ComplaintsforWhite Sands Treatment Center

• Initial Complaint

  12/22/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I went to outpatient rehab at White Sands on *********************************************************************** from May 15-July 15.My insurance paid $3,000. Tricare. I am a retired military physician, 100% disabled, total permanent disability.******* said my portion was $1800. I was required to pay $3000 to start the program. Once the explanation of benefits was complete, ******* said my portion was $1800.I am due a refund of $1200.I finished rehab on July 15th and White Sands has refused to refund my money.Medical Director is ***********************. **************

  

  Business response

  01/09/2023

  Good afternoon,

  On December 22, 2022, *************************** spoke to the *************** Director inquiring about his receipt of a refund based on an Explanation of Benefits (***) statement he received from Tricare.

  The *************** Director explained the *** statement to ****************** and assured him that after all outstanding claims had been processed by *******, he would be issued any refund due him.

  There are currently two (2) claims for services provided on August 4, 2022 and December 22, 2022 that have not been processed by Tricare yet.

  I attempted to contact ****************** upon my receipt of this complaint on January 6, 2023 and was able to leave a message with my contact information; I have not been contacted by him at the time of

  this correspondence.

  I apologize for the delayed response.  We discovered that the previous complaint notification was sent to an unmonitored email address.  We have corrected the issue, and I will be your point of contact

  going forward.

  Please feel free to contact me if you require additional information.

  ***********************
  Director of Quality Assurance
  White Sands and Sunspire Health *******
  1820 *************.
  Ft. Myers, ******* 33907
  C:  ************

   

   

  Customer response

  01/31/2023

   
  Complaint: 18625870
  
  I am rejecting this response because: I am an 100% disabled veteran with the ** Army. On May 15th I was ordered to attend rehabilitation for alcoholism by my Physician. I contacted White Sands treatment center in Ft Myers, Fl. They reviewed my insurance with Tricare and told me that the cost of treatment is $6,000 and that my insurance would only pay $3,000. They told me that I needed to pay $3,000 up front in order to begin treatment. I paid this from my checking account with Fairwinds credit union ending in x9494. I attended treatment from 15 May to 15 July 2022. After I completed treatment, I contacted Tricare. Tricare told me that the patient responsibility for the treatment I received was only $1200, not $3,000 and that I was due a refund from White Sands. I contacted White Sands multiple times, including the admissions office, the medical director, and the billing office where I spoke to Chaz. **** told me that they have not received an explanations of benefits from Tricare and that without an explanation of benefits, they could not give me a refund, I contacted Tricare one month ago and again today, 27 January 2023. The explanation of benefits was mailed to White Sands on 22 December 2022. This document states that my responsibility was only $1190. I am due a refund of $1810. In addition, White Sands overfilled Tricare by $6,004.00 and Tricare is seeking a reimbursement from White Sands due to fraudulent billing practices. The claim number for this is claim # ******* *******. This is the SECOND TIME that I have made a complaint against White Sands for this issue. The first claim was closed on 1/22/23, where the BBB stated that White Sands had made a good faith effort and did not have the appropriate information. Either White Sands is lying or the BBB did not due their due diligence. I need someone to stand up for me, a disabled veteran, and help me obtain my refund of $1810 that I need in order to live. Please assist me in this matter as soon as possible.Sincerely, ***********************
  
  Sincerely,
  
  ***********************

  

  Business response

  02/01/2023

  Good morning,

  I asked the *************** Director to review ********************** second complaint, and the following response was supplied:

  I have reviewed *************************** complaint. I did speak with ****************** on two occasions informing him that he still had claims pending review at Tricare. ****************** states that he spoke to ******* who advised him the claims were processed and paid. Again, we have yet to receive any explanation of benefits (EOB) or payment from Tricare for the Dates of service (DOS), 08/04/2022 and 12/22/2022.  As I explained to ******************, he could potentially be entitled to a refund, but at this time we cannot process any refunds until all claims have been processed, in case he has more or less of a refund due him. I have also offered to have a 3-way call with ****************** and his insurance company, Tricare, to discuss further processing status of the claims. ****************** states the claims have been processed and paid, however that has not happened. 

  Several individuals at White Sands Treatment, including myself, have tried to assist ****************** with understanding our process and business practices. We do sympathize and regret that a disabled veteran who fought for our country, the same country in which we operate our business and strive to provide outstanding care and services, is experiencing financial difficulty. We are available to provide aftercare services and to assist ****************** in initiating a 3-way call with Tricare so that we may proceed to expeditiously process the correct and full refund for him.

  Please let me know if you require additional information.

  Thank you,

  ***********************
  Director of Quality Assurance
  White Sands and Sunspire Health *******
  1820 *************.
  Ft. Myers, ******* 33907
  C:  ************

  
  

*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. ↩