Rock Therapeutic Services

Complaint: [redacted] I am rejecting this response because: Rock Therapy Services clearly does not have their clients best interest at heart. We have never had a medical professional, office or specialty service not take the time to make sure all coverage (or lack there of) is clear and as precise as possible BEFORE charges or services are initiated. I also found a $400 charge submitted to ***, instead of the $250 fee that was presented in the new patient packet I received. When I brought this up to Rock Therapy, I was informed that I was given outdated information - "I apologize for the outdated and incorrect information on our policies and procedures". If I hadn't found this on [redacted] I would have had to take even more time to clear up the issue of over charging me for the evaluation. I find it incredibly hard to believe that they didn't have access to ALL of our coverage because I gave them our medical insurance card information, including the insurance ID#. They specialize in speech therapy, you'd think they would know the ins and outs of medical coverage and at the bare minimum give their potential clients a heads up. How disappointing! So you bet I believe they had information that would have led me to understand that my son wouldn't be covered by insurance and I wouldn't have kept his evaluation appointment. Signed papers or not (which by the way, Rock states are outdated), such poor customer service from a medical specialist is nothing but disappointing. Sincerely, [redacted] ***

While we understand the client’s frustration there is some mis-information in her complaint
Firstly, *** *** signed our Policy and Procedures which states:
Rock Therapeutic Services may verify the client’s benefits as a courtesy Quoted benefits are not a guarantee of benefits, the
client is ultimately responsible for verifying their own insurance benefits
The client is ultimately responsible for all charges of rendered services
She also signed our Consent for Private Therapy which states:
I have read the furnished Policy and Procedure information and accept the terms stated within
We called the client’s insurance company to verify speech therapy benefits just as we do for all of our new clients who request verification Speech therapy is a complicated benefit because there are a plethora of reasons why someone may need speech therapy Because of this, some insurance plans require a predetermination before they will cover speech therapy In order to get a predetermination we have to submit clinical data In order to get clinical data we need to perform an Evaluation of the client *** *** was told via phone that:
Speech therapy would be covered with a 10% coinsurance, after a $deductible has been met, and her son would get visits per year combined with other therapies And that this would all be dependent upon a predetermination
We then explained the process of getting predetermination: Her son would come in for an evaluation, we would then write up the report and submit to the insurance plan and wait for a response No therapy sessions would be scheduled until we knew the insurance plans response to our predetermination inquiry
*** *** even states in her complaint: "I called to confirm the coverage with *** and it matched.”
She had the same information we had Insurance coverage information was not withheld from the client as she claims in her complaint
Upon receiving notice that her son would not be approved for speech therapy because the diagnosis fell under the learning disability/developmental delay category, *** *** contacted us to get clarification on why an insurance plan would make such a decision I explained that based on the verbiage of the denial I would conclude that this particular insurance plan would only cover speech therapy if it was needed “to restore a previous function lost due to injury or illness, ie: a stroke, broken jaw, etc.”
I believe that since I was able to provide this information to *** *** so quickly that she assumes we had prior knowledge of this information and withheld it from her purposely just so we could charge her $for an evaluation This is simply not the case The reason I was able to provide her with that explanation so quickly is because I have a lot of experience dealing with predeterminations and when a plan denies a predetermination based on a ‘learning disability or developmental delay’ diagnosis code then I know that 99% of the time it means that they would have only approved the predetermination request if the diagnosis was related to an injury or illness
We have many clients with the same insurance company, ***, for whom speech therapy is a covered service for learning disabilities or developmental delays If we knew that *** never approved speech therapy for developmental delays we would have told *** *** that right away It is certainly not in our best interest to deceive potential clients into a $bill when word-of-mouth is our largest source of marketing/referrals From a business perspective this wouldn’t make any sense
*** *** also mentions in her complaint that little to no help was given to resolve the issue I responded to every phone call and email in a professional matter answering her questions, clarifying confusing insurance practices, and expressing sympathy for her frustration She did not request nor suggest any kind of reconciliation or resolution to the situation Her last email to us simply stated that she would be contesting the charge with her insurance company and filing a complaint with the Revdex.com

Complaint: ***I am rejecting this response because:
Rock Therapy Services clearly does not have their clients best interest at heartWe have never had a medical professional, office or specialty service not take the time to make sure all coverage (or lack there of) is clear and as precise as possible BEFORE charges or services are initiatedI also found a $charge submitted to ***, instead of the $fee that was presented in the new patient packet I receivedWhen I brought this up to Rock Therapy, I was informed that I was given outdated information - "I apologize for the outdated and incorrect information on our policies and procedures"If I hadn't found this on *** I would have had to take even more time to clear up the issue of over charging me for the evaluation.
I find it incredibly hard to believe that they didn't have access to ALL of our coverage because I gave them our medical insurance card information, including the insurance ID#They specialize in speech therapy, you'd think they would know the ins and outs of medical coverage and at the bare minimum give their potential clients a heads upHow disappointing! So you bet I believe they had information that would have led me to understand that my son wouldn't be covered by insurance and I wouldn't have kept his evaluation appointmentSigned papers or not (which by the way, Rock states are outdated), such poor customer service from a medical specialist is nothing but disappointing.
Sincerely,*** ***

While we understand the client’s frustration there is some mis-information in her complaint
Firstly, *** *** signed our Policy and Procedures which states:
Rock Therapeutic Services may verify the client’s benefits as a courtesy Quoted benefits are not a guarantee of benefits, the
client is ultimately responsible for verifying their own insurance benefits
The client is ultimately responsible for all charges of rendered services
She also signed our Consent for Private Therapy which states:
I have read the furnished Policy and Procedure information and accept the terms stated within
We called the client’s insurance company to verify speech therapy benefits just as we do for all of our new clients who request verification Speech therapy is a complicated benefit because there are a plethora of reasons why someone may need speech therapy Because of this, some insurance plans require a predetermination before they will cover speech therapy In order to get a predetermination we have to submit clinical data In order to get clinical data we need to perform an Evaluation of the client *** *** was told via phone that:
Speech therapy would be covered with a 10% coinsurance, after a $deductible has been met, and her son would get visits per year combined with other therapies And that this would all be dependent upon a predetermination
We then explained the process of getting predetermination: Her son would come in for an evaluation, we would then write up the report and submit to the insurance plan and wait for a response No therapy sessions would be scheduled until we knew the insurance plans response to our predetermination inquiry
*** *** even states in her complaint: "I called to confirm the coverage with *** and it matched.”
She had the same information we had Insurance coverage information was not withheld from the client as she claims in her complaint
Upon receiving notice that her son would not be approved for speech therapy because the diagnosis fell under the learning disability/developmental delay category, *** *** contacted us to get clarification on why an insurance plan would make such a decision I explained that based on the verbiage of the denial I would conclude that this particular insurance plan would only cover speech therapy if it was needed “to restore a previous function lost due to injury or illness, ie: a stroke, broken jaw, etc.”
I believe that since I was able to provide this information to *** *** so quickly that she assumes we had prior knowledge of this information and withheld it from her purposely just so we could charge her $for an evaluation This is simply not the case The reason I was able to provide her with that explanation so quickly is because I have a lot of experience dealing with predeterminations and when a plan denies a predetermination based on a ‘learning disability or developmental delay’ diagnosis code then I know that 99% of the time it means that they would have only approved the predetermination request if the diagnosis was related to an injury or illness
We have many clients with the same insurance company, ***, for whom speech therapy is a covered service for learning disabilities or developmental delays If we knew that *** never approved speech therapy for developmental delays we would have told *** *** that right away It is certainly not in our best interest to deceive potential clients into a $bill when word-of-mouth is our largest source of marketing/referrals From a business perspective this wouldn’t make any sense
*** *** also mentions in her complaint that little to no help was given to resolve the issue I responded to every phone call and email in a professional matter answering her questions, clarifying confusing insurance practices, and expressing sympathy for her frustration She did not request nor suggest any kind of reconciliation or resolution to the situation Her last email to us simply stated that she would be contesting the charge with her insurance company and filing a complaint with the Revdex.com

Complaint: [redacted]I am rejecting this response because:
Rock Therapy Services clearly does not have their clients best interest at heart. We have never had a medical professional, office or specialty service not take the time to make sure all coverage (or lack there of) is clear and as precise as possible BEFORE charges or services are initiated. I also found a $400 charge submitted to [redacted], instead of the $250 fee that was presented in the new patient packet I received. When I brought this up to Rock Therapy, I was informed that I was given outdated information - "I apologize for the outdated and incorrect information on our policies and procedures". If I hadn't found this on [redacted] I would have had to take even more time to clear up the issue of over charging me for the evaluation. 
I find it incredibly hard to believe that they didn't have access to ALL of our coverage because I gave them our medical insurance card information, including the insurance ID#. They specialize in speech therapy, you'd think they would know the ins and outs of medical coverage and at the bare minimum give their potential clients a heads up. How disappointing! So you bet I believe they had information that would have led me to understand that my son wouldn't be covered by insurance and I wouldn't have kept his evaluation appointment. Signed papers or not (which by the way, Rock states are outdated), such poor customer service from a medical specialist is nothing but disappointing. 
Sincerely,[redacted]