Kelley Counseling PLLC

Kelley Counseling has submitted claims to my health insurance company that were not authorized nor should have been claimed through my insurance.Kelley Counseling has fraudulently submitted claims to my health insurance company and failed to reimburse me for payment they received. I notified them on January 5, 2016 that I had received several Explanation of Benefits (EOB) statements from my insurance company ,for services for my daughter, that should not have been claims against my insurance. I requested they immediately cease submission of any claims. The counselor apologized, stated she had been billing through another account or self-pay and would follow-up with the billing department. On February 19th, I received another EOB from my insurance company for a claim Kelley counseling submitted on January 20th for services on January 11th and confirmation that payment for these billed services were taken from my Health Reimbursement account and paid to Kelley counseling. I immediately contacted Kelley counseling. I received a response from the counselor advising she had contacted their billing staff, [redacted], to follow up and resolve the issue. Included in this email was their internal exchange where the counselor advised [redacted] that she did not know how to respond to me since there was no reason they should have been billing my insurance company. As of today, March 25, 2016, I have yet to receive a refund for the money Kelley counseling received nor has it been credited back to my reimbursement account. In addition, all of the 2015 claims are still applied against my insurance and another claim was processed against my insurance account (my insurance company did deny the last claim). Kelly Counseling offered no apology for the continued submission of claims after I notified them to immediately cease on January 5th and has not corrected their errors.Desired SettlementI would like a refund for the money Kelley Counseling received through my health reimbursement account and for all the claims, including the ones filed in 2015, to be cancelled with my insurance company.Business Response Contact Name and Title: [redacted], MS, LPCContact Phone: XXXXXXXXXXContact Email: [redacted]@gmail.comClinician responded to individual's initial report of concerns on January 5, 2016 and communicated with billing person same day. Individual reported on January 5, 2016 it may be a confusion between her and her husband's insurance regarding their daughter On February 19, 2016 individual reported by email having another insurance claim processed. Clinician followed up with billing person same day to investigate and/or resolve issue. Clinician directed individual to billing person on February 19, 2016. On February 26, 2016 individual requested to be advised for timeline regarding refund of claims, billing person responded same day, indicating the claims have been requested to be voided and indicated 1 check was received for payment. Billing staff submitted corrections to have claims removed from individual's[redacted] account and confirmed with [redacted] that claims were removed on 3/4/2016, reference number [redacted] In addition, clinician on 3/28/16 followed up with individual by email stating the claims were removed as of 3/4/16 and provided the reference number. Clinician also stated that a check with the refund of $100 could be mailed or available for pick up from counseling office, also apologizing for any inconvenience this situation may have caused. At this present time the check has been written and is being disbursed to the individual via mail in an effort to resolve this matter. If you would like an image of the check please let us know. Thank you for your time. Consumer Response It is discouraging to see the facts continue to be misrepresented. There was email communication on September 29, 2015 and October 20, 2015 regarding my insurance so there would be no reason why anyone should still be confused on January 5th, 2016. In addition, I have a copy of an internal email their own clinician sent to their billing person stating that she didn't know how to respond to my email, regarding the fact that claims continued to be submitted to my insurance through February 2016 (even after my email on January 5th, 2016), because "there is no reason that we would be billing her insurance". On February 26th, 2016 their billing person sent an email stating she had canceled the claims with my insurance company and the check they received two days prior would be returned to my insurance company to be reissued to me. In their response to the Revdex.com (Revdex.com) complaint, they state that the claims were removed on March 4th, 2016. I had contacted my insurance company numerous times prior to reaching out to the Revdex.com for assistance and, as of March 25th, 2016, they had not received any request to cancel the claims nor did they receive the check that was supposedly returned to them on February 26th. Only after the Revdex.com contacted Kelly Counseling was any action taken to correct these issues. [redacted] confirmed that the request to cancel the claims was only submitted by Kelley Counseling on March 28th, 2016 and that the reference number provided was issued on March 28th, 2016. In an effort to provide Kelley Counseling the benefit of the doubt, I called and spoke to three different [redacted] representatives, over two days, and all three advised the same; that the request to cancel the claims was submitted on March 28th, 2016 and the reference number was issued the same day. They explained that it takes 7 to 10 days to process the request so if it had been submitted on February 26th or March 4th, it would have already been processed. Nonetheless, I finally received a refund check, and a card with an apology note from the clinician, directly from Kelley Counseling on April 2nd, 2016. Since [redacted] only received the request to cancel the claims on March 28th, they expect to complete the review no later than April 8th, 2016 and will send me a report to confirm all claims were included. Thank you, Revdex.com, for resolving this issue!Final Consumer Response