Complaints

• Initial Complaint

  10/04/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  The physical therapists and the personal trainer at Elite are wonderful. However, this complaint is regarding the billing department. In 2021, I had met my yearly deductible and Elite was in network. The billing rep from Elite called me as soon as I was referred there by my PCP. She took my insurance information and checked on my coverage and told me that each visit would only be $20, since I had met my deductible for the year. So, we scheduled for 2 visits per week based on this. After going to Elite for about six months I received a bill for $1200. I checked out all of the charges and some visits were billed for over $300 with 0% of the visit covered. I called my insurance and was told that they likely miscoded the visits. I have contacted Elite billing several times to better understand and was rudely told “go ahead and appeal.” One of the billing reps told me I should have gotten a quote in writing and signed by the billing rep (who CALLED me with a quote after contacting my insurance). I asked for a copy of the documents that I supposedly signed indicating I agreed to be billed for the services and was told they would be sent in the mail. It has been six months and I have not received that. I called Elite numerous times since and each billing rep provided a different explanation for the charges: “we couldn’t have known what insurance would cover,” “your insurance coverage changed halfway through the year,” “actually, you owed 20% not $20,” and the most recent, "you went over your allotted # of visits." All of these reasons were incorrect, per my insurance company, and I’ve been sent four different invoices at this point. I’m somehow down to $600 owed, which is nice that it has been reduced, but there is no explanation as to why and I still should not owe $600 when I was told I would owe nothing outside of the $20 visit fee. Sadly, I will not be returning to an incredible staff because the billing procedures are horrible.

  Business response

  10/20/2022

  Unfortunately, due to HIPAA regulations, we are unable to release information that is specific to any patients to include their protected health information, billing information, etcetera. However, as a part of our practice and as a courtesy to our patients we contact the insurance companies prior to the patient's first appointment in order to verify insurance benefits. These benefits are provided to the patient by our staff verbally as well as in written format. The patient is prompted to sign a written disclaimer that acknowledging that they understand, " I have been informed of my benefits and understand that this is not a guarantee of payment. Please note: estimates for deductible and coinsurance are only estimates. There may be a balance/refund due depending on the actual payment from your insurance company."

  Customer response

  10/24/2022

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. 
  
  This was the first excuse provided by Elite and I asked for a copy of said document, which I never received. Further, they should not be in the practice of assuring patients (which MULTIPLE individuals did) of the cost of services, without indicating verbally that the cost could be significantly more.

  
  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. ↩