ComplaintsforWadsworth Psychiatric Services PLLC

• Initial Complaint

  09/19/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I was originally authorized to see ***** Wadsworth through my insurance on February 17th 2022. My referral would last until 5/17/2023. In April of 2023, I began expressing concern to my provider about needing to get reauthorized. I was told by my insurance that it was not something that I could do, but that the office needed to do. I was told by Wadsworth office that I did not need a referral to see them. I called my insurance again, and they said I did need a referral. I told his office this, and they said they sent one in. I never saw a referral authorized on ******** website. For the next several months, I would occasionally message the office, asking them about this, but was continually put off, or would not receive a response at all. Then I started to receive bills from my insurance, saying that I was not preauthorized to be seen by his office. If they had sent in the reauthorization, i would have been! Finally, after threatening to complain, they sent in a referral on August 28th, 2023. However, they did not backdate it like they were supposed to. I contacted them multiple times, and they assured me they didn't make any mistakes, but I received a bill today from their office saying I owe them 270 dollars! I don't get copays from my insurance for mental health visits. I checked online, and they still did NOT fix the referral. It should not take MONTHS to send in a reauthorization form .They need to fill it in correctly by backdating it from 5/17/2023 and fix this issue so I don't get billed. I have wasted so much time trying to figure out this issue and waiting to hear back when it not my responsibility to do so!

  Business response

  09/20/2023

  Respond to the claim

  Customer response

  09/25/2023

   
  Complaint: 20623372
  
  I am rejecting this response because:

  Their office did not do it correctly. I have talked to my insurance and they have not received anything. They said that they cannot back date on their end, their office needs to. There is only a referral starting August. It needs to be started from May. I have mentioned this many times to Wadsworth's office, but they have not done it correctly. They need to submit a form or call. 
  
  Sincerely,
  
  ***************************

  Business response

  10/11/2023

  I hope this message finds you well. We would like to inform you that the application has been completed correctly in accordance with our patient's request.
  However, we have recently received a response from her insurance provider, which states that her coverage "only applies to care and services that are specifically authorized in advance."
  If you require any documentation or evidence regarding this matter, we are more than willing to provide you with the response from the insurance company, along with the dates on which the patient contacted us regarding her insurance coverage.
  As a reminder, it is the patient's responsibility to ensure that their insurance information is up-to-date and to notify our office in advance of any appointments, as per our office policy.
  Thank you for your attention to this matter. If you have any further questions or require additional information, please do not hesitate to reach out to us.
  Best Regards,

   

  Business response

  10/12/2023

  I hope this message finds you well. We are attaching herewith more detailed information pertaining to our previous correspondence.
  Email Request from Patient: One of the attached files contains the email in which our patient requested a backdate.
  Fax Confirmation: Another document shows the fax confirmation for the form we sent, which included the requested backdate.
  Insurance Response: Lastly, we are providing a file that contains the response from the patients insurance company, stating that the authorization form should have been sent in advance.
  We hope this additional documentation will assist you in resolving the matter. Should you require further information or clarification, please do not hesitate to contact us.

  Best Regards, 

   

  Business response

  10/12/2023

  I hope this message finds you well. We are attaching herewith more detailed information pertaining to our previous correspondence.
  Email Request from Patient: One of the attached files contains the email in which our patient requested a backdate.
  Fax Confirmation: Another document shows the fax confirmation for the form we sent, which included the requested backdate.
  Insurance Response: Lastly, we are providing a file that contains the response from the patients insurance company, stating that the authorization form should have been sent in advance.
  We hope this additional documentation will assist you in resolving the matter. Should you require further information or clarification, please do not hesitate to contact us.

  Best Regards, 

   

  Business response

  10/12/2023

  I hope this message finds you well. We are attaching herewith more detailed information pertaining to our previous correspondence.
  Email Request from Patient: One of the attached files contains the email in which our patient requested a backdate.
  Fax Confirmation: Another document shows the fax confirmation for the form we sent, which included the requested backdate.
  Insurance Response: Lastly, we are providing a file that contains the response from the patients insurance company, stating that the authorization form should have been sent in advance.
  We hope this additional documentation will assist you in resolving the matter. Should you require further information or clarification, please do not hesitate to contact us.

  Best Regards, 

   

  Business response

  10/12/2023

  We have been attempting to contact the insurance company since June 1st, as requested, but were unable to reach them. Consequently, we were only able to submit the form after she provided the link on August 28th at 4:48 pm. The first form was faxed on August 30th, with the date 08/30/2023, and the backdated form was sent on the same day, per her request, to reflect the date 02/17/2023.

  Best Regards,

   

   

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