Nova Pain & Rehab Center

Review: Deceptive billing practice during car accident treatment. I was not fully informed that my treatment could be billed through my medical insurance. I was told that they'll deal with the other person's auto insurance for payment. Settlement was paid to directly to me. Was told I owed over $5k. Asked to negotiate rates because they accept rates much lower than that from my insurance company. Was told by the Dr., "Our rates are our rates. If you want to be mad at anyone be mad at the insurance." Asked them to then file with my medical insurance. Was told they checked and could not because it was not considered timely (over 90 days), but I might be able to get some reimbursement, but my bill was still over $5k. Made an offer of $3k settlement. Was told only 20% discount, but had to be paid within 3 days. Paid because I didn't want to be on the hook for the $5000+. I filed with my insurance, they sent check to doctor instead of me. ONLY $1688. My insurance told them that I could in fact file and have them be paid even though it had been past 90 days. This information was not passed on to me. This is why they rushed my settlement payment. They knew if I filed with insurance, and the check was sent from [redacted], they would have to accept [redacted]'s negotiated rates for coverage. Received fine treatment at this facility, but these deceptive practices started once I was in a car accident and they saw dollar signs. I saw three other doctors or PT's during my car accident, and there was never a question of whether they would bill through my medical insurance. All of the others billed directly and immediately. NOVA Pain took advantage of my lack of how insurance really works in Virginia.Desired Settlement: I want $2323.03 refunded to me, and for them to accept my insurance company's payment of $1688.17 as payment in full like they should have originally.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is not satisfactory to me, but it is clear that the practice's integrity and ethics are not where I assumed them to be, so I feel that fighting them will be a waste of time. I'm tempted to file an ethics complaint with their medical board. I have responses to their assertions so they can be posted with the case for the public to see.

1. They may have told me (I honestly don't remember) that I could in fact file with my insurance, but I do know they certainly did not encourage it. I

said, and I quote, "I don't believe I can because it was an auto

accident." Shantelle just nodded at intake. She could have corrected

me then, and said that I actually could. Instead they said they would

work directly with the insurance company. There is no law that says

personal injury cases have to billed from the get go. In fact, I sent

the bills to my insurance after the fact, and my insurance company paid

them! They did return the check because they had already been paid by

me in full (see explanation of that below).

2. I was not given updated bills as the current

treatment amounts throughout the process. That is a fallacy. The only

bill I saw was at the end.

3. The "large check" settlement I

received was based mostly on my lost income for work time lost seeking

treatment and pain and suffereing, not the medical bills. They have

no clue how much I got, and should consider the fact that it has to be satisfactory to

continue the treatment should I have a relapse. They assume it's large,

and therefore feel it's okay to charge exorbitant rates.

4. When I

didn't bill through insurance for a time, they charged me

$40-$65/treatment. Going through insurance, they received

$60-$100/treatment. Their "settlement" offer is still over $150/visit.

5. I have not been slanderous, as I have not stated anything that is not true.

6.

They understand insurance way better than their patients, and if they

truly care about their patients, they should do what's right for their

patients in all instances. It's not like they weren't going to get paid at all. The

treatment I received for the injury was no different than treatment I

could receive going there anytime, so their services did not take extra

time. The so called time they took with the auto insurance adjusters is no more time than it would have taken for them to submit it to my insurance. They provided no extra services during my injury time that merit the increase in charges.

7. I know they were told that I could file with my insurance and they could get paid. Instead, that's when they offered me the "discount" for a quick payment. They knew as soon as I filed with my insurance, they would have to accept that payment. If that's not deceptive, I don't know what is.

Regards,