ComplaintsforPhysician Practice Specialists

• Initial Complaint

  02/01/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I paid $**** to be contracted with 15 insurance companies and the company only got less than five. They filed the contracts wrong which required additional paper work for correction and delayed business starting.

  

  Business response

  02/15/2024

  Upon review of this individual, I do not find that he reached out to me at all during this process. I usually handle any complaints, and the first time I have heard of this gentleman is with a BBB complaint. I usually at least get a call or email to help rectify any situation that may have arisen in the course of doing business--as a courtesy. However, I have reviewed this project, and see that we were in contact with this practice during the course of the project, and during that time, we supplied a charge master and an office address demographic change, along with processing credentialing paperwork for up to 15 payers. After the first address change, we heard he had another address change which we processed, then nothing more from this individual for several weeks, then he notified us he had a third address change, and finally a fourth, for none of those last three were charged. We processed paperwork for the insurance payers he requested, and our charges are based on the paperwork being completed and filed; not on whether or not the plan is open to new providers. If we were unable to get a contract for a provider, the work was still performed. I understand it is frustrating for closed networks in this arena, and it is even more frustrating to pay for a process in which you have those closed networks, but those closed networks were not the fault of PPS, just as it was not the fault of this provider. We have not discussed next steps with this provider as to possibly filing appeals, re-submitting when the panel is open, etc., because he chose to file a complaint instead of discuss his options with us. For that, we are sorry, but we stand behind the work that was performed for the insurance companies, and in fact, are still processing some of these as this is an active client. 

• Initial Complaint

  10/10/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  This business charged me $2,375.00 to credential me with multiple insurance companies for my practice. The company did poor work, could not assist with general questions I had, and agreed that there were issues in the work I received based on my specific needs. I got in contact with *********************************** who agreed to speak with the team about a refund in June 2023, I have not heard back from her despite checking in. I paid for ten insurance contracts and received two - and the two I did receive was not helpful to my practice. I would appreciate a refund so I can pay for this work to be done correctly.

• Initial Complaint

  03/21/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  In December of 2021 ***** ** **** ******* * ********** **** contracted with this company to get our ******** ********** **** ***** ************ credentialed with ******** and several insurance companies. Fifteen months have passed, and our ** is now credentialed only with ********. Every time we ask for an update, we either get no response or several weeks after our request, we are told that our account manager has changed. We have had 3 different account managers, and the changes were not communicated to us. Worse than having poor and unhelpful communication, they are not producing what we have paid them to do. In December 2021 we paid this company $3,450, and we still have very little to show for it. I am requesting a full refund of our payments.

  Customer response

  03/21/2023

  The last time we were in touch with Physician Practice Specialists was 11/22/22.  Please let me know if you have any more questions.  I appreciate you looking into this.

  ******* ****

• Initial Complaint

  02/16/2023

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  The original contract between Physicians Practice Specialists and ********* Transitions was signed and accepted on March 21, 2022 for credentialing and contracting the following insurance companies: 1. Regence BC/BS or Oregon (completed) 2. ***** (completed) 3. PacificSource (not completed, unknown status) 4. United Health (not started, PPS update spreadsheet indicates this payer replaced Optum on 5/5/22) 5. **** (not started per ****) 6. Medicaid (completed) 7. Medicare (not started) The total price paid for the credentialing and contracting services of PPS was $3000 with an estimated time frame of 60-120 days. We have now exceeded 311 days and the amount of work on our part to maintain progress and correct the mistakes of PPS should in my opinion, nullify any agreement for services promised, as the promised services were not rendered. Some pertinent details: 1. 136 emails concerning the service promised. 2. Credentialing team at PPS was completely replaced due to incompetence on August 31, 2022 (email attached as a document). 3. Email 0n 10/28/22 requesting a more detailed update was not addressed or acknowledged. A reminder was sent on November 4th and was not answered or acknowledged (email attached as a document). 4. In May 2022 credentialling began for ****, updates were given by PPS over the next 4 months that our application was “in process”, and at the end of August 2022 we were notified by PPS that **** was closed to new providers. We called **** at that time and were told that “PPS dropped the ball” and we begged them to re-open the file and consider our application, which they did. We notified PPS and (unfortunately) re-tasked the new PPS team to complete credentialling with ****, only to find out in January 2023 that they dropped the ball again. ********* Transitions is now paying another credentialing and contracting service to complete the job PPS failed to perform, at our expense. Supporting emails and documents are attached.

  

  Business response

  04/17/2023

  I have attached the update for your records as well.  We were contracted by ********* to provide credentialing and contracting services for their practice and ***** ****** (contract and paid invoice attached).  This was for the practice and one provider.  When signing up this client, we were never informed that ***** ****** was NOT fully licensed to provide unsupervised care.  As you can see by the attached email, ***** did eventually tell us that he was basically an intern and couldn't treat patients independently.  Upon learning this, we were requested to credential ******* ***** instead of him.  Again, we were never told this when signing he signed up for services as we would have sent him elsewhere.  We did end up proceeding with attempting to credential ******* ***** and were successful in some cases such as ***** & Uprise (see attached Aetna.pdf approval and Uprise approval for ******* *****). However, the approval of ******* ***** did not help ***** see patients and is ultimately not what he wanted.  He essentially wanted to skirt the licensing requirements and have us credential him to practice independently which was not something we felt comfortable fighting for nor was it part of our agreement.  The whole situation with him seemed fraudulent and that he was intentionally hiding/misleading us.  We never had direct contact with ******* after repeated effort on our part which is very odd to say the least.  

   

  Emails/documentation attached for the below

   

  PPS contract

  Notes from Account Manager

  **** initially declined to work with ***** (see attached email from ****)

  ***** closed as they would not issue a contract to ***** due to his licensing issue.  ******* ***** approved

  Optum- the licensing issue for ***** caused issues here too.  They gave him two options, wait until ***** is fully licensed or submit claims under ******* which would require a supervisor contract for ******* to sign.  This was all outlined in the update from 11/11.  ***** did not proceed with the supervisor contract to our knowledge.

  Uprise - ******* ***** approved

   

  We went above and beyond for this particular client but because what he wanted wasn't legal and certainly wasn't what he signed up for, he remains dissatisfied. In accordance with our agreement, we are in no way obligated to provide any type of refund.  However, considering that I take part of the blame for ever proceeding with this project in the first place, I would be willing to provide a courtesy refund in the amount of $1250 (half of initial contract) provided if and only if, we never have to hear from him again AND he removes his negative review on Google.  If he does not want to do this, I will publicly respond to his complaint, have my entire team post their own reviews online and ask all payers to do an audit of his practice to ensure he is meeting all standards of care and that his documentation supports what he is doing.  We do not like having our name associated in any way with a business like this and I hate that we ever agreed to work with him.  Had we known the truth at the outset, it never would have happened.  

   

   

  Sincerely,

   

  ..

  
  

• Initial Complaint

  12/16/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  On 6/9/22 I paid (PPS) Physician Practice Specialists $11,900 to credential me as an ** in *****, and **. The credentialing was unable to move forward due to my *** name change (my maiden name was **** ***** and my married name is **** ***********) after 6 months of contacting the ******* I am no-where the *** is backed up since 2020, the only way to reach them is **** (they have no fax number, no phone number, no in-person option) - I went in-person to the *** ***** ********** ****** in ********* and they cannot help with *** only back taxes, I contacted 3 tax lawyers and no one wants to take the *** to court for a name change. I let PPS know on Friday 12/9/22 that I gave a 30 day notice on my office rental space and no longer am interested in pursuing a private practice. Personally, I am ** ***** ******** at *** ** and I was hospitalized on 11/10/22 and 11/11/22 for ******** ***** so medically I cannot start a private practice at this time. I let them know that I paid $11,900 on 6/9/22 and no credentialing has been accomplished due to the ***. I have not heard how my $11,900 will be refunded. I reached out to *** ***** and **** **** via email and I sent a hard copy paper request in writing to the ************ address.

  

  Business response

  02/24/2023

  We offered $5500 and will raise this to a total of 60% refund as a one time courtesy.  Again, contractually this is a courtesy as she is not owed a**thing.  It would be different if she would have terminated 30 days after signing. I will forward you our most recent correspondence where we sent her all the work that was done on her behalf.  She claims nothing was done but that is not true.  

   

  Here is an account of what was done.  We sent this to her and she basically insulted us saying that this was worth about $150.  We paid sales staff bonus for the sale, held her spot for over 4 months (thus limi***g our ability to take more work on), had to pay our staff for the work done and have software costs for crea***g her profile.  

  Good afternoon, 
  

   

  From July 13th to August the 8th I spent a lot of time on her account. I noticed a *** issue on July 28th. I emailed the provider and let her know this would need to be corrected before we could submit the application since she had her *** listed as her *** ** for the group. We were in correspondence several times in regards to this. She said she had to have this fixed *** as a tax advocate.

  I would check in from time to time with her but she was still having issues trying to get this corrected. I am sorry to see her go since she is such a lovely person to work with. Let me know if you need me to send my emails to you. There are quite a few. I hope this helps some. Please let me know if there is a**thing else you need from me. 

   

   

  Payers **:

  15 payers were assigned. ******* *** ******* were submitted. 

  *** was closed/**** was not here in US. Emailed and let her know

  *****************: Could not apply since *** ** issue

  *******: individual was submitted was wai***g on group

  The rest were left in limbo since I had started on the ** application 1st and this was when I discovered the *** ** issue. 

  ***: Sent interest form they noted they did not do ** providers at this time 

   

  Payers **:

  13 payers were assigned 

  ********: ***** portal was made for provider

  *****: Submitted interest form( Does not do that market was the response)

  *******: individual submitted for the provider only was wai***g on group 

  ****** emailed for an application 

  ******** **: Called and emailed and they noted that they did not accept this type of provider/ Must have group

  *******: Called she had to have ******** first

  ***: Interest form was submitted 

  ******** ********: Did an app but did not send since the group tax was incorrect

  ***: Sent interest form they noted they did not do ** providers at this time 

   

  Payers **:

  11 Payers were assigned 

  *******: Individual application submitted was wai***g on group

  ** ********: Created account to apply 

  The ** apps were on hold do to *** **

  ***: Sent interest form they noted they did not do ** providers at this time 

  

  Business response

  02/24/2023

  We offered $5500 and will raise this to a total of 60% refund as a one time courtesy.  Again, contractually this is a courtesy as she is not owed anything.  It would be different if she would have terminated 30 days after signing. I will forward you our most recent correspondence where we sent her all the work that was done on her behalf.  She claims nothing was done but that is not true.  

  Here is an account of what was done.  We sent this to her and she basically insulted us saying that this was worth about $150.  We paid sales staff bonus for the sale, held her spot for over 4 months (thus limi***g our ability to take more work on), had to pay our staff for the work done and have software costs for crea***g her profile.  

   

  From July 13th to August the 8th I spent a lot of time on her account. I noticed a *** issue on July 28th. I emailed the provider and let her know this would need to be corrected before we could submit the application since she had her *** listed as her *** ** for the group. We were in correspondence several times in regards to this. She said she had to have this fixed *** as a tax advocate.

  I would check in from time to time with her but she was still having issues trying to get this corrected. I am sorry to see her go since she is such a lovely person to work with. Let me know if you need me to send my emails to you. There are quite a few. I hope this helps some. Please let me know if there is anything else you need from me. 

   

   

  Payers ***

  15 payers were assigned. ******* *** ******* were submitted. 

  *** was closed/**** was not here in US. Emailed and let her know

  *****************: Could not apply since *** ** issue

  *******: individual was submitted was wai***g on group

  The rest were left in limbo since I had started on the ** application 1st and this was when I discovered the *** ** issue. 

  ***: Sent interest form they noted they did not do ** providers at this time 

   

  Payers ***

  13 payers were assigned 

  ********: ***** portal was made for provider

  *****: Submitted interest form( Does not do that market was the response)

  *******: individual submitted for the provider only was wai***g on group 

  ****** emailed for an application 

  ******** *** Called and emailed and they noted that they did not accept this type of provider/ Must have group

  ******** Called she had to have ******** first

  ***: Interest form was submitted 

  ******** ********: Did an app but did not send since the group tax was incorrect

  ***: Sent interest form they noted they did not do ** providers at this time 

   

  Payers ***

  11 Payers were assigned 

  *******: Individual application submitted was wai***g on group

  ** ********: Created account to apply 

  The ** apps were on hold do to *** **

  ***: Sent interest form they noted they did not do ** providers at this time 

  Customer response

  02/24/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

   Complaint: ********

  I am rejecting this response because: A total of 130 minutes were given to helping me get credentialed but ultimately I could not get credentialed because the *** is processing claims from 2020 and the tax assistance specialist is no longer accepting new cases to help me with my *** name change - I contacted 3 tax lawyers all of which refused to take the *** to court to petition for a name change. I no longer am interested in pursuing a private practice - I was hospitalized in November 2022 and was in a **** **** ********* **** ******* *************. A lot of the action that's on the list was "waiting for ***" which was the ultimate problem. I would like my refund back - I paid $12,000 and for PPS to say "we don't owe her anything" is unethical.

  Regards,

  **** ***********

• Initial Complaint

  10/19/2022

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I hired PPS as a credentialing agency. I am a nurse practitioner and PPS was to credential me with 10 insurance agencies in Pennsylvania. I worked with them for approximately 10 months now. There were numerous times that I contacted management because my assigned rep was not returning correspondences for weeks at a time. After I was told that I was contracted with a few insurances (took far longer than it should have), I finally started to see some patients with those insurances. I have come to find out that I am not credentialed with those insurances and was lied to. I am now more than $2,000 in debt because I will not get refunded from the insurances. In addition, I paid PPS $2,500 for their services, which were not provided. I wish to be reimbursed minimally the $2,500 for services that were not provided and would hope that another $2,000 would be given for my time being wasted. I have tried calling PPS multiple times over the past 2 months to settle this professionally, but I have never received a phone call back. I have also sent emails and have not received an email back.

  

  Business response

  11/02/2022

  This particular client was a problem from the beginning and we completed nearly everything she contracted us to do.  Refunds are at our sole discretion per our contract.  In addition to her being extremely difficult to work with, she was also wanting us to assist her in opening a business that was not in compliance with state and federal laws regarding supervision.  She wanted to have registered nurses go to patients homes and administer Botox for cosmetic purposes which is not within the RNs scope of practice without DIRECT supervision.  I am open to refunding her 75% of the money she paid if she removes her negative (unfounded) google review and ceases any further slander.  Failure to do so will force me to involve my legal counsel and consult with her state’s nursing board to look into her practice.  

  Customer response

  11/03/2022

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]

  Better Business Bureau:

  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. 

  Regards,

  ********* ****

   

*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. ↩