ComplaintsforPain and Spine Specialists of Maryland LLC

• Initial Complaint

  05/03/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I have been attempting to resolve a billing issue for the past 2 months for a procedure that took place on January 18, 2024. There was a corrected benefits statement issued by my insurance company for the plan allowance and this has not been adjusted. I have also not received credit for all of my payments. The practice is attempting to charge me for more than $900 when in fact I only owe $210. I have made numerous phone calls requesting assistance to resolve this matter and have received no responses even though I was promised someone would call me back. I would like this billing corrected asap to avoid a notice of late payment.

  Business response

  05/10/2024

  From billing manager Dipti P**** 5/9/24:

  I just spoke to the patient about the complaint . She stated she will tell the case manager that she is satisfied with the resolution we have come up with.  I assured her she will not be sent to collections and that we are just waiting for the correct EOB that just came in our system to be posted.  After which if she has a credit, we will send out the refund. I will monitor this closely myself. This all started with her insurance company processing a TFESI claim in ******* incorrectly.  All has been corrected and Patient is going to take back the complaint.  
  
  
  I emailed the case manager and left a voice mail for her.  The patient is going to tell the case manager to close the case as resolved.

  Customer response

  05/17/2024

  
  Complaint: ********
  
  I am rejecting this response because: while I agree that we agreed on a path forward to resolve this matter, there has been no follow-up since that conversation and so the issue remains unresolved.
  
  Sincerely,
  
  ****** ************

• Initial Complaint

  10/16/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  This complaint is a last resort to resolve a billing issue.On 6/15/23 I received my second of two radio frequency ablations on my back. Prior to the procedure, PASS confirmed it would be covered by my insurance (insurance covered my first treatment on 4/18/23). They actually told me I had to wait 2 weeks for my 2nd injection to ensure insurance would cover it. I advised them from the outset that if I had to pay out of pocket I wouldn't be able to get the procedure. They reassured me several times that it was covered. I then received a bill for $5K - the entire amount of the procedure. Per my insurance company, they never got prior authorization so payment was rejected. I have phoned their office at least 3x per week for the last 3 months in attempt to resolve this issue. No one will return my phone call and I continue to receive past-due notices. I sent emails through their online system. I inquired with the front desk in the MtAiry office who told me they couldn't assist. I even resorted to messaging one of the Drs on ******** to ask for a return phone call from their billing department. At this point, I cannot resolve this issue without speaking with someone and it is apparently about to be sent to collections. I dispute that I owe this amount since had they done the prior authorization insurance would have covered it. Filing this complaint is my last option to try to resolve this matter since no one at the dr's office will contact me to discuss.

  Business response

  10/25/2023

  Good Morning,

  There was a error on the Insurance company side which triggered the issues on the patients statement.  We have contacted the insurance co and the rep we spoke to stated there was a error on there part for putting wrong info on the EOB.  The denial reason on the EOB triggered out EHR system to roll balance to patient.  We have spoken to the patient and have assured her we are working with the insurance company to resolve this matter.  The patient was very understanding and is willing to work with us.  

  Please let us know if there is anything else you need to help close this case positively.  

  Thank you, 

  Dipti P****

  Customer response

  10/25/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.  It is unfortunate that my last resort of filing a complaint needed to happen in order to get a return phone call but accept and appreciate the response and course of action proposed.
  
  Sincerely,
  
  ***** ******

• Initial Complaint

  04/11/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I am trying to resolve a billing issue that stems back from my initial office visit of 9/9/2022. I received a bill for this date of service on 10/6/2022. The Altoona office where I was treated gave me the billing department number (412-220-2336). I spoke with Tiffany at that number. She told me there was a problem with their computer system, specific to **** ***** members. She told me to disregard the bills. I continued to receive invoices monthly, including for other dates of service. In the meantime, ******* **** ****** my medical carrier has paid all of the bills that they've received to date. They still have not received the bills for date of service 9/9/2022. Capital **** ***** has instructed me multiple times to call the provider's office to get them to send the bills. The billing office in Mount Airy Maryland where the invoices are sent (phone 301-703-8767) has never returned my messages. I've left multiple voice mail messages to no avail. I've sent multiple emails through the patient portal with no response. I have even sent a certified letter dated 3/8/2023 with no response. I am certain that there would be an easy resolution to this if someone would just get back to me. I've never had an experience like this in which no one will return a message. I did notice that they have me listed with two different account numbers. However, we could rectify this if someone would just call me. At this point, the medical bills are indicating that I may be in collection status given the timeframe. I certainly hope we can resolve this without any impact to my credit score. Do you have any suggestions to get this resolved? Thank you!

  Business response

  04/14/2023

  The patient has been contacted by senior management and the billing department. Our billing dept has contacted her insurance company and has identified the issue and they have taken responsibility for the errors. All outstanding claims have been resubmitted to the insurance company and we should have a full resolution within 30 days. All of this has been communicated to the patient and she has a direct line to senior management if she has any additional questions or issues. 

  Customer response

  04/18/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  **** *********

• Initial Complaint

  01/17/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I have been seeing pain and spine for years, on 2/28/22 I went in for an appointment and payed the usual $30 copay on4/11/22 on their web site and received a proof of payment. Pain and started sending a bill for that payment in July. I tried calling their billing dept. 301 703 8767 option 4 for the next 6 months The message said mail box full call back I tried 12 times and nothing. I emailed with proof of payment no response, I had the receptionist at the office to fax to billing no response. I also have a copy from my bank showing the $30 applied to my credit card for pain and spine specialist Connellsville, pa. I don't know what else to do. I believe if a person from pain and spine billing would talk to me if would have been solved just seem impossible. I have resisted involving you for $30 but am lost for an answer. Thank you Wally

  Business response

  01/25/2023

  Business Response /* (1000, 5, 2023/01/20) */ By our recordkeeping it appears that the patient still owes us $30 for an outstanding co-pay. However we can provide him a provider discount and adjust off that $30 balance. Our billing department has reviewed and adjusted off the $30.00 balance from this patient's account on 1/20/2023 Consumer Response /* (2000, 7, 2023/01/24) */ (The consumer indicated he/she ACCEPTED the response from the business.) It's a win win. The zero balance is what I was seeking and Pain and Spine saves face

• Initial Complaint

  08/19/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  please see attached

  Business response

  11/02/2022

  Business Response /* (1000, 20, 2022/10/18) */ James ******* is a pain management patient of Pain and Spine Specialists of PA that was receiving chronic care management (CCM) services on a monthly basis. Patient states he did not receive the services for the month of January. However, our Chronic Care team did spend clinical time reviewing and updating patients care plan prior to calling patient to discuss their care. The care team spent time trying to get hold of the patient to review their care plan, we have documented they attempted to reach the patient on January 12th, 21st, 24th and 31st of 2022 without success. The team could not reach the patient for scheduled CCM call after multiple attempts, therefore on 1-31-22 we billed for the clinical time spent. Our Solution: Since Clinical time was spent and documented for this service, we billed the patient's insurance resulting in a balance owed for deductible. Since the patient was not satisfied with the care, we have retracted the claim as billed in error with Medicare. We have spoken with the patient and have apologized for any inconvenience it may have caused him. The patient is aware of the actions we have taken in regard to his bill.

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