ComplaintsforSSM Health Physical Therapy

• Initial Complaint

  05/20/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Location:  Highway **************************************************************************************************

  I began PT for my left shoulder in Sept. 2023. At that time, the admin employee who did phone intake told me my insurance would cover all my visits, and that SSM would advise me if my appointments would be approaching exhaustion of benefits. On October 25, 2023, I was in a vehicle accident requiring PT for my neck. I wasn't told that my sessions were about to run out. At the start of 2024, I received a bill that I owed SSM PT well over $2,000 because insurance had stopped paying due to exhaustion of benefits after 10/24/23. I called office staff who spoke to their ***, who stated SSM would write off the charges since it was a clerical error as opposed to my fault.However, those charges were never written off. I contacted the billing department who sent me to the *** ******, who referred me back to the billing department, who referred me back to ******. This went on for a while until ****** went back on her word and said I had to pay. I found out from office staff that my sessions stopped being covered on 10/24/2023, though I was never notified of this because the first admin girl I spoke to in August put down the wrong number of sessions I had available. I have never been able to speak to an actual decision-maker for SSM and was told that all they would do is reduce my cost to $100/session AFTER I had already been told the charges would be written off. I have been made aware through personal connections within SSM that I am not the only patient this employee made the error with, and that she was fired due to these mistakes. Additionally, the visits were not coded as a new issue even though therapy starting after 10/25/2023 was focused on my neck injuries from the vehicle accident rather than what I came to therapy for initially, which was my left shoulder. Staff is aware I have financial hardship due to injury/unemployment. It is my expectation that SSM will write off my balance for the remainder of 2023's charges, totaling $1,400 as of 5/20/2024.

  Business response

  06/11/2024

  This complaint has an incorrect business address/location. This was sent to SSM Physical Therapy ************************************************, ******************************************************************. That is an incorrect address of where the complaint occurred. The correct address/location is SSM Health Physical Therapy ************************************************************************************. I have spoken with the individual who submitted the complaint. I am working with our office to remedy the complaint. I am following up later this week. There is other information that can be provided but at this time I am unaware of what would be a potential Health Insurance Portability and Accountability Act violation so am unwilling to provide documentation of any kind at this time. I would like the opportunity to respond again later in this week when issue has been fully resolved. 

  Customer response

  06/12/2024

  I paid the $1,400 last week only because I received notice that my account was being sent to collections and I hadn't yet received communication from SSM. We had to open a new credit card in order to pay - husband just started new job after being laid off in February.

  Customer response

  06/12/2024

  Signed HIPAA doc

  Business response

  06/20/2024

  The correct address for the complaint is ************************************************************. That is the only address that should be used for this complaint, no others. 

   

  A notification of patient responsibility for payment was provided on 9/22/23 to this individual with the complaint which we provide to every patient stating how many visits have been authorized or used in the current year and deductible and out of pocket amounts which we are quoted from their insurance. This document stated 26 visits for the year were authorized by the insurance and 15 visits had been used already for the current year. This document was signed and dated by the patient acknowledging the 26 visits per year that the insurance authorizes and the 15 visits out of those 26 that have already been used leaving 11 visits covered by insurance for the remainder of the year. 

  There were 22 total visits for this therapy case, 11 of those visits covered and the remaining 11 not covered by insurance. (See above for explanation as to amount of visits remaining covered for the year after 15 had been used by the patient prior to attending therapy at this location). Those 11 visits that were not covered were billed to the patient. That amount has since been discounted and the patient has been reimbursed for a portion of the bill that was paid as well.

   

  I believe this case/matter has been closed and completed.

  Customer response

  06/20/2024

  Complaint: 21738015
  
  I am rejecting this response because:
  
  There has not been any refund. I was told verbally by staff (I have a voicemail by *****) stating SSM was going to write everything off because they gave me bad information. Verbal statements are just as valid as anything in writing, and SSM has yet to provide me a copy of the statement they are saying I signed. 
  
  Sincerely,
  
  *****************************

  Customer response

  06/25/2024

  Complaint: 21738015
  
  I am rejecting this response because: See previous rejection. Same thing applies. I was told verbally it would all be written off. Now it has been sent to collections and no refund given even after I already paid.
  
  
  
  Sincerely,
  
  *****************************

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩