ComplaintsforFunctionabilities, Inc.

• Initial Complaint

  05/25/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  The business model is designed to take advantage of parents of children with special needs. They operate under a veil of secrecy with no insight into the treatment provided, parents can't be in the room with the child during sessions, the company couldn't provide us with notes or documentation into services claimed to be provided (no notes from a doctor of what actually happened in sessions), guilt vulnerable parents into paying more than is necessary with scare tactics and premature diagnoses, judgemental good, better, best treatment options, and confusing billing process.-We were referred to this business by our primary care doctor to treat our daughter for behavioral concerns that were shortly thereafter diagnosed as autism (3 years old at the time)-Scared us into thinking our daughter was broken and required excessive therapy and may never live a normal live (this has been refuted by several additional providers, and our daughter is thriving with a positive therapy experience elsewhere). Guilt trip video shown of the need to be "the best" parent i.e. spend the most money with them.-They bill their visits in a way where we pay our co-pay for an in-network covered service, the insurance provider gets an adjusted rate, and pays a substantial amount, and then the company will still bill ** an additional $75 per visit above and beyond that. They are in constant disputes with insurance companies over their billing of visits not being just for a single visit.-Diagnosed our daughter with conditions that aren't diagnosable until 6+ years old, Oppositional Defiant Disorder (multiple other doctors have disagreed with their diagnosis) after 1 short evaluation. The assumption is in order to exaggerate our daughter's condition in order to secure additional services.- Two invoices served 10+ months after service because the insurance company continually refuted how they were billing services.-Unclear and unaccessible billing; unanswered calls, charges with no warning etc

  Business response

  06/14/2023

  Due to HIPAA laws, we cannot speak to the specifics of this or any other case without proper releases being signed.  Therefore, speaking in generalities, Functionabilities is a business designed to help make life easier for children and their families. Starting from the initial call, we do our best to inform the parent(s) of any relevant information. Every family who schedules an evaluation for their child receives 3 separate emails with information, forms, and videos that explain our processes and prepare them for what to expect on evaluation day. We point the parents to our website and our intake information where it clearly lays out our evaluation options.  We really don't care which evaluation option is chosen but have found that most parents like to have options.  We have a thorough FAQ section that answers most of the common questions we receive.  While we do not allow parents in the treatment session, we do tell parents up front that they will not attend treatment sessions with their child.  In fact, ALL parents sign and initial in the intake paperwork that they agree to this practice.  We acknowledge that we are different than other places but we also attribute our amazing results to those differences.  We have an open gym format where there are multiple therapists and multiple children in one-on-one therapy so we do not allow additional people to attend sessions.  After an evaluation is completed we provide parents with a detailed report and treatment plan that is individualized to their child.  This report is also sent to the child's primary care physician.  We do NOT diagnose but must give diagnostic codes to bill for our services; therefore, we are dependent on things parents and doctors tell us about the child.  We do not allow any diagnoses to limit our belief that children daily amaze us and rise above their challenges.  When it comes to payments, suffice it to say that health insurance can be difficult to understand and deal with for anyone.  We ask our patients to call their insurance before coming in and give them the specific questions to ask their insurance company and then we call the insurance company with the parents on the first day they come in.  While we would love to guarantee that an insurance company will do what they say, any issues in this area are actually between the policy holder and the insurance company.  We try to help as much as we can in these situations; however, we are not obligated to do this.  Our patients sign that they are aware of this and that ultimately the bill is theirs within 30 days of the date of service.  We try to be as understanding as possible but there are so many different insurance plans we cannot possibly be an expert in everyone of them.  We are a small business and cannot carry balances with all of our patients.  As with all companies, we do have a collections and records request process that often includes multiple invoices, conversations, appeals, and unfortunately, time.  We even offer discounts to all of our patients in hopes of helping them.  After filing this complaint, the complainer has agreed to pay their bill.

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