ComplaintsforHigh Quality Home Therapy, LLC

• Initial Complaint

  02/13/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Our son has Autism spectrum disorder (ASD) and requires occupational therapy. To accommodate his needs and upon review of the services on their website, we contracted High Quality Home Therapy (HQHT) led by Caryn M********** President & CEO. OT sessions started on 5/21/23 and were terminated by us on 8/16/23 due to extremely poor quality of services. Ms M********* never provided supervision to any of her therapists whose qualifications we questioned and who kept getting rotated in and out without any consistency in services. Attaching email to Ms M********* raising concerns about services and example of the 4th change in OT which was our last straw. We were billed $245 per session and paid in total $2,695. Additionally, HQHT has collected $6,214.41 from our insurance. When we learned that insurance made these payments, we suggested to Ms M********* that we should get refunded. Ms M********* issued $567.31 check to us. When we told her we would like to get a complete refund of $2,695, she told us $567.31 is all we will get and proceeded to accuse us in insurance fraud and harassment. Given the disservice our son received from HQHT (wasted entire summer without proper OT support which is one of the critical pillars for managing his ASD), HQHT's enrichment from our insurance company (we question their dealings with our insurance, but leaving it up to the insurance company to handle it with HQHT), we feel it's unfair for HQHT to hold on to our money. We paid them believing we would receive the services advertised. Instead, this company took advantage of our child's disability and enriched itself at our cost. The right thing for HQHT would be to issue a full refund to us ($2,695), apologize to us for accusing us of fraud and harassment (asking for a refund via email does not constitute harassment) and stop misleading desperate parents like ourselves (who would give anything to get the child better) by advertising high quality services that do not live up to that name.

  Business response

  02/22/2024

  I represent High Quality Home Therapy, and I am disputing the claims made by Mr. and Mrs. **** regarding their request for a refund for therapy services provided to their son.

  
  Firstly, I would like to address the nature of our services and the efforts we made to accommodate the **** family. High Quality Home Therapy is an out-of-network provider with private insurance companies. This intentional choice allows us to prioritize our focus on providing quality care rather than navigating complex insurance procedures. This policy was clearly communicated to the **** family prior to initiating therapy sessions, and they agreed to our terms. Please see attached signed intake forms.

  
  Upon commencement of therapy sessions in May 2023, we assigned an occupational therapist to work with the ****** son. Regrettably, the therapist fell ill after four sessions, necessitating a change in personnel. We sincerely apologize for any inconvenience this may have caused the **** family, but it's crucial to understand that unforeseen circumstances can affect the availability of therapists. We took immediate action to rectify the situation by offering four free sessions with another therapist, as well as a complimentary physical therapy evaluation, demonstrating our commitment to customer satisfaction.

  
  Furthermore, despite encountering challenges with scheduling and therapist availability, we diligently worked to accommodate the **** family's needs. When the second therapist expressed constraints regarding late appointments due to the **** son's existing therapy schedule, we promptly offered an alternative therapist. We made every effort to ensure continuity of care, emphasizing our dedication to providing the best possible service.
  Regarding the payment arrangements, the ****** initially opted for our self-pay discounted rate of $245 per session. However, they later requested assistance with insurance claims, leading to a transition in payment method. Our policy clearly states that when billing insurance, the discounted self-pay rate is not applicable, a condition to which the ****** agreed by signing our intake forms.
  In response to Mr. ****** request for a refund in January 2024, we conducted a thorough review of the insurance payments and identified discrepancies. Upon verification with the insurance company, it was determined that an overpayment had occurred, resulting in a refund of $567.31 being issued to the **** family. This amount was calculated in accordance with the insurance company's findings, aligning with our commitment to fair and transparent billing practices.

  
  Despite our efforts to resolve the matter amicably and in accordance with contractual agreements, the ****** persist in demanding a full refund of all payments made for therapy services. However, it is essential to emphasize that our services were provided in good faith, with the utmost professionalism and dedication to meeting the needs of the **** family.

  
  In conclusion, High Quality Home Therapy fulfilled its obligations under the terms of the agreement with the **** family. We provided exemplary care, made genuine efforts to address concerns and accommodate their requests, and upheld our contractual obligations. Therefore, we respectfully request that the ****** claim for a full refund be dismissed, as their account has been settled in accordance with the terms agreed upon.

  
  Thank you for your attention to this matter.

  Sincerely,
  Caryn M********** DPT, CEO
  High Quality Home Therapy
  
  
  

  Customer response

  02/24/2024

  
  Complaint: ********
  
  We are rejecting this response because we stand behind our original complaint and we are disappointed by Ms. M*********'s numerous inaccurate and false statements.

  Ms. M*********'s claim that the first assigned therapist fell ill after four sessions, necessitating a personnel change, is untrue. We provided feedback to Ms. M********* expressing concerns about the first therapist's poor quality of work. During a phone call, Ms. M********* admitted fault for allowing the therapist near our son and assured us she would stay on top of the quality of services to our son going forward. However, this assurance was negated by the revolving door of therapists.
  
  Ms. M********* repeatedly speaks about HQHT's service quality in her response, yet she never attended a single session, whether in person or remotely. Unlike our other providers, HQHT has failed to provide supervised sessions and to share with us regular progress updates. We were never provided therapy notes for any of the sessions despite our previous requests. Neither Ms. M********* nor her therapists discussed our son’s goals or progress with us before, during, or after sessions. Her claims of providing quality services are unfounded, considering our repeated concerns voiced over calls and in writing as well as HQHT's lack of transparency in sharing our son’s therapy information.
  
  We are perplexed by Ms. M*********'s attachment of our group communication to all service providers on July 30th, 2023 in her response to this claim. If she is implying that she received our gratitude for the lack of quality, she is mistaken. We included her in the group communication out of necessity, not appreciation. Our true feedback was expressed in the email dated July 17th, 2023, which was also reiterated to Ms. M********* during calls, and attached to this complaint. Despite our attempts to address concerns, Ms. M********* consistently redirected discussions towards additional services, showing little interest in our son's goals and progress. 
  
  Ms. M*********'s alleged commitment to customer satisfaction is doubted due to HQHT's billing of four "free sessions" to us and our insurance company. As you can see from HQHT’s final refund calculation (attached), the difference between what they billed the insurance for the four “free sessions” vs what the insurance paid HQHT was deducted from our refund amount. This raises concerns about whether these sessions were genuinely free and intended for customer benefit or simply to prolong billing insurance. Furthermore, the failure to coordinate the promised complimentary physical therapy evaluation further undermines confidence in HQHT's ability to fulfill commitments. 
  
  Regarding our alleged request for assistance with insurance claims, we did not initiate it; rather, Ms M********* offered her help to submit the claims to our insurance company, which we accepted in hopes of reducing our out-of-pocket costs and navigating insurance complexities more effectively. Despite agreeing to HQHT billing the insurance, we were still charged the full self-pay rate of $245 shortly after each session, contrary to our expectations. If we had known we'd only receive approximately 21% ($567.31 out of $2,695) reimbursement for poor-quality services, we wouldn't have accepted HQHT's assistance with insurance claims or continued their services. HQHT's revenue soared from our original self-pay arrangement of $2,695 to $8,342, a nearly 310% increase, raising doubts about the transparency and good faith of their offer to help with insurance claims. See HQHT’s final refund calculation and check attached. 
  
  We initiated the refund process in mid-January 2024 after almost a month had passed since our insurance provider sent payments to HQHT without any communication from HQHT about the next steps. The delay in refund and lack of communication seemed unfair, especially considering prompt payment was expected from us. HQHT's final refund calculation deducted the difference between what they billed the insurance for the four "free sessions" and what the insurance paid. See HQHT’s final refund calculation and check attached.
  
  After realizing HQHT claims were treated like in-network claims, we requested a full refund based on our $25 co-pay standard, following discussions with our insurance provider. Despite us approaching the matter with openness and refraining from expressing complete dissatisfaction, Ms. M********* abruptly ceased communication and accused us of insurance fraud and harassment (see copies of the emails attached as Ms M*********’s submissions were not properly printed). As professionals held to ethical standards in our respective fields, we take these accusations seriously. Ms. M********* stated she reported us to "proper authorities" regarding insurance fraud. We seek clarification on the authorities involved.
  
  In conclusion, Ms. M********** as CEO of HQHT, failed to meet ethical marketplace trust standards in our case. Despite advertising high-quality services, she neglected proper therapist supervision and implemented pricing models that prioritized revenue over client benefit. This violated our consumer rights and deprived our son of essential support for adjusting to life with ASD. Instead of acknowledging the failure to provide the quality services advertised and addressing billing concerns transparently, Ms. M********* accused us of insurance fraud and harassment posing serious threats to our careers and our entire family’s livelihood. No parent of a child with disabilities should endure what we have. We reject her response and her request for dismissal of our claim. We demand a refund of $2,695 and an apology for the distress caused.
  
  Sincerely,
  
  ******** * ******** ****

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