Complaints

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• Initial Complaint

  Date:07/18/2022

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  - Original date of doctor's appointment: 08/26/2019 (confirmed to be covered by insurance). - First contact from provider (phone call), May 2021 - No invoice received, neither back in 2019, nor following the phone call in 2021 or later on, in spite of several requests from our side to received this from the provider. - Another call in September 2021, promising to revert with further info. This never happened. - In June 2022, our credit score deteriorated dramatically, and we requested a credit report. On the report, there is a collection claim registered 12/03/2021. Still no invoice nor any kind of communication, neither from the medical provider, nor the collection agency. We request that the collection is reversed, that the billing is adjusted, and that the credit report is corrected. Please see attachment for further information and details.

  Business Response

  Date: 08/04/2022

  Business Response /* (1000, 5, 2022/07/29) */ Patient's father was notified that we were out of network prior to his appointment on 08/26/19. Father agreed to be seen by us, an out of network provider. His insurance did not cover any of the visit. Insurance was rebilled several times and denied payment. It was made patient responsibility. We sent several bills (monthly) and attempted to contact dad on several occasions without any response. In May 2021, almost 2 years after the visit, our billing department was able to reach dad and explain the situation. Dad refused to pay. We attempted to negotiate a discounted rate but he never responded. In August of 2021 he sent us an email requesting that we write off the balance. We called him to try to resolve the issue but he was irate, hostile, and unprofessional on the phone. He did not respond to any of our correspondence afterwards trying to resolve this matter. We sent this account to collections in December of 2021 Consumer Response /* (3000, 8, 2022/07/30) */ (The consumer indicated he/she DID NOT accept the response from the business.) Dear Sirs, There seems to be a deep and serious misunderstanding and/or human error in this case: - First of all, we were NOT informed that insurance would not cover the health check, on the contrary we were confirmed over the phone that it would (see written communication). If not, we would not have scheduled, or we would at least of course have paid at the time of the visit, which was never requested. However, this is not the most important error in this case: If for any reason, the insurance company refused to pay, we can understand that Pediatrics Associates sends the invoice to us. - However, this was never done. Nobody from Pediatrics Associates reached out in any way until May 2021, i.e. no invoice, no communication, neither written nor over the phone, until almost 2 years after the health check. If invoices have indeed been sent, please forward copies with the address you sent these to. - We have not received any written proposal regarding a discount, and this was never negotiated. Please forward this as well. - I have not sent any email requesting to write off the balance (please see complete email communication attached). On the contrary, I sent an email following up a phone call, explaining (again) that I did not receive any invoice, that our insurance agent again had confirmed that this should be covered by our then insurance, and I asked Pediatrics Associates to revert if they needed anything else from us. They did revert, asking for a copy of the two-year-old insurance card, which I replied that I had not kept. - Since then, no more communication from Pediatrics Associates, neither phone, email, nor post (e.g. invoice, which I repeatedly asked for). - There is not one single email, phone call, or other attempt to reach out to me, that is unanswered or not responded to. I have immediately responded to the very few emails and phone calls received from Pediatrics Associates. - As for not being able to reach us: we have had the same phone numbers since 2015, never been disconnected. We lived at the same address where we were living at the time of the visit for one full year, and we had mail forwarding for another year (i.e. until August 2021). Thus, any invoice or other mail should have been received. The company also demonstrably has my email address, as we have been communicating about the matter. Thus, they should have been able to forward invoices by email. I therefore strongly question that they have had difficulties to reach us, or that we have not responded. - I take the accusations of me being irate, hostile, and unprofessional as a personal insult. Yes, I was most likely quite upset when the company did not respond to my arguments, nor did they forward copies of the invoice as promised. They called after 2 years with a claim, and they did not follow up with copies of the invoices as promised. Then I did not hear back for another 3 months with the same claim, still without any copy of the invoice, nor any understanding for the human error made by someone (Pediatrics Associates or the insurance company) back in 2019. - Again, I need to repeat that we STILL HAVE NOT RECEIVED ONE SINGE INVOICE from Pediatrics Associates (nor from the collection agency), and we have thus no information about how to pay the invoice or even the exact amount. - All these errors, misunderstandings, or mistakes in the written response from Pediatrics Associates make me question if the company have me mixed up with someone else in their files. I.e. do they have the wrong contact details? The wrong invoice address? I would very much like to receive copies of the invoiced sent on a monthly basis, as we have not received any of them. In addition, we subscribe to "**** Informed Delivery", and we have not seen any letter from Pediatrics Associates that should have been received. - Please find attached a full copy of the complete email communication between me and Pediatrics Associates. - Our primary request is to withdraw the collection claim, as this is seriously and unfairly hurting our credit score, and thus our family's financial standing. We have, until now, had an excellent credit score, never having failed to pay an invoice in time. - Our second request is to reconsider the charge, given the full documentation and history of the case, which clearly shows that an error has been made. - Please revert to us with your suggested next steps, in order to solve this very old error, as we still do not have any information about how to proceed. Sincerely, **************************** Business Response /* (4000, 10, 2022/08/03) */ Our EHR send out bills to patient's guarantor with an outstanding balance on a monthly basis that is mailed/delivered via ****. It is all stored digitally. If we generate a new one then it will have todays date on it. We have never received a returned statement for this account/patient. Attached is a print out of the final statement sent to the guarantor prior to going to collections after 2 years of trying to resolve this issue. Multiple attempts have been made by phone and emails. Attached is one of the last email correspondence that claims that his child had coverage (if his child was covered then he can submit the claim and get reimbursed as we were told otherwise and have gotten denials). All documents have been sent to our collection agency, *************************. The agency attempted to contact the father a couple of days ago. All further communication to resolve this issue should be directed to the collection agency.