Psychological and Life Skills Associates, P.C.

I received your correspondence dated February 17,2016. I appreciate the opportunity to respond to this complaint.Psychological and Life skills Associates, PC has been  in business since 1989. Over the last 27 years we have successfully treated over 12,000 patients. This is only the second...

complaint that has ever been filed against us. After reading the complaint the patient failed to share some essential details of this situation. First, the patient has insurance that is out-of-network with our office- meaning we are not participating providers with his insurance insurance. He was informed of this prior ti his first appointment. Second, our policy with out-of-network insurance is that the patient pays our full fee at each appointment. All doctor's offices have the same policy regarding this. The patient was fully aware of this prior to staring treatment with us. Third, as a courtesy to assist the patient, we agreed to bill his insurance for him. However, his insurance company has not reimbursed him as of yet. unfortunately this is a situation that we cannot control. We have provided all the necessary information to the insurance company. In fact, both my administrative staff and the doctor who treated him have that they have spent hours back and forth with him and his insurance company trying to determine why he has not been reimbursed. The issue ultimately is between the patient and his insurance company.We deal with hundreds of patients who use their out-of-network benefits and we never have issues like this. I would be pleased to meet with this patient face-to-face to discuss the matter, but at this point I don't know what more we can do.

Review: I came to the Psychological and Life Skills to help my son for his language impairment. First, they asked me for my insurance information; the ID number and policy number, to see if my insurance will get an authorization for coverage. They later told me that the insurance approved the authorization but I asked many times to see if they are correct and they always say that they approve. I went on March 14th for a 30 minute test, then again on March 17th for a 2 hour test. Later I have received a bill of $2,072 for the testing. I was lied by the office manager many times saying that I was approved for coverage when I wasn't. I called my insurance company and they said that Psychological and Life Skills have never called for an authorization of coverage. I called Psychological and Life skills to tell them what my insurance told me but they said they have done a request by the internet but they will resolve the problem as soon as possible. So as they said that I thought they would fix my problem but a few months later I have received another bill of $2,072 and found out they still have not called the insurance. I tried to complain but no one would return my phone calls. Later the doctor called me and spoke to me very rudely saying I have to complain to the insurance company or if I don't pay them "I'll see what happens" like he is blackmailing me. First, I felt so disrespected by the way he talked to me and second, I have been with [redacted] for 12 years and never had this problem. My overall complaint is the miscommunication between the doctor and the office manager and the way I was poorly treated as a customer. I do not want to be lied to and I am close to suing them but I do not know what to do. Can you please help me? I can go to sleep because too much stressful..Desired Settlement: It was too much and unexpected and even they kept lying to me. The doctor called me last time and he was so rude, so he has to change his attitude which is to not say to the customer to change their insurance or blackmail to the customer. I cannot pay because I made sure to the office and the doctor but they keep brushing off the problem they made me pay and did not even apologize. I am curious if he is a real doctor or not. Thank you for helping me.

Business

Response:

To whom it may concern:

Due to the Health Information Portability and Accountability Act of 1996 (HIPAA) we can neither confirm nor deny that the individual filing this complaint is currently or has ever been a patient at Psychological and Life Skills Associates, PC. In order to release any information, we are legally and ethically required to obtain a Signed Release of Information form. We have attached the form to this letter. Please return the signed consent form to the address below or fax to ###-###-####.

Respectfully,