ComplaintsforCarolina Occupational Therapy Of Greenville, Inc

• Initial Complaint

  11/04/2021

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  I received services 2/10/20. I never received a bill for a balance due until 10/27/21 (one year and 8 months later). The bill was dated 10/18/21. Now they want me to pay them $240.44. I would like to know if I have any recourse?

  Business response

  12/01/2021

  Business Response /* (1000, 5, 2021/11/04) */ The complainant was made aware during her initial visit that she had not met her deductible and that it was very probable that any charges incurred for the visit would go against her deductible. It usually takes 2-4 weeks for insurance to respond with payment and/or explanation of non-payment via an Explanation of Benefits (EOB). At the time that our clinic received the EOB, COVID-19 was hitting the US hard. Businesses were closed, non-essential personnel were not working, schools were closed, etc. and so forth. Some insurance companies began to not require co-pays to be paid by patients at the time of service due to the financial hardships being incurred by many people. As a way to help our patients that had private insurance and deductibles to meet (it was early in the year and many insurance deductibles reset in January each year), we delayed sending statements/bills as a way to ease financial hardships and ensure that patients would not be hesitant to seek the medical services they needed. When regular billing resumed, we sent out the delayed statements. It so happens that the complainant's statement did not auto-generate and this was not discovered until a recent reconciliation. The amount due cannot be disputed as the services were provided. Initial statements are typically sent out after all treatment is completed and the billing department has ensured that the insurance companies have paid for everything they are contracted to. For those persons that are in therapy for multiple weeks/months, it is not uncommon for a person to receive their initial statement 4-6 months after completion of treatment. However, it is very atypical for an initial statement to go out so late if there is only 1 visit. It should be noted that there was expectation of more treatments to follow which did not come to fruition. As a token of goodwill, we would be willing to write--off 50% of the amount due if the complainant pays the remainder by 11/27/2021.

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