and low back pain due to a motor vehicle accident that occurred per her report on 8/29/10.  This also happens to be the Purchase Date in her Revdex.com claim against our company- nothing was purchased, she was not seen by us until October, and this was the date she gave us as her motor vehicle accident date.
9.  33 physical therapy visits were performed for the complainant due to chronic pain, the extent or her injuries and a long recovery with significant deconditioning and weakness.
10.  By mid-December into early January, our treatment notes report the complainant had begun walking more, which she stated was helpful for her pain.  At no time in any of these 33 treatments including after reporting the benefit of walking, did she mention or complain about orthotics or anything else from the previous episode of care.
11.  This episode of care was billed through the complainant's [redacted] insurance, and each billing code matches the treatment rendered appropriately at each session.
12.  The complainant reached the end of her PIP coverage, in part due to an extensive treatment history with other providers concurrent with her physical therapy, and had an outstanding bill of $22227.92 for 12 visits.  She was delinquent in payment of this bill, and after years of effort and multiple attempts to remedy through contact with her and her lawyer's office, was turned over to collections in 2014.
13.  To this date, no resolution to her outstanding balance for this episode of care has been made and her case is still open, unpaid and unresolved with a balance of $2227.92 plus any collection agency fees.
Observations and Remarks
At the beginning of therapy for episode one, her work-related foot injury, the complainant had a well documented history of previous treatment for this as well as other problems including an unstable right knee with knee pain.  She was seeing multiple providers over the course of her two episodes of cared with us and received multiple interventions for each injured region.  Again, never during the course of her two episodes of care or in the subsequent years to follow did she complain once about the care she received at our clinic, and we have recorded multiple times her desire to return for additional care.  This complaint and action has only occurred years after our episode of care, suggesting the real issue is her inability or unwillingness to settle her outstanding balance with the collections agency hired to remedy her delinquent account.
The complainant believes that Focus Physical Therapy is:
responsible for her custom orthotics from [redacted]- her receipt or failure to receive these orthotics is a matter between her referring physician, her workers compensation claim and [redacted]- it has absolutely nothing to do with our plan of care or the treatments she received with us.  The actions of our clinic and therapists during the course of her care could not possibly affect her workers compensation's determination  of her eligibility for orthotics with [redacted].
provided her with OTC insoles- our demonstration ring binder has only one of each insole type (ie a left foot example of the different versions they produce) and there is no way we could have provided insoles for her other than a single shoe trial in the clinic.
responsible for defaming her character/slander- this claim is unfounded, as she is protected under HIPAA, and there is no way we could ever share any information about her to anyone unless they were a covered entity per HIPAA and only then for purposes of her care or resolution of care-related business matters.
responsible for 'refusing to fix the problem'- no record exists from time the time she started care with us in April 2010 through her litigation of her [redacted] case in subsequent years of any complaint by her regarding her care at any time or any mention of a negative effect of any part of her treatment for her either episode of care.  She willingly returned to our clinic some months later after this initial episode for treatment of a different problem (Episode two above- related to her [redacted]) with no mention of any of these issues.
This claim is for activities alleged to have happened in the spring of 2010, but are only emerging now in 2015.  No fewer than 4 contacts including phone calls and letters were recorded by our clinic from the end of her second episode of care and into 2011, with the final documented contact being a letter mailed describing flexible options for re-payment, which was not answered.  During these multiple contacts, again no mention was ever made of complaints related to our care. and in fact records of earlier conversations while her [redacted] case was still in litigation state the complainant wanted to resolve the insurance issues in order to come in for more treatments.  Our later submission of the complainant to collections and their attempts since 2014 to collect her outstanding balance may be the trigger for this retaliatory complaint and attempt to extort money from our company.
Every possible measure was taken with the complainant for years prior to releasing her account to the collections agency, including multiple contacts by phone and written notices. Once individuals are released to collections (an Independent, contracted third party), contact and actions taken by the collection agency in an attempt to recover funds occur independently from the actions and administration of out company.  Any complaints with the collection agency should be made directly with them.
Our clinic has a proven record of industry-leading levels of service and skill, and we approach delinquent cases with more patience and understanding than the industry normal.  I stand behind the work that our therapists do and the professionalism and compassion of all staff members.  We've given this individual every opportunity to address her reasonable and appropriate bill and never received any prior mention of problems.  Thank you for your attention to the matter of this unfounded and erroneous complaint, and please let me know if I can provide any additional information to resolve this complaint.  Additionally, please notify me of the resolution of this case.