ComplaintsforTier 1 Therapy PLLC

• Initial Complaint

  08/24/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I moved into Bonaventure Senior Living in August 2021. Within the first few weeks of living there I was approached by the Physical Therapist that has an office in the building. "Hey there, are you interested in receiving physical therapy?" I was asked. I showed them my insurance card. I was told that my insurance would pay 100% of my PT. I was not prescribed PT by my doctor but received PT every other day from ********* and ********. Before I knew it, they charged my insurance $4,320. I am a 94 year old WW2 veteran. I relied on the fact that they said my insurance would cover these charges. Well, come to find out, they are out of network, and every month, my insurance has been re-evaluating the charges for the PT, 32 visits in all, and some visits were charged at $95 and others $188! Now my amount due is up to $321.05 and continues to increase. I believe this onsite PT office is taking advantage of the elderly and their insurance. What they call PT was more like touch your toes, and walk to the end of the hallway and back. It was nothing like the PT I received when I had my knee replacements done. I think it is just terrible that they are allowed to prey on unsuspecting elderly at the Bonaventure facility and bill insurance for such a ridiculous amount of money. Approaching the elderly who have not been prescribed their services is way out of line!

  Business response

  08/24/2022

  Upon starting therapy the patient gave us a ******** card which was inaccurate since the patient was under a Humana PPO at the time if they had ******** part B as their primary and Humana as a secondary it would have been covered. Once we found this out we rebilled with the correct insurance which charges a co pay per visit. After speaking with the patients daughter and discussing the mistake we waived the balance on the account. The total amount charged was $4320 of which we only collected $1484.61 before waiving the remainder. Which means we netted a loss on this transaction. Additionally, the patients primary care provider signed off on the plan of care so saying we had no doctor oversite is inaccurate. It is not our intent to take advantage of our patients, hence why we waived the balance on the account. The difference in charges per visit is dependent on the different procedures per visit.  as for the effectiveness of the therapy, over the course of treatment the patient increased their **** score from 33/56 to 45/56 which indicates a significant decrease in fall risk, the patient also reported their hip pain had decreased from 6/10 to 2/10 which is a a good result. I am sorry you are unhappy with your experience.

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