Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:03/03/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On 10/09/2023 I slipped and fell while staying with friends, (******), breaking my hip. As a pro se litigant I filed a complaint against the ****** renters insurance policy ALL STATE. We reached an agreement of $100,000., less my ******** bill. Prior to my fall I had home health care due to a serious infection. When I was released from the hospital this concluded all medical care for my hip. My home health was continued for my other medical condition and any upcoming knee surgery. My home health care had nothing to do with the slipped and fall or my hip. ******** was one of the companies that provided home health care to me.ALL CARE sent ******** a bill for the same service dates in 2 different amounts. $1300 and $6,000 and tried to attach it as if it was care for my hip. ******** denied the claim because it wasn't coded correctly. Per ********, I told them to resend the bill correctly which they never did. First of all home health care is paid 100% in full by ********. The patient has no financial responsibility. ******** submitted the bill and because they were aware of the insurance settlement they attempted to increase their bill from $1,300 ,to $6,000 and coded it as if the care was for my hip. ******** denied the claim. I told ******** to resubmit the bill again with the correct code and they would be paid in full by ********. THEY DID NOT! ******** only allows them to charge est $100 per day. In an attempt to ***** me for more money they didn't change the coding for the correct service. They did not do this but instead tried to jump on the insurance settlement to get more money. This was nothing more than a company committing fraud and price gouging on an elderly DISABLED PERSON. I informed All State Insurance to deny ALL CARES claim and if they attempted to pay ******** i would not settle the claim. As a pro se litigant it is my responsibility to pay my bills out of my settlement which I did. I have additional documents that won't load.

  Business Response

  Date: 03/12/2025

  Better Business Bureau                                                                                                                                                 03/12/25
  Complaint ID: ********
  ******** *****
  
  Response to Complaint:
  
  Complaint:  (1) My home health care had nothing to do with the slipped and fall or my hip
  
  All Care Home Health received a home health referral from *********************************** on 10/23/23.  Per Sunrise history and physical, primary diagnosis was acute left intertrochanteric hip fracture, status post open reduction and internal fixation surgery that was completed on 10/10/23. (Exhibit 1)
  
  ******** Submitted both claims with diagnosis code: S72.142D Displaced intertrochantieric fracture of left femur, subsequent encounter for closed fracture with routine healing which corresponds with the reason for the home health referral.  (See exhibit 2)
  
  Complaint:(2) ALL CARE sent ******** a bill for the same service dates in 2 different amounts;
  
  We submitted the following claims to ******** one time only and there were no corrections or adjustments completed after the initial submission
  
  Dates of service 10/16/23 11/24/23 Total Charges $690.01
  Dates of service 11/25/23 12/21/23 Total Charges $690.01
  
  Complaint:(3) ******** denied the claim because it wasnt coded correctly
  
  ******** denied the claims due to reason code: ***** This claim was submitted as ******** Primary and a positive auto/no fault record exists at the CWF.  (See exhibit 3 for complete description).  Claim was coded accurately per referral received from *****************  Home health must code and bill what is documented in the home health referral and/or medical records from the referral source. 
  
  Complaint:(4) First of all home health care is paid 100% in full by ********,
  
  Home health is paid in full by ******** when they are the primary payer.  Per our claim denials,******** was NOT the primary payer. 
  
  Complaint:(5) ******** submitted the bill and because they were aware of the insurance settlement they attempted to increase their bill from $1,300 to $6,000
  
  ******** pays home health agencies using (PDGM) which is a Patient-Driven Groupings Model where payments are based on a 30-day period rather than individual visits, and is adjusted for admission source,timing, clinical grouping, and functions impairment. 
  
  Claims were submitted to All State with the expected payment amount we would have received from ********. All State also verified that are charges were usual, customary and reasonable.    
  
  Complaint: (6) ******** only allows them to charge est $100 per day
  
  Each home health agency is allowed to setup up an individualized fee schedule.  They are allowed to bill what they determine to be reasonable for each home visit.  As stated above, home health is paid per PDGM and the per visit charge is a non factor in the amount of payment we receive.    
  
  Complaint: (7) ******** Smiths Attachment dated 05/15/24
  
  This letter is not related to ******** or our services.  ******** did not receive any payments from ********.  This letter states that ******** had closed their lien that ******** had filled with All State. 
  
  Complaint: (8) This was nothing more than a company committing fraud and price gouging on an elderly DISABLED PERSON
  
  All Care Home Health, Inc.has been providing services to seniors for over 30 years in the *****************  We are committed to maintain the highest ethical standards in all aspects of our work.  We follow all regulations and guidelines carefully to ensure that our services are transparent and trustworthy.  We are INSULTED with this accusation as it is a deliberate falsehood and will be forwarding this complaint to our lawyer for possible legal action. 
  
  
  
  Sincerely,
  
  
  
  ******* A ******
  Administrator