ComplaintsforBay State Physical Therapy, P.C.

• Initial Complaint

  11/14/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  Date August, 2023 amount $331.51 treatment: Physical Therapy I was give a quote for treatment but Bay State charge my insurance and me a higher price.Offered to pay the balance based on what original quote Account *******

  Business response

  12/01/2023

  The claimant (patient in question) had been attending physical therapy visits and requested billing for services sent to their health insurance carrier, ********** Blue Shield ('BCBS'). The claimant did not communicate a request to change this billing process to our office until after the 8/22/23 date of service (appointment) had already been billed electronically to BCBS.

  Retrospectively, the patient wanted the payor changed from BCBS to self pay (self pay is an established rate for services the patient agrees to pay without services being billed to any health insurance carrier they may have) for dates beginning in August as outlined below: 

  Dates of Service in question with billing:
  8/2/23                 $168.67
  8/4/23                 $108.84
  8/8/23                 $117.58
  8/11/23              $117.58
  8/22/23              $108.84

  Because notification by claimant did not happen until after the date of service 8/22/23, the claims were submitted to claimants insurance, BCBS, and processed towards the claimant's insurance deductible. 

  Once submitted and processed, we cannot reduce/reverse/cancel those charges as that would be a direct violation of our contract with BCBS and be considered fraud.

  Once the patient did notify our office of the request to self-pay, our billing office did waive the full charge of the 8/29/23 visit which was never billed to BCBS, and charges for 8/29/23 visit and any after that time were at our self-pay rate.

  Total patient responsibility was   $621.51
  Total patient payments to date    $370.00
  Total patient balance due             $251.51

  Please let us know of any further information needed to resolve the dispute.

  Customer response

  12/07/2023

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered. 

  [You must provide details of why you are not satisfied with this resolution.  If you do not enter a reason for your rejection, your complaint will be closed as Answered.]
  
  Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
  
  FAQ
  
  Regards,

  ******

   

   

  Business response

  01/08/2024

  Good Morning, Our office has reached out to the claimant directly to let them know we have adjusted the balance on the account to $0 due in order to resolve this complaint. If any additional information is required or requested, please let us know. 

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