ComplaintsforEating Recovery Center and Pathlight Mood & Anxiety Center

• Initial Complaint

  01/18/2023

  Complaint Type:

  Order Issues

  Status:

  Resolved

  More info

  In June 2021, I enrolled one of my daughter in an In-patient program at Chicago ***. When I dropped her off I paid a check of $2730 to cover my max out of pocket. This was confirmed by insurance and ***. All billing was run through insurance several times through 2021 and 2022. All was completed and done with it. I Did not hear anything until September 2022 I start receiving threatening letters that I owe them close to $6000. Due apron receipt I have lengthy discussions with them. No one has any recollection for the check I wrote and there is no record of it with them. Insurance doesnt know about it because it was never processed through them. Someone at *** told me that the bill had been not being mailed until September 2022 because it was flagged as not to print not patient responsibility. However, another lady told me I was lying and had been getting it. Keep in mind the *** got well over $45,000 from insurance for the treatment they gave my daughter. I was told back at the end of 2021 through an intermediary company helping me to deal with this that my portion would likely be forgiven because of the extreme circumstances regarding the health of my child. But here we are 2023I am now receiving bills again. Terribly run billing.

  Business response

  01/20/2023

  Statement from ERC Pathlight Business Office:  Claims for this member we incorrectly adjudicated by the member insurance provider.  Payer indicated higher than anticipated patient cost sharing and underpayment of claim responsibility.  Over the course of 12 months, we continued to pursue appropriate payment from the payer and ERCPL ultimately agreed to a reduced payment from insurance which reduced the patient cost sharing from $43K to under $6K.  Liability was finalized in NOV of 22.   Robust communication with ERCPL business office and FRP throughout the process. 

  Customer response

  01/20/2023

   
  Complaint: 18833421
  
  I am rejecting this response because:
  

  The explanation does not indicate why my max-out-of pocket would be impacted. Negotiations were between insurance and provider and changed patient expectation without cause or notification. Their explanation basically read: insurance didnt pay enough so we are gouging the patient after signing contracts to not do that. No different service, no different insurance oops charge the patient. Sounds like maybe they goofed up the negotiation with insurance. Not my problem. I have fulfilled my obligation per attached contract.

   

  also, I need the discrimination addressed leading no accommodations for men at the facility I had to spend ****s to stay nearby. While moms have accommodations provided.

  Sincerely,
  
  ***************************

  Customer response

  01/23/2023

  I apologize. **** is slightly inaccurate. The amount is listed below. ******* I gave them. I inadvertently included the hotel deposit I had to pay because they have no accommodations for divorced dads helping daughters through anorexia. Males are not allowed to stay in the facility provided accommodations.
  
  There were no changes in coverage. No additional services are included.
  
  Supporting pic of doc attached.
  
  *********************
  

  
  

  Business response

  01/31/2023

  At this location, most of our patients are from the local area.  However, there are occasions when housing is requested for a parent/patient who lives outside of the area.  To meet this need, ERC Pathlight has 1 apartment available for use for a patient/parent to stay while the patient is receiving treatment in the *** level of care.  The 1 apartment had already been assigned to another parent/patient.  We did not have another resource available.  

  Customer response

  02/06/2023

   
  Complaint: 18833421
  
  I am rejecting this response because: 

   

  At the time I went, they had two apartment suites that connected. Neither of which was in use at the time. They had 2 other patients in route later that week. Because I am a male and not female I was skipped to allow the 2 mothers coming to stay in the connecting apartments. Dont be fooled. This decision was NOT based on availability but making sure they could utilize both side of the double apartment. I understand that policy has changed at the facility which is nice. Because now they do only have 1 apartment. The entire management, staff and policy changed. Facilities dont change management, staff and policy unless they are broken. Now new management is protecting previous bad behavior which makes them destine to repeat. They are attempting to take no responsibility for past mistakes yet they still want to collect the money. 
  
  Sincerely,
  
  ***************************

  Customer response

  02/08/2023

  Staff at this facility participated in a Intentional False report to DCFS the day I took my daughter home.  I was on my way to the facility.  I believe the staff participated in the report the last day in order to get me back for raising concerns for my daughters care while at the facility.  I had provided numerous forms, court documents and DCFS contact information educating them on my situation with intentionally false' reports in the past.  Why else would they file the report and then within hours later provide my daughter to me? The staff knew it was false and wanted to make the situation harder. It was retaliation similar, to the way my concerns have not been addressed in this complain. They avoid all responsibility. We all know as mandated reporters we have to report abuse if it is suspected.  However, this Northbrook facility did not follow the guidelines provided to them by me, the court, and DCFS contacts.  They bypassed all the protections I had put in place. 
  
  I can provide the Internally False finding if needed.
  
  *******************;  
  

  
  

  Customer response

  02/13/2023

  Please close this complaint. I will no longer have contact with this organization. I am good with that. My billing issue is also resolved.

   

  Finally got the right person.

   

  Thanks

  Sent from my iPhone

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