ComplaintsforFlorida Fertility Institute, PA

• Initial Complaint

  01/05/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  We previously saw this location for fertility treatment. It was not until we left for another clinic that we were informed by our insurance that this business charged more than was contractually allowed under the plan. We approached the clinic about the excessive charges and they immediately informed us that we had a credit of almost $2000 on the account. When we asked how they got that number and why it was not more, like our insurance company said it should be, we were told they needed to look into it and get back to us. We originally reached out over the summer and were told to wait until the end of September. We have now given them an additional 3 months with no reply. We asked for all insurance EOBs so we can cross reference how much we should have been charges vs how much we were actually charged. We still have not heard anything back.

  Business response

  01/22/2024

  Refund was issued to ****************** in August of last year.  The account was in review since patient felt an additional refund may be due.  It was determined after review of the EOB's that the refund issued was correct and no additional refund was due.  This information apparently was not communicated to ****************** and we apologize for that over-sight.  A letter with explanation of benefits regarding her portion of patient responsibility due in addition to copies of the EOB's reflecting that amount have been provided and mailed to her and should be received in the mail by the end of this week. 

  Customer response

  01/22/2024

   
  Complaint: 21090981
  
  I am rejecting this response because: the insurance company specifically told us that the amount was not accurate prior to receiving the first check in August. I have made several attempts to get a break down of the EOBs to resolve the discrepancy and have transparency and I was repeatedly told that was a lot of work on their part and that I should be satisfied with what I received. After months of no communication I am not satisfied with this response as we have yet to receive anything in the mail from this clinic. We will need a complete breakdown of the EOBs received before closing this complaint 
  
  Sincerely,
  
  *************************

  Business response

  01/23/2024

  ****************** has stated a few times that her carrier says an additional refund needs to be issued.  We are requesting a copy of this documentation that states the refunded amount is incorrect and also the reference # provided to her so that our insurance coordinator can contact her carrier directly.  A copy of each claim processing where money should be refunded needs to also be provided as well. It is noted on her complaint that $15000.00 is the disputed amount.  Please be informed that this amount was not paid by *******************  Her OOP amount the entire time she was doing treatment was far less than this amount. The amount she paid for her last procedure had several services that were non-covered by her policy and we will be happy to provide her with all the financial agreements that she signed that gave her this breakdown.  Prior to this her services were paid as she came in and any balances due were paid each time.

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