ComplaintsforSalsbury & Co LLC

• Initial Complaint

  06/12/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  This company is billing for medical services provided to myself and my daughter (*******************) through *************** Healing Arts. The amount of our bills over the past few years changes constantly and billing is inconsistent. I attempted to reconcile our accounts to pay our providers in full and am not able to get a correct amount owed or even for our bills to be sent to correct address. I have called, with no response. I have emailed numerous times. Have an email from manager, ***** stating that our address had been updated and he would personally review accounts. I have received 2 piece of mail since (more than a month ago) to the wrong address. I have never heard from ***** again.I have spoken with a ********* who reviewed visits with me that we received a bill for 5/8/23, the 1st bill I have seen for these visits that are from April, Aug, Sept, Nov, and Dec of 2022!. I reconciled these with our EOB's and learned that one was fraudulently billed for a provider we have never seen on a date we were never seen. And 3 were billed to the wrong insurance. interestingly, visits before and after these dates have been paid so clearly some were billed correctly. ********* stated she would look into this and follow up with **** then got another bill, for a different amount and different visits sent again to the wrong address! I also received a call from ********* to discuss payment. She stated that we had never spoken, I reminded her of our conversation and that we had talked to which she kept replying that we had not.I now have a new bill, with a new amount, for different dates. I have a bill from May that shows a total due of $9991.40 for my daughter and $165 for myself. According to my EOB's I owe $98.80 for my daughter and $105 for myself. This new bill shows ****** past due for 90 days but the one in May shows $991 past due for 90 days. I would like to pay my account and have a receipt showing paid and no further charges! Hours of my own time

  Business response

  07/12/2023

  Our address has been updated, it is now:

  **************************************

  *********, ** 98686

   

  Thank you for expressing your concern. We apologize for any inconvenience or frustration this has caused you. There are many aspects to your statement that need further development in order to best describe the medical billing actions taken on these accounts.

  
  We provide third party medical billing services and only manage the insurance billing process for *************** Healing Arts. *************** Healing Arts continues to handle all of their copay collection, cash payments, patient refunds, patient balances older than six months, and retail sales.

  
  Statements have been sent on both the parent and child accounts throughout 2022 and 2023. We were notified on April 11, 2023 via email from the parent that their address had changed and an update was needed. The new address information was collected from the parent and updated in the systems that we use for insurance billing purposes on April 25, 2023.  The statements we have sent since this date have had the correct mailing address, the parent confirmed that they were receiving statements at the new address in an email dated May 9, 2023.  *************** Healing Arts has also sent the parent and child statements for non-insurance related services or patient balances that have exceeded our medical billing threshold of six months through their own system that *************** Healing Arts continues to bill the parent and child for, which we do not have access to. We notified *************** Healing Arts of the address change on April 25, 2023. If the parent and child are still receiving statements to the incorrect address, the statements would be coming from outside of our system. We were notified by the parent in an email on May 9,2023 that the statements were being received at the updated address, however they were receiving refund checks with the incorrect address. At this time, we notified *************** Healing Arts again of the address change as they internally issue refunds to patients.
  
  The balances on statements have varied over time due to the number of visits and based on when the insurance carrier responds. In this situation,the insurance carrier was denying all claims due to coverage not being in effect for the parent and child. A statement would have been issued at this time for the affected date(s) of service as the balance would be patient responsibility. We contacted the parent after receiving the estimate of benefits (EOB) from the insurance carrier to collect updated insurance information. The parent assured us that the insurance information was correct and the visits should be covered by their insurance benefit. At this time, the claims were disputed and reprocessed by the insurance company. While the claims were reprocessing, the patient would have received statements excluding these balances and including only balances that were not being disputed with the insurance.  Insurance companies can take up to ***** days to process or reprocess claims. Each time a claim is reprocessed,the time between the date of service and the mailing of a statement to the patient increases.

  
  The claims that were disputed with the insurance carrier came back again as coverage not in effect and the parent and child were sent an updated statement reflecting the balance due. We contacted the parent and spoke with them about the insurance determination. The parent was adamant that coverage was in effect. We encouraged the parent to contact their insurance and update their information with the insurance company directly.

  
  The parent contacted us via email on May 15, 2023 noting that they had reconciled their EOBs and the balance owing from the patient was different than the amount on their statements. We called the patient to explain that the balance is different because the insurance denied multiple claims, not assigning an amount to bill the patient but allowing the provider to bill the patient directly.

  
  On June 8th, 2023 we received notification that the insurance carrier received updated information for the parent and child and that we were able to submit the claims for reprocessing again. These claims have been sent and are either still processing, been paid by the insurance to clear the balance, or have been denied again.

  
  The balances on the accounts are over a year old and more than six statements have been mailed. It is *************** Healing Arts process to send six total statements for a date of service, the last three statements with a reminder that the account could be sent to collections if not paid, and then the accounts go to the provider to determine if the account should be sent to collections.  The provider has chosen to write off the patient balances due for the dates of service in question, which was completed at the end of June 2023. The parent and child were mailed statements in early July 2023 that reflect the amount due after the provider write off for visits outside of the time frame in question.

  
  We have sent another reminder to *************** Healing Arts to update their internal system with the new address. Once they update their systems, the refunds and statements sent from their system should go to the correct address.

  
  One visit in January 2022 was billed to insurance that should not have been. This visit was voided with the insurance company and any payments received by the insurance company were refunded. Any patient balances due for this visit were also voided and removed from the patient account immediately after the error was noticed.

  
  Three visits were billed to a different insurance in early 2022 because the patients insurance had been with a different carrier prior to 2022 and updated insurance information had not been provided for visits in early 2022. Once the updated insurance information was received from the patient, the visits were submitted to the correct insurance carrier.

  
  We understand the billing process can be confusing and frustrating, even more so when a clinic uses multiple systems and separates duties. We have attempted to maintain contact with the patient as new information is provided when it is a result of the medical billing process. For balances due and refunds from *************** Healing Arts other systems, we do not have access or control over these processes.
  We invite the parent to contact us again if they have any questions regarding their insurance billing and encourage the parent to contact their provider at *************** Healing Arts for questions regarding all other aspects of their care and billing.

  Customer response

  07/20/2023

   
  Complaint: 20176529
  
  I am rejecting this response because:
  

  
  I have received a response from Salsbury that is full of inaccuracies, misinformation and blatant lies. I had requested a call from the manager, ***** numerous times over the past few months while attempting to resolve this and had no response until this action from the BBB. He did call me and tried to tell me that my insurance company was denying one claim. He also told me that our address has been updated for months yet I quite literally received several things from them that week with our address that is over a year old!  These had been forwarded as I had renewed our change of address. I checked with the front desk at *************** in person this week and they have our correct address so...another untruth.
  I also received a refund for an amount that makes no sense! 
  I have spoken with our providers at *************** and shared this correspondence with them as well as copies of the mail with incorrect address.  They are aware, as I told ***** with Salsbury, that we will no longer pay any statements from Salsbury. We've reconciled our accounts with EOBs and paid the amounts due as well as pay co-pays at time of visit.
  I feel this business is clearly incompetent and potentially fraudulent and feel they should be investigated. 
  ********************************;
  
  
  

  Business response

  08/03/2023

  Thank you for your response. 

  I am sorry you are still receiving mail and refunds to the incorrect address. As stated in our previous response, these statements and refunds are not coming from our office. The statements and refunds are coming directly from the administrative office at ************************************. We did send a reminder to the administrative team to update your address upon receiving your complaint. We do not have the ability to update this information other than sending an email to the *************** team members that can make these changes. I have notified the clinic owner and your provider of the situation in hopes that they can assist in resolving this for you. 

  ***** reached out to you because we heard back from your insurance regarding the status of your claims and he wanted to provide you with an update. 

  Thank you again.

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