Complaints

• Initial Complaint

  04/10/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I had an office visit with ******************************* at Multicare Plus on February 8, 2023. At the time of my visit I was required to pay $275.00 for the estimated total of services that day, even though I do not have a copay and ****************** has suggested that payments not be made until claims have processed. My claim was finalized in February and it showed that my responsibility for that visit totaled $153.06, leaving an overpayment of $121.94 that should be due to me. I placed a call to Multicare Plus on February 24th and spoke to the Office Manager, *****, who told me that ******* didn't cover all items that they billed for and that I was responsible for the full amount and not entitled to a refund. I requested a copy of the full ledger of all accounts for my family and was told to pick it up in the office. I requested to speak to the office manager in person when I picked up the documents but she said that she was unavailable and would call me later. I placed another call to ******* and they confirmed that ******************************* is an in-network provider and as such, Multicare Plus is not permitted to balance bill for anything outside of the contract with *******. Since I did not hear back from ***** in February as promised, I called again on March 10th to speak with the office manager. She returned my call on March 13th and advised that they would rebill the charges. On March 24th I sent a certified letter to Multicare Plus requesting the refund for the overpayment. On March 29th ***** called me and left a voicemail stating that they would be rebilling and not issuing a refund. As of today, April 7th, ******* still does not show receipt of any revised claims for this service.

  Business response

  05/01/2023

  I left a message for ******* at the BBB upon receiving the first letter.  This patient was advised this was an insurance billing issue and that as soon as we received a response from her insurance I would send her a refund check. As of today we have received her corrected EOB (which I attached to this letter) and she will be refunded a total of $135.71.  This patient has made false claims against our business.  She stated I spoke with her and told her I would not refund her money back which is false.  I left her a detailed message stating we sent her claims back for reprocessing and that as soon as I heard back from the insurance I would send her a refund. I did state this would not be done by the date on her letter that she demanded her money back by, this claim was in the hands of the insurance.  A check will be sent out in the mail within the next two days.  

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