ComplaintsforKeturah Health

• Initial Complaint

  03/05/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I received psychiatric services from this business from 10/21/2021 to 01/03/2023. On 02/03/2023, I was in contact with the billing department regarding a bill that was not processed through my insurance before being sent to me. I received a prompt response stating that they would look into the issue. On 03/08/2023, I was told that I needed to wait ***** days for insurance to respond to their claims. This was the last non-automated message I received from Keturah Health. I spent many hours working with my insurance companies to understand why I received such a large bill when I was covered by two insurance plans. On 08/14/2023, I sent an email to Keturah Health which outlined each error and its resolution. This includes direct phone numbers to the insurance representatives who worked with me on identifying the claim issues. Rather than a response from the billing team, I have been sent the same incorrect bill via email and text multiple times. Since it has been over one year since the dates of services, I cannot submit claims to insurance myself.Additionally, I believe that I may have been billed for services I did not receive. I have been billed for CPT code *****, which is a charge based on appointment length. All of my appointments occurred either via the telehealth website or phone, and my phone call log has no record of an appointment lasting for longer than 15 minutes. I believe I still have access to these records should they be necessary.I have been attempting to work with this business since 02/03/2023 and am frustrated by their lack of cooperation. I have spent multiple days learning about my insurance policies and have even gone as far as telling them exactly how to resolve the issues. I am happy to pay this bill once it has been adjusted so that I can move on with my life.

  Business response

  03/05/2024

  Good Afternoon, 

  Thank you for the information.  The client is incorrect.  ***** is a code our provider uses when she provides psychoeducation/psychotherapy.  This is done when the provider discuss medication with the patient.  If the patient has questions with disease process, the provider will educate the client on symptoms and how to manage symptoms with or without medications.  Where there are med changes education is needed to discuss the medications and the changes.  Codes such as ***** allows the provider to bill for evaluation and managment of the needed services.   

  Patients insurance is not paying the claims.  Patient would have to follow up with the insurance as to why they are not paying her claims.  Per financial policy she agreed to pay if the insurance does not pay.  We are adhearing to the patients contracted rates per her insurance provider. Due to multipe non payments from insurance and client we are unable to continue her serives.   We have provided claims from all the insurance she provided.  They all have PR for patient responsiblity.   We can not make the insurance pay for the claims.  It falls back on the patient.  

  Customer response

  03/05/2024

  I am rejecting this response because: see attached pdf, "Keturah Health & BBB-- *********".

  Business response

  03/05/2024

  To whom it may concern, 

   

  This client was last seen 1/3/2023.  We pulled the note from her last visit.  Appears the time for this client was within a 20min window.  See the start time and end time on the clients note.  Due to the nature of the visit we are unable to provide the full note but the provider was justified to bill this code.  We understand the client is upset regarding the balance she owe's the clinic.  Perhaps she needs to call in and speck with the clinical director unstead of disputing her charges through this portal.  

  Customer response

  03/05/2024

  I am rejecting this response because:   

  I have spent many hours over the past 14 months attempting the rectify this matter. The last email I received from this business dates 03/08/2023, where I was informed that I would be provided with an update in approximately ***** days. I have sent this business two emails since then, which did not receive a response. On 04/11/2023, I emailed them with updated insurance information, and asked that they reach out if they were needing any further information. After not receiving a response, I emailed them again on 08/14/2023, after spending hours on the phone with my insurance providers. The insurance representatives suggested that I have the business call them back. In the 08/14/2023 email, I sent the business direct phone numbers to the insurance representatives I worked with. Additionally, this email outlined the reasons why insurance declined my claims. These reasons came directly from my insurance representatives, who reported that they requested additional information from the business and did not receive it.

  Contacting the BBB was a last resort. I believe this was the only reason the business responded to my concerns. Still, the business has yet to address my concerns. 

  Customer response

  03/08/2024

  It is my understanding of timely billing laws that I must be billed for services by the 1st day of the 11th month following the date of service. If my understanding is correct, this means that I may not be billed for services prior to 04/01/2022.
  

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