The Virginia Chiropractic and Natural Health Center

Review: I began seeing this office for chiropractic care in september for a back spasm. I went through the normal chiro work-up & proceeded to receive care. My insurance was verified and care plan est. After my original complaint was fixed (approx a few visits) I proceeded to continue to receive care because the adjustments felt good and helped with my overall physical health & with my portion being approx 20 dollars a visit, fit in my budget. Still a completely optional service for myself but one that I felt was do-able price wise for my budget. I continued to see this office for 3 months with most of my visits 2x per week that I eventually spaced out to 1x per week or 1x per two weeks. In december after three months of care, I received a phone call from the office manager who stated that my insurance claims were being rejected & I would be receiving a bill for $474.00. I was very upset to say the least, not that the insurance company had reported the wrong information to the office regarding meeting my deductible, but that they let me continue to receive care & not say a word to me about the claim problem for 3 entire months during which I racked up a substancial bill. I had made a decision to get care based on a 20 dollar a visit bill & had I known that I would be responsible for close to 500 dollars I would not have continued care. As a consumer I feel very violated as a patient, almost like I was tricked into a bill I cannot afford. Since it was half the offices fault for not informing me of the problem and half the insurance companies fault for reporting the wrong info. to them I wrote the office a very professional letter describing the problem from my standpoint and sent them a check for half the bill. I agreed to take responsibility for the insurance comp. mistake since they clearly would not. After which, I received another bill requesting payment for the rest of bill. I refuse to pay this bill due to their lack of professionalism in billing and keeping their patients informed.Desired Settlement: I agreed to pay half of the bill and want the company to take responsibility for the other half since they are at fault for continuing to let a patient receive care for 3 months knowing that the insurance claims were being rejected. I have already sent them a check, which they cashed. I feel like this is an appropriate solution for the given situation.

Business

Response:

We are very disappointed to hear of the previous patient’s

frustration over receiving the bill. As

they stated, our office did call to verify their insurance, however, before

receiving any information from any insurance company we are always given a

disclaimer which states “the information that you are about to receive is not a

guarantee of payment”. So, simply

stated, our office has absolutely no idea of what the insurance company will

actually pay until the claims are processed and we receive an Explanation of

Benefits from their company. Our office

files paper claims, so it can take approximately 6-8 weeks for us to receive a

response from the insurance company on the very first patient encounter. Unfortunately, this patient was coming to our

office to receive chiropractic care 2 times per week for several weeks which

explains the accumulation on her total charges.

Also, a fact that the former patient declined to share, was that they

were only allotted 10 visits per calendar year with their insurance company and

they willingly came to our office for 14 visits, this leaves 4 visits which

were uncovered by their insurance company.

Also, the patient stated in her letter to our office that they felt that

the care that they received was “beneficial” for their condition. So, I’m a little confused as why they stated

that they cannot “justify paying for the full balance” when they have already

received the treatment and it benefited them. Although, we can understand the individuals “frustration”

with the fact that their insurance company did not cover the way that they and

our office expected, the patient is still responsible for the care that they

received and we have signed documentation of the patient’s acknowledgement and

willingness of this fact. Our office

regrets that the patient is disappointed; however, they are in fact responsible

for the balance.

Consumer

Response:

I have reviewed the response offer made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

Regards,