Psychology Specialist of Oklahoma, PLLC

This letter is in response to a complaint filed on 4/3/ID
***This complaint, from our understanding, was filed due to some confusion regarding the claims filing process for services rendered in our clinic.An initial statement was sent to the patient with estimatedcredits and/or charges
before final insurance claims were processed.Upon first visit, the
patient was asked to pay up front due to having a deductible that had not yet
been metWe are well withinour legal and ethical rightsto collect this money up front as statedin our contract with the insurance provider.Patients are ma.deaware ofthis at their first appointmentFurthermore, they sign a fonn stating they have
been made aware of our clinic's policies and that, ultimately, they are responsible for anything insurance does not pay for.Itis typical for the patientto have a credit showingon their accountwhen claims a:rcin process, and until
they arc finalizedOnce a claim is finalized and either
paid or denied by ins urance , we are then able
to allocate the creditto the patient responsibility, as reflected on the explanation of benefits received directly from the patient>s insuranceThe patient
contacted a member of our staff demanding that the credit be paid to her in
full, at which time, the staff explained to her that she had received this statement in eJTor and thatany credit onthe account could not be refunded until the claimshad processed and finalized She was notified that once the claimshad processed and finalized we would contacther to make sure she was refunded any credit remaini1lg on the account.We reached out to notify the consumer that the claims had finally processed and finalized, and after the patient responsibility owed, as indicated by the insurance company,there would be a credit refunded to her.The patient was upset that the amount had changed, thus leading to this complaint.This complaint is largely due to the patient not understanding
the claims filing process, and unfortunately,
there is nothing we could have done differemly in this case,

Complaint: [redacted]
I am rejecting this response because: while it may have been a misunderstanding it was not handled professionally by the front desk staff. I was not told why I was not receiving my. Owed balance other than the person who was in charge of refunds was out of town and would call me when they returned. I was NOT informed that they had not finished filing claims months after services rendered and was not informed that I had received the statements showing amount due was a mistake. I called several times before going up there and couldn't get anyone on the phone. I will be getting my children's files and moving our business elsewhere.
Sincerely,
[redacted]