Select Medical Corporation

To Whom it May Concern- Revdex.com,
We are responding to the complaint received from [redacted] (complaint ID [redacted]). A copy of the letter that we received from the Revdex.com is attached. Ms. [redacted]'s insurance, [redacted], has since reprocessed her claims on...

March 20, 2015, to correctly show that the patient owes $0.00. The patient no longer has a balance with Kessler Institute for Rehabilitation. We attempted calling the patient on April 10, 2015 to inform her of this, but we were unable to reach her and left a voicemail. A letter was also mailed to the patient on the same date informing her of her $0.00 balance.If you have any additional questions on this account, I am available to discuss the information from 7:30am-4:30pm eastern time, Monday through Friday, at ###-###-####.
Thank you,
Trisha N[redacted]Kessler Outpatient Supervisor

[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:
There were obvious missed communications between Select Physical Therapy and [redacted] South when [redacted] of SC and [redacted] of TN. were separate entities in 2013. Neither Select Medical or [redacted] notified me that Select Physical Therapy was not in the network of [redacted] of TN. Select Physical Therapy provided the services agreed to, but should have done further checking to make sure [redacted] of TN was going to provide payment for these services. The office manager at the [redacted], SC. location obviously telephoned [redacted] of SC. for benefit verification. I clearly pointed out that I have [redacted] of TN, not [redacted] of SC. This was the first mistake. I was not made aware that Select Physical Therapy was not in network with [redacted] of TN. until all physical therapy sessions were completed. This was the second mistake. Select Physical Therapy turned my account over to collections without proper notification. This was the third mistake. I am now holding "the bag" for another $386.47 bill that could have been completely avoided, if Select Physical Therapy had communicated with both myself and [redacted] correctly. I also now have a mark on my credit through Select Physical Therapy's collection agency, which should have never happened. I have paid this balance in full on 7/272014 under protest. Again, corporations duck responsibility and act unprofessionally, yet still get their way.  [redacted] of Select Medical has been very helpful in getting to the bottom of this issue. This problem stemmed from poor communication between [redacted], Select Physical Therapy and myself resulting in an injustice that I am left to pay. This is not right!
Regards,
[redacted]

To whom it may concern,
We have received the rejected response from Mr. [redacted] dated May 5", 2016. Again, we do apologize to him for any inconvenience and hope to be able to resolve his outstanding balance of $997.28 amicably.
To address his continued concerns, the dates of service that he was seen with us for where his insurance did request additional documentation were resolved with no balance being billed to him. As a company, even though we felt that 30 of the therapy visits provided to Mr. [redacted] were medically necessary, with the insurance having denied them, 59,575.00 was written off in November 2015 with no Cost pushed to the patient. At this time, there is nothing further to provide the insurance company; the $997.28 balance is the patient's responsibility under their insurance carrier benefits through [redacted].
AS for the phone Calls and verbal permission given to speak with his mother, verbal permission is only good for the day the Call is made and verbal permission from the patient granted. Every effort was made each time the patient's mother called in and the patient gave verbal permission to explain that we still needed documentation for any future communication with his mother. Multiple emails were sent t email address [redacted] and email address [redacted] with the documentation attached that the patient needed to complete and send back so his mother would be formally listed on the HIPAA compliant billing disclosure form, No response was ever received.
We want to continue to try and work with Mr. [redacted] on this outstanding balance. Mr. [redacted] has 90 days to resolve the balance owed by setting up a monthly, interest-free, payment plan or issuing payment in full for the $997.28 outstanding, if this balance is not resolved by July 26, 2016, the account may be turned over to our collection agency.
if you have any further questions, please feel free to contact me at the number below between the hours of 8am to 5 pm EST.
Respectfully,
 Theresa M. L[redacted], M.A. Collections Manager

[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:  Below is the response from the Insurance Company.. According to them, they never received documentation, and if they were requesting external review, I was never notified.
Good Afternoon,

 
Thank you for contacting [redacted], Educational Markets Customer Service.

 
Upon further review we have found that the denial of the 3rd appeal was sent to the providers office with instructions of how to request an external
review.  Please contact your provider for assistance.
 
If you would like to request the Explanation of Benefits for the referenced services we will need a request from the member.

 
It has been our pleasure to be of service to you today. Please, let us know if you need additional assistance.

 
 
 
 
[redacted]
Customer Service
[redacted]
Regards,
[redacted]

July 25, 2014To Whom It May Concern at the Revdex.com:We have received the complaint filed against Select Medical by [redacted].We were able to resolve the issue with [redacted] through the attached email correspondence this week.If you need any additional...

information from us regarding this matter please contact me by phone at [redacted] or by email at [redacted]Thank you for your time.Sincerely,Katie ROutpatient Collections Supervisor

August 5, 2014To Whom It May Concern:This letter is in response to the complaint submitted to the Revdex.com about Select Medical by [redacted].The customer's complaint was that we did not inform him we were out-of-network with his insurance company. We are in-network and claims processed in-network correctly. Based on the customer's specific policy there are different tiers of in-network benefits. The patient's financial responsibility varies depending on the provider chosen. It is a patient's responsibility to know and Communicate their policy stipulations to the provider. The customer signed a document prior to treatment acknowledging that though benefits are verified as a courtesy he is ultimately responsible for his bill. This document also specified that insurance companies often have additional stipulations that may affect his coverage and that he would be responsible for any amount not paid by them, Based on the patient’s Tier 2 In-Network benefits a deductible was applied.
Another complaint the customer had was that we turned his account over to collections without proper notification and now he has a mark on his credit. After sending him 3 statements without receiving a response we sent a letter on May 2, 2013 advising him his account would be forwarded to a collection agency. We then received a partial payment but the patient still had not contacted us to question his bill. Three more statements were issued before we received another partial payment from him. After that 7 additional statements were issued without any further payment or communication from the patient. At that point the account was forwarded to the collection agency in March 2014.
Prior to treatment our customers sign an agreement that they will pay for services rendered at our facilities. Unfortunately these agreements are not always upheld and the services of an outside Collection agency are used to collect any unpaid balances. We are always more than willing to work with our Customers who contact us regarding their outstanding balances. We had not received communication from the patient until July 2014 at which time we were promptly able to give him an explanation of his bill. As soon as his payment was received and posted to his account we notified the collection agency that it was paid in full.
If you have any further questions, please feel free to contact me by phone at [redacted] or by email at [redacted] between the hours of7:30 am and 4:30 prm EST.Sincerely,Katie R[redacted]Collections Supervisor Select Médical

-------- Forwarded message ----------From: Revdex.com of Metro Washington DC<[redacted]>Date: Thu, Apr 23, 2015 at 9:19 AMSubject: Fwd: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint #[redacted].To: [redacted] <[redacted]>
---------- Forwarded message ----------From: [redacted] <[redacted]>Date: Wed, Apr 22, 2015 at 5:05 PMSubject: RE: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint #[redacted].To: [redacted]Thank you for your help
[redacted]