Despite months of communication and a prior BBB complaint, I still have not received a complete,…read moreaccurate, and reconciled accounting of charges, insurance payments, patient responsibility, and credit card charges associated with my account.
Since 2024, I have repeatedly contacted the billing department regarding discrepancies involving therapy session charges, insurance billing, and payments charged to my personal credit cards. While the provider has acknowledged insurance credentialing changes, claim reprocessing, and Coordination of Benefits (COB) issues, the records provided to me remain incomplete, inconsistent, and difficult to reconcile.
The primary issues are as follows:
Incomplete and Inconsistent Billing Records
Credit Card Charges Not Properly Reflected in Billing Ledger
My primary concern is that approximately $1,395 in charges were made to my AMEX credit card on file that do not appear to be properly reconciled or applied within the billing ledger provided to me.
These charges were processed while the account itself remained unresolved due to insurance claim disputes and COB denials. I was never provided with a clear explanation showing:
Why these charges were processed
Which sessions they applied to
Whether insurance later paid those same sessions
Whether duplicate payment situations occurred
Whether any overpayments were created
To date, I still cannot determine whether these charges were legitimate patient responsibility amounts or improperly charged while insurance claims were still pending or under review.
Lack of Adequate Communication and Transparency
I repeatedly requested clarification beginning in August 2024. Despite this, I was not provided with a clear itemized accounting before additional charges continued to be processed against my card.
The business states that automated billing statements were sent, but automated statements alone do not resolve disputed accounting discrepancies when a patient is actively requesting clarification and reconciliation.
Additionally, I was never properly informed that unresolved Coordination of Benefits issues could result in denied claims becoming my responsibility, nor was I adequately guided through resolving those issues with my insurance carrier before balances escalated.
Collections Concerns
My account was sent to collections despite the ongoing unresolved billing dispute and despite my repeated requests for documentation and reconciliation.
I believe it was inappropriate to send the account to collections before:
providing a complete reconciled billing ledger,
resolving the insurance discrepancies,
and addressing the disputed credit card charges.
Provider Network Status and Evasive Responses
I also need a clear explanation as to why my healthcare provider was initially considered out-of-network and then later became in-network. This change directly affected how my sessions were billed, what insurance paid, and what I was told I personally owed.
Many of the billing inconsistencies only became apparent after I began asking questions and requesting clarification from the billing department. Instead of providing clear answers, the billing department has repeatedly failed to directly address my questions and has evaded providing a complete explanation of the charges, insurance payments, network status change, and credit card charges.
Desired Resolution:
A complete reconciled ledger showing all dates of service, insurance payments, insurance adjustments, write-offs, patient payments, and remaining balances
Full accounting for all charges made to my AMEX and other cards on file
Clarification regarding whether any duplicate billing or overpayment occurred
Clarification regarding all claims denied due to COB issues
Removal or correction of any balances improperly sent to collections
Reimbursement for any charges that cannot be properly substantiated or reconciled
I am not refusing to resolve legitimate balances. However, I cannot reasonably verify what I owe when the billing records remain incomplete and inconsistent despite repeated requests for clarification.
