This practice sued over a self-paid $65 claim/office visit. After just a few weeks of service, SL&HA was flagged by our insurance carrier for failing to obtain required preauthorization per their contract and continually changing the diagnosis code (despite evaluating our child prior to commencing services). This caused all new claims to be rejected and all previously paid claims to be retracted (SL&HA was required to pay back our insurance company in full). Per our insurance carrier (and stated on ALL rejected and retracted claims) SL&HA was PROHIBITED from billing us for all retracted/retracted claims due to their failure to obtain precertification per their contract. SL&HA responded by sending US huge statements for roughly 25 office visits, threatening to sue if we did not comply by paying.
SL&HA also put through two claims on one date of service. We went in for a speech evaluation, yet two claims were submitted on this date: 1) speech evaluation and (2) speech therapy. We hadn't even commenced speech therapy yet as we were in evaluation stage, yet were billed for it. SL&HA would not admit to this error and insisted we pay for speech therapy despite showing them their own dated speech evaluation as documentation and informing this practice that speech therapy did not commence until several weeks later.
Since it was impossible to reason with this practice (and we wished to terminate any further contact), we REpaid ALL retracted (previously paid with insurance benefit) claims in full (self-pay rate = 100% out of pocket - no insurance benefit) except for ONE $65 office visit, explaining in writing it was paid, in full, directly out of our HSA, and had the documentation). Upon receipt of our certified letter with payment closing our account, SL&HA proceeded to sue us over a privately paid/self-paid $65 claim/office visit.
We have NEVER had our health insurance carrier RETRACT paid claims from a healthcare provider. SL&HA did not follow their contract, instead choosing to threaten and eventually sue a patient, all in hopes to gain $65. SL&HA accepted zero responsibility and blamed our insurance carrier (and us) hroughout this entire ordeal. We lasted less than 4 months at this practice, but this matter took an entire year to resolve.
It is completely noteworthy we were at another Speech practice for 3+ years, and NEVER had a problem claims or coverage. (Same insurance carrier.) read more
