Interwest Interiors Inc

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

Dear *** ***, We understand *** *** feels that we did not adequately explain his summary of benefits and because of his frustration we are happy to honor the $he expected to pay based upon the estimate from his insurance companyWe know insurance verification is a hassle for patients, so we offer that service to help navigate them through insurance claimsWe are only able to quote benefits based upon what the insurance representatives give us at the time, and in all cases (including *** ***'s) we do have records and reference numbers to help resolve the disputeAt the time that we were going through this process for *** ***, it was a perfect storm of bad coincidences*** was in the process of renegotiating our contract, and once the contract was updated the rates changedSimilar situations happen all too often, so we do our best to ensure each patient knows that what we provide in advance is the best estimate possible at the timeInitially our Care Coordinator did not feel that they had the necessary information to answer *** ***’s questions effectively and did not want to give him incorrect informationThat is why there was a delay in responseAs mentioned, in light of these facts and because we want to be fair to *** ***, we are willing to accept the $amountMoving forward, we will continue to work with our Care Coordinator teams to make sure that each patient has more clear understanding of their patient responsibility and we will be sure to emphasize the written portion that states that it is an estimate based upon the information provided by the individual insurance companyBest, Cathy C***, PT, DPT, SCS Clinical Director, SPEAR Physical Therapy, Midtown West

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]
 
When I signed the paperwork, it was explained that it was a contract, not an estimate of benefits. I would happily pay the $72 that I was instructed I would have to pay. It was explained on that visit in question that they 'would figure out the billing issue'. If it was explained that the charge for 1 physical therapy session would be $158 vs 72, I would have walked out the door and not accepted any service. further, my deductible goes from July to July.  I don't have a deductible based on calendar year.  
 
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
Sincerely,
[redacted]

Dear [redacted], My name is Cathy C[redacted] and I am the Clinical Director for SPEAR Physical Therapy’s Midtown West office, where [redacted] was treated. I am very sorry that he feels that we incorrectly billed for his treatment, and I can understand his frustration. Upon initial evaluation,...

on 11/*/2015, [redacted] signed a Summary of Benefits stating that his “Estimated Patient Responsibility” was “$72 for each visit for 36 visits then $14”. At that point, [redacted] had not reached his deductible and was paying our best estimate for [redacted]’s reimbursement for physical therapy visits. This estimate is based upon our best ability to predict the reimbursement from [redacted] for 2015, but we do not know the exact amount from each session until after each claim is processed through the insurance company, which can take up to 90 days. In 2016, [redacted]’s insurance company, [redacted], changed their reimbursement contract with our company, which resulted in a change in our bi lling estimates, which we based upon the information provided by [redacted]. The summary of benefits that we had requested [redacted] sign indicated that until his deductible was met, his “Estimated Patient Responsibility” would be $120. Again, we do our best to predict the charges for each patient, based upon feedback that they would like to pay for individual sessions rather than receive a large bill once all dates of service have processed. Once his date of service on 1/*/2016 was processed, the charges that processed towards his deductible was $158.76. We would like to come to a mutual resolution with [redacted] and we are sorry that he had a negative experience. Cathy C[redacted], PT, DPT, SCS Clinical Director, SPEAR Physical Therapy [redacted]