Physiotherapy Associates

--------- Forwarded message ----------From: Revdex.com of Metro Washington DC<[email protected]>Date: Thu, Jan 15, 2015 at 10:05 AMSubject: Fwd: ID# [redacted] - [redacted]To: [redacted] <[redacted]@myRevdex.com.org>
---------- Forwarded message ----------From: F[redacted], Maureen <[redacted]@physiocorp.com>Date: Wed, Jan 14, 2015 at 10:04 AMSubject: ID# [redacted] - [redacted]To: "[email protected]" <[email protected]>
Attn:  [redacted]
 
In response to your question, I have corresponded with the treating PT and she indicates that she was never provided a form.  Typically the physician actually completes the form using the information provided on the DWA.  The doctor provides a prescription for a DWA which we do and provide to him.  [redacted]’s claim is inaccurate.
 
Maureen F[redacted]
Manager Legal and Regulatory Affairs
Physiotherapy Associates

We
have reviewed [redacted]'s complaint and disagree with her assessment of the
charges for March 12th.  [redacted] was correctly billed as follows:
rgb(0, 0, 0); font-style: normal; font-weight: normal;">1 unit Eval
2 units Ther Ex (18 mins)
1 unit Man Ther (8 mins)
1 unit Ther Act (14 mins). 
Each
unit is for 1 to 15 minutes. 
As
a courtesy to [redacted] we are rebilling that day of service as follows: 
1 unit Eval
1 unit Ther Ex
1 unit Man Ther
If
you should have any questions or require any additional information, please do
not hesitate to contact me.
Regards,
Maureen F[redacted]
Manager Legal & Regulatory Affairs
Physio™
[redacted]
Exton, PA  [redacted]
P ###-###-####
F ###-###-####

January 30, 2015
Revdex.com serving Metro Washington DC & Eastern Pennsylvania (Washington, DC)1411 K St. NW, 10th Floor Washington, DC 20005-3404
Re: Revdex.com Case ID [redacted])
Thank-you for bringing this customer issue to our attention.  It is our goal to provide excellent service to our patients and we take matters such as these very seriously.
Ms. [redacted] wrote in with concerns of a refund. We billed all claims to her insurance, collected a good faith estimate from the patient at the time of service, and once insurance paid her claims, and adjustments were made based on her benefits, a refund check was issued.
Check # [redacted] was released 12/24/2014 in the amount of $79.63. Ms. [redacted] did not agree with the amount, but we have advised her that the total patient responsibility for all dates of service was $1044.28 ( $912.81 deductible + $131.47 coinsurnace ) and Ms. [redacted] paid a total of $1134.91 leaving an overpayment amount of $79.63.
At this time, there is no patient responsibility at and the overpayment has been returned.
.
We apologize for any frustration that this may have caused Ms. [redacted].
 
Sincerely,
Kristen C[redacted]
Customer Service Supervisor
Physiotherapy Associates

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because: Ms. N[redacted] is a liar.  I presented the Social Security form to her when I first registered.  That's when she informed me that they would complete the form right after the exam, as long as I paid the money up-front. Their male receptionist witnessed everything.  Ms. N[redacted] is insensitive and  unethical. Furthermore, when I got off the treadmill, I was gasping for breath, and Ms. N[redacted] got angry because I wanted to rest.  So,  Just give me back my money, and we can all move on.
Regards,
[redacted]

[A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
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. 
Regards,
[redacted]
thank you for your help  I will have a check in the mail Saturday
just wondering why this was not done when I called
would have been better for all of us
thank you again
[redacted]
id [redacted]

Deborah N[redacted], Physical Therapist and Clinic Director,  performed a Disability Work Assessment (DWA) on Ms. Janet
[redacted] on 11/21/2014 at the request of [redacted]'s physician,...

Dr. [redacted]. 
Dr. [redacted] was faxed a copy of the report. 
[redacted] picked up a copy of the DWA on 11/28/2014.
[redacted] called to discuss the DWA report with Deborah N[redacted] on 11/28/2014.  [redacted] was
irate on the phone and disturbed concerning the content of the DWA report.  [redacted] did not allow Ms. N[redacted] to respond to her
remarks and [redacted] subsequently hung up. During the phone conversation, [redacted] indicated that she felt her character was being attached in the report and no one was going to destroy her effort to get disability.  She said she was giving Ms. N[redacted] until noon on Monday (12/1/2014) to change her
report.
The results of a DWA are based on a review of the medical
records sent to Ms. N[redacted]; review of client written documentation regarding work history ; various standardized questionnaires; and on two hours of observations of
physical and functional abilities in the clinic.  Ms. N[redacted]'s professional opinion is
based upon all those factors.  Ms. N[redacted] stands by her observations and subsequent report.  She cannot change the record. 
[redacted] was sent a cease and desist letter on December 1, 2014.
Regards,
Maureen F[redacted]
Manager Legal & Regulatory Affairs
Physiotherapy Associates
855 Springdale Drive, Ste 200
Exton, PA  19341
P ###-###-####
F ###-###-####

We have reviewed the account, please see the details of our analysis below.
Our patient, [redacted] has CO HealthOP as her only insurance. It appears that her first visit (DOS 8/26/15) was processed Out of Network in error and has been appealed. The...

remaining 18 visits were processed correctly In-Network and applied towards the patient’s deductible. I personally called CO HealthOP on March 28th 2016 and they sent the IE claim (DOS 8/26/15) back to reprocess under our correct TAX ID#. The patient has still not met their deductible so she will be responsible for our fee schedule rates once it is finalized.
We have attached an account overview summary and a copy of all documents received from CO Health OP to date so you can verify.
All charges except the initial visit have been adjusted to reflect the accurate deductible amount per the Colorado HealthOP Explanation Of Benefits (EOB). The 97010 (hot/cold packs) charges show the patient responsible for $6.89 per our fee schedule and the insurance EOB for each visit where the service was rendered.
According to the forms reviewed and signed by the patient at her first visit, the patient was advised that she had not met any of her $6,500 deductible prior to treatment. The agreement was that the patient would pay $50 "in good faith" per visit (signed on 8/26/15 and attached) until the exact patient responsibility was applied by CO Health OP. The patient made only two of these agreed payments (on 10/22 & 10/28/15). We received a $15 payment on 11/2/15 and a payment of $100 on 1/27/16. Mr Ivan recently made a $50 payment on 4/19/16 making the total patient payments to date equal $265.00.  
The patient is being billed correctly and does owe the balance being billed to her for 18 visits (DOS 9/1/15 – 11/13/15) which totals $1,728.12. The patient will also be responsible for the contracted allowed amount for her initial visit (DOS 8/26/15) once we received the reprocessed Explanation of Benefits from CO Health OP.
If you have any further questions, please let us know.
Thank you!

This issue was brought to our attention on 9/4/15 and we immediately began working to get this resolved.  When we originally received the Explanation of Benefits from the patient's insurance company, [redacted], they indicated a patient balance responsibility of $340.00 as part...

of the patient's co-insurance.  Therefore, accordingly, we moved that balance to reflect patient responsibility.  Shortly after 9/4/15 we called the patient's insurance company to verify if our claim had been processed correctly.  [redacted] advised that they had processed our claim incorrectly, placing $340.00 as patient responsibility which exceeded the case fee amount.  [redacted] is now reprocessing our claim per our request and we should receive a corrected Explanation of Benefits from them within the next 3-4 weeks.  In the meantime we regret that the patient received a call from us regarding a balance owed.  We have moved that balance out of patient responsibility so the patient will not receive any more calls.  We will wait for [redacted] to send out the corrected EOB at which time we will post to the patient's account.  We encourage the patient to contact their insurance company should this issue arise again.  Thank-you for the opportunity to serve.
Joe M[redacted]
Manager
Physiotherapy Associates - Customer Service Department

I have been calling and emailing Physiotherapy Associates asking them to put my charges thru my insurance company before the deadline, so I will not have to pay so much out of pocket for their services...

. The deadline isn't up yet, but is nearing is what the insurance company told me, but Physiotherapy still hasn't submitted the claims to my insurance company. The Physiotherapy employees are saying they will call me back, but nobody has called me back yet, and I have been calling and emailing Physiotherapy for a while. I have another order from my Orthopedic for physical therapy which I had scheduled with Physiotherapy, but I cancelled it after seeing this poor customer service from Physiotherapy Associates employees!For Physiotherapy employees to call me and get my insurance information and put my physical therapy charges thru my insurance company today before the deadline, so I don't have to pay so much out of pocket!

Revdex.com of Metro Washington DC & Eastern Pennsylvania (Washington, DC)1411 K St. NW, 10th Floor Washington, DC 20005-3404
 
Re: Revdex.com Case ID [redacted] ([redacted])
 
We are in receipt of the complaint filed with the Revdex.com by **. [redacted].  When verifying benefits, the local office was advised that the patient had a $147 deductible and that her plan processes claims at 80% insurance responsibility and 20% patient responsibility. They in turn advised the same to **. [redacted].
 
Subsequently, the claims were processed by the insurance with only $34.96 being applied to her deductible, and there are still dates of service outstanding that the patient has paid a $20 per visit good faith estimate.
 
At this time we cannot determine an accurate overpayment amount on the account, as there are still dates of service that have not been processed by the insurance carrier.  We will be happy to refund any overpayment amount to **. [redacted] once we have received that payment from her insurance.   We apologize for any inconvenience that this may have caused **. [redacted].
 
 
Sincerely,
 
 
 
[redacted]
Customer Service Supervisor
 Physiotherapy Associates

---------- Forwarded message ----------From: [redacted] <[redacted].[redacted]>Date: Thu, Jun 12, 2014 at 11:55 AMSubject: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania complaint #[redacted].To: "[redacted]" <[redacted]>Cc: "[redacted]" <[redacted].[redacted]>
Hello [redacted],
As per our conversation, we are processing the refund to the patient , attached is the letter we will be sending.
 
 
Thank you,
[redacted]
Customer Service Team Supervisor | Patient Support Center MRSC | Toll Free ###-###-#### | Fax ###-###-####

Complaint: [redacted]
I am rejecting this response because:The business did not address the concerns in the original complaint as follows:1) Why their represent admitted that they have "had problems with our insurance."2) Why the therapist insisted my wife keep coming back, despite concerns raised regarding consulting with her doctor and the insurance coverage.3) Why the true cost of the therapy was never revealed.  Again, $500 for a one hour visit is ludicrous.  I have had physical therapy for multiple injuries and surgeries and never seen extorted like this.4) The business says they recently called Colorado Health OP and the patient has, "still not met their deductible."  This is dubious as Colorado Health Op stopped offering health care end of year 2015, and we have not had them since November. Additionally, the response brought up some interesting points:1) The business claimed they told my wife she was to make $50 good faith payments each visit.  This is not accurate.  She was not told this, only asked to sign a stack of papers and was also only asked to make 2 such payments during actual visits.  2) If the business "had problems with our insurance," they should have offered the reduced out-of-pocket option.  I was informed after the fact this was an option. Sincerely,
[redacted]

Complaint: [redacted]
I am rejecting this response because:
---------- Forwarded message ----------
From: <[redacted]>
Date: Mon, Apr 21, 2014 at 11:03 AM
Subject: Complaint ID: [redacted]
To: [redacted]
Hello,
Thanks for your call. I attached my response to "Reject Business Response." I was not able to respond via the web site, as it would not let me type in the text box.
Thank you!
[redacted]
[redacted]
 
-- 
PLEASE SEE ATTACHED.

[redacted] did have a credit of $25 from our Smyrna, GA clinic for services rendered between 1/16/15 – 2/9/15. [redacted] paid a $25 copay on the first...

visit but once the insurance processed the claim, [redacted] had no financial responsibility.
The $19 pulley was purchased from the Norcross GA clinic on 6/22/15. [redacted] returned it on 7/1/15 and her account was credited in full ($-19). She was treated 8 times in Norcorss between 5/22/15 – 7/7/15 and was responsible for a $25 copay on each treatment date. She faithfully paid on all visits except the last one. On 7/7/15 she paid $6 expecting her credit of $19 from the returned supply to pay the remaining balance. However, the credit was not applied and there was a remaining balance of $19. A refund check in the amount of $19 was mailed to [redacted] on 7/27/15, leaving a balance of $19 for the copay on her last visit. 
 
The original credit of $25 was moved from the Smyrna clinic to settle her debit balance account in our Norcross GA clinic account on 12/3/15. Once this was applied, there is an overpayment of $6.
 
We have researched the check that was sent for the $19 refund and confirmed today that it has not been cashed. We are working to cancel that check and re-issue a refund check of $25 for the original refund amount plus the additional $6 currently overpaid on the Norcross account.

Review: There are a couple of areas of concern. The first being that I have never received a bill from this company. Secondly, I have a complaint abut their billing practice for Medicare patients. Here is my scenario ...... First of all, let me say that I LOVE the local business, [redacted]. I believe that they have the absolute BEST therapists in the valley, and I have been using them for over 15 years. I wouldn’t go anywhere else. Until my recent need for therapy. While I love All Care, I’m not so happy with their current parent company, Physiotherapy Services. They have a few policies in place that have not been beneficial to me, as a Medicare patient, and I want to warn other Medicare patients. Earlier this year I found myself in need of therapy, so I went straight to All Care and set up a schedule of visits. Before I could start though, I had to pay my deductible up front. I told them that I had had a medical visit before theirs, but I was told that Medicare hadn’t been billed for that visit yet, so I still needed to pay $147.00 up front. I also needed to pay my portion of my visits at the time of service. I was surprised as this was never their policy before. I am retired and on a fixed income, so this was a hardship for me. As it turns out, All Care holds their requests for insurance reimbursement and submits them once a month (at least for Medicare). By the time the first month of visits was submitted, the other medical company had submitted their bill. So now I owe THEM my deductible too, which I have already paid to All Care. Long story shortened, All Care now owes me a refund, which they don’t deny, but because of their policies, it will take 3 months for them to issue it. Well great. I owe this other medical group because of All Care’s policies. I wonder if they will be willing to wait 3 months to get paid??? Just for the record, I hate All Care’s parent companies’ policies. I am one that it hasn’t worked out for. Lucky me. Thank goodness all of the other places that I do business with, in the medical field, don’t follow suit. All Care/Physiotherapy no longer appear to be about the patient, but about the money. Very sad.Desired Settlement: In a perfect world, I would love for my refund NOT to take 3 months.

Business

Response:

Revdex.com of Metro Washington DC & Eastern Pennsylvania (Washington, DC)1411 K St. NW, 10th Floor Washington, DC 20005-3404

Re: Revdex.com Case ID [redacted])

We are in receipt of the complaint filed with the Revdex.com by **. [redacted]. When verifying benefits, the local office was advised that the patient had a $147 deductible and that her plan processes claims at 80% insurance responsibility and 20% patient responsibility. They in turn advised the same to **. [redacted].

Subsequently, the claims were processed by the insurance with only $34.96 being applied to her deductible, and there are still dates of service outstanding that the patient has paid a $20 per visit good faith estimate.

At this time we cannot determine an accurate overpayment amount on the account, as there are still dates of service that have not been processed by the insurance carrier. We will be happy to refund any overpayment amount to **. [redacted] once we have received that payment from her insurance. We apologize for any inconvenience that this may have caused **. [redacted].

Sincerely,

Customer Service Supervisor

Physiotherapy Associates

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

My insurance, Medicare, told me that they sent the final documents to you on May 14th, and that you should have the information that you have requested. That was 11 working days ago. I called your company yesterday, and was told because of the holiday, any paperwork will be delayed, and that you are very busy, and that her records indicated that nothing had been received yet from Medicare. I was told that you are waiting on insurance, and insurance has said that you should have all responses requested. I would like to be able to use that same excuse if the roles were reversed. Instead, I would most likely be sent to collections. I was also wondering when I would receive any detailed billing? In this age of electronic input, it is sad and frustrating that these things are allowed/accepted to take so long.

Review: I made three visits to Physiotherapy and paid a twenty dollar copay, on 8/7/13, 8/20/13 and 8/21/13. I found out latter that my insurance paid the total amount, so I did not owe a copay.I contacted Physiotherapy for a refund On 9/13/13 and was told that someone would process this inquiry. I called again on 12/6/13 and was told by [redacted] that they were still processing.I wrote a letter 12/22/13. I have not heard from Physiotherapy.Desired Settlement: DesiredSettlementID: Refund

I would like a $60.00 refund.

Review: services at [redacted],la [redacted] I was told all I had to pay was my medicare deductible which I did why am I getting a bill this location is no longer openDesired Settlement: why was I told this if was not true very poor customer service

Business

Response:

Revdex.com of Metro Washington DC &

Eastern Pennsylvania (Washington, DC)

1411 K St. NW, 10th Floor

Washington, DC 20005-3404

Re: Revdex.com Case ID [redacted])

We are in receipt of the

complaint filed with the Revdex.com by **. [redacted]. When verifying benefits, the local office was

advised that the patient had a $147 deductible and that his plan processes

claims at 80% insurance responsibility and 20% patient responsibility. They in

turn advised the same to [redacted].

Subsequently, the claims were

processed by the primary and secondary insurance with $167.10 being the patient

liability. We did receive a payment of $147.00, and at this time, the final

balance due is $20.10.

[redacted] signed a

Patient Payment agreement which indicates: I will be responsible for payment

for services. I understand that my good faith payment may not be inclusive of

all payments for which I am responsible for and I may be billed for any

remaining balance.”

At this time we feel the $20.10

balance owed by [redacted] is a true and legitimate

balance.

Sincerely,

Kristen C[redacted]

Customer Service Supervisor

Physiothisapy Associates

Consumer

Response:

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.

Regards,

[redacted]thank you for your help I will have a check in the mail Saturday just wondering why this was not done when I calledwould have been better for all of us thank you again[redacted]id [redacted]

Review: Hello,

My son [redacted] used Physiotherapy Corporation at [redacted], GA [redacted] on 11/29/12 and 12/10/12. Account# [redacted]. For some reason this company keeps sending myself and my son a billing statement for his services. The only problem is this is not my bill and my son was 23 at the time of the services. Now I am the polocy holder, but I am not responsibile for his bills. I have called the office several times to have my name removed and to stop sending the statements. They said they would and that I am not responisble for the balance. But the bills continue to come and I don't want to receive someone else's bills. Other Office on statement: Physiotherapy Corp, PP, PO Box 824181, Philiadelphia, PA 19182, ###-###-####Desired Settlement: I want my name removed from this account plain and simple. It is not my bill and I should not be harrassed for it each month for a year now. I am not responsible for it and don't want the bill reported as a collection on my credit report. My other older kids go to the doctor and if they have balances, those bills come in their names only, not mines.

Business

Response:

Re: Revdex.com Case ID 9835883 ([redacted])

Review: Yes, I have been contacting Physiotherapy Associates for three weeks now asking for them to put my claim thru insurance, so I don't have to pay so much out of pocket, but I have got no response from Physiotherapy Associates except the response of I Don't know by managers which I think is strange!Desired Settlement: I am asking for Physiotherapy Associates to email me all itemized statements from all Physiotherapy locations, or I need Physiotherapy Associates to fax me all itemized statements from all Physiotherapy locations this week

Consumer

Response:

I have been calling and emailing Physiotherapy Associates asking them to put my charges thru my insurance company before the deadline, so I will not have to pay so much out of pocket for their services . The deadline isn't up yet, but is nearing is what the insurance company told me, but Physiotherapy still hasn't submitted the claims to my insurance company. The Physiotherapy employees are saying they will call me back, but nobody has called me back yet, and I have been calling and emailing Physiotherapy for a while. I have another order from my Orthopedic for physical therapy which I had scheduled with Physiotherapy, but I cancelled it after seeing this poor customer service from Physiotherapy Associates employees!

For Physiotherapy employees to call me and get my insurance information and put my physical therapy charges thru my insurance company today before the deadline, so I don't have to pay so much out of pocket!

Review: In Feb 2013 I contacted the local office at [redacted]) for an appt for physical therapy. I was referred by an orthopedic through [redacted] Insurance.

I was asked if I could give them my insurance info to verify, I did and was called back and notified that my visit would not be covered by insurance as my deductible was high and if I wanted to make appointment I would be required to pay for services with each visit. I told them no problem , I would gladly pay and that my insurance was about to change any way and the therapy needed would not come close to deductible.

2/12/14 Came to office first time told fill out for** new patient so of course they ask me to fill out and I provide my insurance , because I am insured ... however I get up and tell them that I was told that I would be paying they said they report only to [redacted] .

had 3 visits and paid $130.49 ,$99.39 and $87.39 ... In March I rcvd a bill stating $47.87 owed called up corporate office billing and told them this had to be an error I paid for all services after each visit. They said they would call local office and get back to me. June no call and another bill called again spoke with [redacted] she said would notify local office to call me....

Again no call... Today I get a collection call about the balance , at this point I am angry... so I call the office in [redacted] and [redacted] she informed me of what the problem is and why there is a balance.

According to her when I filled out the insurance information I agreed and checked off a box saying I would be responsible to pay. Well of course I would be responsible we talked about this and I am paying each visit...

so I filled out information as if it was informational only....

Well it see** that if I would have asked for self pay I would have been charged less amt and would have not balance.... but because I provided the insurance information they charged the insurance company the allowable rate (which is higher than charged with each visit ) and now I have to pay the additional $47.87 and it is in collection !

Despite me calling corporate and getting completely upset they say nothing can be done ! I told the Supervisor today why didn't someone tell me of the cheaper self pay option ? The insurance information is standard on all new patient for**... why was insurance used when I was told that I would have to pay ? Why was I not given and detail of billing from each visit ? Why did no one fix issue back in March and June when called. Apply this service to my soon to be old provider was pointless and more costly ? why is it that the rate they bill self pay is $270 and they are billing the insurance company $365.14 and this is even remotely OK << ? So they are clearly overcharging insurance companies for the same services ?

If they would have made the change back in March to undo the billing to the insurance company there would be no balance. They knew very well I wanted to pay and the insurance would not cover.

If they had any ethics they would have reimbursed me the extra amt charged vs self insured billing..

I paid $317.27 in fees and if I would have been charged as self pay like I was suppose to the amt billed would have been $270 a $47.27 overpayment .

But no one at the corporate office wants to do anything and 1 year later I am getting collection calls because they now say the billing should be $365.14 vs $317.27 paid !!Desired Settlement: desired outcome

my balance should be written off

I should receive an apology for their lack of follow through

customers should be advised more clear that the insurance information can be declined and self payment options are avaialble ~ this should be clearly marked on form. it is NOT

Business

Response:

April 16, 2014