Doctor might be okay, but how they handle business deserves negative stars. This medical office has a dubious front office staff, shady business practices, and bad debt collection/remediation methods. In the unfortunate case that you are not in network, due to a mistake on their behalf, this office will go to extreme measures to get their money, including violating state and federal laws. Currently, there is a complaint against Pumphrey Patch Kidz Medical Office, located at 29798 Haun Rd Suite #304, Sun City, CA 92586, for a violation of the No Surprises Act. Please see below for a copy of the complaint.
'The issue began when a patient went in for immunization. Prior to the appointment, the office staff verified that she was covered by our health insurance provider, AETNA. We even found the facility using our insurance's website for "in network doctors". This verification reassured us that we would be covered for the services received and would not incur any unexpected charges. However, to our shock, we later received a denial letter from our insurance company and a surprise medical bill from the medical office, which amounted to a total of $1,140.00. We appealed the denial decision with our insurance, but they provided documentation to show that they were not in network anymore.
In an attempt to resolve the issue, we contacted both AETNA and the medical office, which led to a verbal agreement for a payment plan and a lowered bill in the range of $700 - $850, to be paid in installments. We were even told that if we did not pay we would be sent to collections and then offered a "cash discount." As a result, we paid three installments, each worth $144, totaling $432.
Unfortunately, I fell ill and was unable to make further monthly installments. In response, without any prior warning, the medical office sold my debt to a collection agency, Coachella Valley Collection Service, for an amount exceeding the previously agreed upon maximum sum of $850.
This action, we believe, is in clear violation of the No Surprises Act. Despite our earnest attempts to honor the financial agreement we had entered into, the office not only reneged on the established payment plan but also escalated the issue by involving a collection agency, thereby negatively impacting our credit rating.
In light of the above, we kindly request that the Consumer Financial Protection Bureau intervene on our behalf to investigate this issue and provide a resolution. We believe that Pumphrey Patch Kidz Medical Office should be held accountable for its actions, which are against the provisions of the No Surprises Act, and thus unfair to us as consumers.
We appreciate your attention to this matter and look forward to your prompt response.
We would like Pumphrey Patch Kidz to revise the amounts we are being billed for to be equivalent to in network charges as stated in the No Surpries Act, stop sharing patient information with collection agencies, and revise their unfair practices for future consumers. Since we have already paid Pumphreys over $400, this would amount to more than we would spend if we were being covered by AETNA. Therefore the ideal resolution would be to liquidate the debt or have us pay only a minimal amount in accordance to the amount we would pay if we were in network.
No Surprises Act states "Starting on January 1, 2022, you generally won't be responsible for balance bills or out-of-network cost-sharing when getting emergency care, non-emergency care from out-of-network providers at certain in-network facilities, or air ambulance services from out-of-network providers. When this happens, instead of you paying for unexpected out-of-network costs, you'll generally only need to pay your normal in-network costs (like coinsurance, copayments, and amounts paid towards deductibles). The health care provider and your health plan are responsible for negotiating the total payment amount." ' read more
