Complaints

• Initial Complaint

  10/20/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  This so called provider network does not provider the service they say they do! It is a scam! They say they send patients to our office through their network-but they do not! They call themselves different names in order to deceive the doctor, and trick you into signing up for long 3 yr. contract this way! They also take a percentage from the already reduced payments for some of our patients! NOT patients they refer to us-our EXISTING, long-time, self-referring patients! They would not cancel our membership and very unhelpful when I requested to do so. They also "claim" to have been responsible for approx. $250K worth of claims paid to our office-a complete fabrication. I would like my annual membership fee paid back & I do not want anything to do with this unscrupulous operation in the future. They also say they are a referral system for the VA-which they are not! Or at least not in my area. We are already community care providers for ********they do nothing & somehow are allowed to take 10% fee.

  Business response

  10/20/2023

  Hi ********

  I am so sorry that you are unhappy. I do not recognize you as a provider in our network. I queried your phone number, however, and found that we do have a provider named ****** ******** ** who has been in our network for 22 years since June 23, 2000. If *** ******* is the provider, please contact me directly to discuss at ************* **** ****

  Thank you,

  *****

  Customer response

  10/26/2023

  
  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.
  
  Sincerely,
  
  ******* *********

• Initial Complaint

  07/10/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I joined the network, I have been getting charged for patients I have not seen several times over the past 3 years. This happens every billing cycle. The issues are not fixed after constant calls. It took them over 2 years to add me to their list of network providers online. I can see patients names that are not mine from other clinics sent to me over unsecure emails. DO NOT JOIN THIS NETWORK. Staff is full of excuses. Look at their ****** reviews AVOID AVOID AVOID

  Business response

  07/10/2023

  Dear Dr. **** *******,

  Thank you for your comments and concerns. We appreciate your network participation and value your feedback as it helps us provide better service to our providers. Please know, you have been issued a credit in the amount of $2.78. As you stated, you are being billed incorrectly. We found through further investigation that your information is getting mixed up with your brother's information at the payor level. It appears the client that provides us this information added your internal client ID to a claim that was your brothers. We will monitor this issue closely, but please do understand we have a provider network with over 10,000 providers nationwide and it can sometimes be difficult to identify a plan's error in their data. Per your agreement, we provide utilization data, and you always have the right to contact us if you disagree or have questions about the data to allow us the opportunity to research and provide a resolution. 

  Dr. *******, we hope the above response is helpful. Please reach out to us directly if you have any questions.

  Sincerely,

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

   

   

  Customer response

  07/10/2023

  
  Complaint: ********
  
  I am rejecting this response because:  The company is well aware of the issue.  They have know of this issue since I started with them almost 3 years ago. I do not have a Chiropractor brother. I want my contract terminated immediately with full refund for one years fees.   No response to the fact that they send documents to providers with patient name and information  unsecured.

    If another business is billing out visits under my name that is fraud.  They need to investigate if this is happening and file criminals  charges against a company stating they are seeing and billing patients out under my name now  for several years.  
    
  Sincerely,
  
  **** *******

  Business response

  07/10/2023

  Dr. **** *******,

  After further reviewing your file, we removed you from the network in 2017 because you stated you were no longer practicing with your brother. Then you contacted us again and requested a second application. You rejoined the network with an acceptance date of 2/19/21. The second agreement you signed, is not eligible for termination until 2/19/24. Per the terms of your agreement, you are required to mail a certified return receipt letter, requesting to terminate 90 days prior to 2/19/24. In order to terminate by that date, please make sure to mail your termination letter no later than November 19, 2023.

  With regard to your statement which you said another business is fraudulently billing under your name, that is not the case. As I explained in my last response, we receive data from the claim's processor, and they inadvertently chose the wrong internal provider ID number on one claim we assume due to the last name being the same. None of these issues were due to our errors. As I explained, it was the plan's error in which they selected the wrong provider's ID number. On those two occasions, we credited your account regarding the errors you contacted us about. 

  Dr. *******, unfortunately, we cannot allow you to be removed from the network prior to your termination date due to continuity of patient care.

  Thank you for your service.

  ***** *****

   

*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. ↩