Major continuity of care problem, please call your insurance if you are having problems with Active…read moreMarin PT switching out insurance rapidly at the end of 2025 or billing you a ton for appointments you booked before 12/28/25. I learned this behavior is not allowed and violates both patient notice requirements as well as Continuity of Care laws and No Surprise laws in the state of California. Forcing a post-surgical patient in severe pain to make a rushed financial decision at the front desk is considered administrative coercion and poor medical ethics.
I had foot surgery in mid November and was referred for post-surgical PT for hip and low back at my 12/22/25 follow up with my surgeon, due to issues that developed from an uneven gait in the walking boot. I contacted my insurance for referrals and was referred to Active Marin PT as well as a few others that were IN NETWORK. I was in pain and not sleeping well, so when I called Active Marin PT on 12/23/25, and was booked in for eight appointments beginning 12/29/25, I was very relieved. In my booking call, I provided my insurance information and Active Marin PT confirmed they were IN NETWORK. I showed up, in pain, on 12/29/25 and was told verbally that Active Marin PT had ended their contract with my insurance the day before, 12/28/25, but Active Marin PT would file something called a "gap form" on my behalf to bring their services back IN NETWORK. I was very confused as I had been booked for eight (8) appointments before they ended their contract on 12/28/25, and because PT was part of my post-surgical care. And I had made sure with Active Marin PT that I was IN NETWORK. I was induced to continue with care because Active Marin PT stated a plan (the "gap form") to deal with their contractual changes so my services would be covered In Network. Importantly, no one from Active Marin PT contacted me BEFORE of my appointment to explain they had cancelled their office's contract with my insurance (Blue Shield of CA, not a small provider) and obtain my consent to different charges or give me alternative options. I was instructed to keep my three appointments that week and wait out the gap form, and frankly I was in terrible pain that was making it hard to walk, and needed help at that point. I have since learned that the medical provider must give written notice to all patients when a master insurance plan is changed. I also learned that the Continuity of Care doctrine means my care continues for a period of time at In Network rates due to the booking date of 12/23/25, and I learned about the Post Surgical Care laws. Both laws disallow Balance Billing, or upcharging the patient to enrich the medical practice above what insurance allows.
I followed up daily on the "gap form" both with my insurance and with Active Marin PT; after the first week (3 appointments) I became concerned about the lack of progress and I cancelled the rest of my appointments. The reception did not seem to have a handle on when or how the gap form might be resolved. I also asked how billing was going to be handled and no one seemed to know. I moved on to an In Network PT who is great, but I had to wait a while to get in for care. Active Marin's behavior cost me additional time in pain.
Flash forward - not only did Active Marin PT NOT bill for the three visits at In Network rates ($15 per visit for me, total $45), they Balance Billed a total of $590 for three appointments. Before I knew the laws, I offered to negotiate the bill. Per my insurance, these appointments would have cost me $15 per, or $45 total. I offered $250 (5X what my bill would have been to try and be fair) in resolution. While I understand business contracts can change, Active Marin PT owed me full and complete disclosure of this change BEFORE booking me in for 8 appointments, taking me on an emotional roller coaster while in pain, confusing me with insurance jargon, and forcing me to start my care over, all while Balance Billing and violating California Continuity of Care Laws and California Post-Surgical Care Laws. Active Marin PT refused to even discuss the problem or work out a solution with me, instead inserting their billing coordinator into a quasi-lawyer position to go back and forth with me. It is important for the community to take extra steps with this business and triple check insurance contracts have not changed before each appointment or risk expensive and fake Balance Bills and a dismissive and rude attitude.
If this happened to you, please file a complaint with your insurance company so you do not pay false and expensive Balance Bills like I did. I am out $590 and a lot of headache due to this bad behavior.