Pediatric Therapy Partners

Initial Business Response / [redacted] (1000, 5, 2014/04/09) */ Contact Name and Title: [redacted] owner Contact Phone: XXXXXXXXXX Contact Email: [redacted] @gmail.com Thank you for the opportunity to address this client's concerns The facts are as follows: Child was being seen by our office for ST and PTChild was covered by the Illinois Early Intervention Program until she turned years oldAt the time the parents requested that the therapy would continue even though we might be considered "out-of-network" providers for the new insurance company I had a conversation with the Mother and she verbally agreed to pay out-of-pocket for continuing PT and adding STShe verbally agreed to pay $per session When their insurance changed, our office contacted them to request the new insurance informationThese requests were made times from June, to August, even though it is the clients responsibility to inform the office of any changes to their insurance benefitsIn September, both parents came to the office and gave us their new insurance information, at which time we promptly submitted the past due amounts through the new insurance planThis new insurance plan advised us that we needed to call them for pre-certification which we did promptlyAs a result of parent's delay in getting us the insurance information, the insurance company would only back-date the pre-certification by one weekAs a result pre-certification approval began 9-11-and therefore did not cover the previous sessions of Speech Therapy that the child received in her homeWe have exhausted all appeals to the insurance company to cover these chargesHad parents provided our office with the insurance information in a timely manner, these charges would have been covered Over the past months, our office has attempted to contact parents by phone and mail to set up a payment plan so as to not cause them a hardshipWe understand the stress of having a special needs child and have always been kind and patient with them, however, medical offices quickly send patients into collections one month after their bill is delinquent They currently have an outstanding bill of $which I can supply the Revdex.com with, and which has been mailed to the parents timesI am willing to reduce their bill to $At this time we have not been contacted by them to set up a payment plan and they do not answer our phone calls or return messagesWe have no other recourse than to have our collections attorney contact themWe have always been patient and kind towards this family and the care they received from our therapists has always been focused on the child's best interest Initial Consumer Rebuttal / [redacted] (3000, 7, 2014/04/10) */ (The consumer indicated he/she DID NOT accept the response from the business.) The office was made aware of the change in insurance in May They were informed several times since May of the change in insurance and given the informationThey never contacted us about the new insuranceThe new insurance information was given to them over the phone in May, June and JulyIn September we finally drove down to the office to give them the new information in person in SeptemberThe office was well informed in advance that the insurance was changing over in JunePlus both the physical therapist and speech therapist were given copies of the updated insurance as well in MayThere was no delay in getting the new insurance information to them and it was given in a timely mannerOn 6/5/they did not bill the right insurance company for speech and I paid them one hundred dollars6/26/and 7/10/they billed the wrong insurance company again for speech therapy and they are looking for me to pay for those two sessionsOn 9/16/they were paid one hundred seventy five dollars by the insurance company for physical therapy but are billing me for The statement that I received from the insurance company for 7/17/2013, 7/24/2013, 7/31/2013,8/07/2013, 8/14/and 8/26/about services billed for speech explained that the reason these dates were not covered was as follows: These benefits were reduced due to failure to obtain pre-certification approval as outlined in the planThis amount represents dollars associated with the pre-certification not obtained for the services renderedThe provider is prohibited from billing the patient for this amountIf you have already paid this amount, please request reimbursement from your providerI can provide the Revdex.com the insurance documentation backing up my accountBilling and disorganization seem to be a problem for this businessI am not disagreeing that I owe this business money I would just like the billing done correctly Final Business Response / [redacted] (4000, 9, 2014/04/20) */ Our office has not made mistakes with our billing and we have always dealt with this client in a professional manner The facts are as follows: Child was being seen by our office for ST and PTI had a conversation with the mother at which time she verbally agreed to pay out-of-pocket for continuing PT and adding STShe verbally agreed to pay $per session When their insurance changed, our office contacted them to request the new insurance informationThese requests were made times from June, to August, In September, both parents came to the office and gave us their new insurance information, at which time we promptly submitted the past due amounts through the new insurance planThis new insurance plan advised us that we needed to call them for pre-certification which we did promptlyAs a result of parent's delay in getting us the insurance information, the insurance company would only back-date the pre-certification by one weekAs a result pre-certification approval began 9-11-and therefore did not cover the previous sessions of Speech Therapy that the child receivedWe have exhausted all appeals to the insurance company to cover these chargesHad parents provided our office with the insurance information in a timely manner, these charges would be covered Over the past months, our office has attempted to contact parents by phone and mail to set up a payment plan They currently have an outstanding bill of $which I can supply the Revdex.com with, and which has been mailed to the parents timesI am willing to reduce their bill to $At this time we have not been contacted by them to set up a payment plan and they do not answer our phone calls or return messagesWe have no other recourse than to have our collections attorney contact them Final Consumer Response / [redacted] (4200, 11, 2014/05/01) */ (The consumer indicated he/she DID NOT accept the response from the business.) The facts are as follows: Pediatric Therapy Partners was informed well in advance of the change in insuranceThey were told in May the insurance would switch over in JuneThey were given the updated information over the phone as well as it was given to them through e-mail,sent to them and given to them in personIt was also given to the Physical Therapist [redacted] and the Speech Therapist [redacted] There was no delay in getting the new insurance information to them and it was given in a timely mannerI have documentation supporting my claimMy wife agreed to pay one hundred dollars a session after the insurance was billed and if they would not pay for the sessionsOn 6/5/they did not bill the right insurance company for speech and I paid them one hundred dollars6/26/and 7/10/they billed the wrong insurance company again for speech therapy and they are looking for me to pay for those two sessionsOn 9/16/they were paid one hundred seventy five dollars by the insurance company for physical therapy but are billing me for The statement that I received from the insurance company for 7/17/2013, 7/24/2013, 7/31/2013,8/07/2013, 8/14/and 8/26/about services billed for speech explained that the reason these dates were not covered was as follows: These benefits were reduced due to failure to obtain pre-certification approval as outlined in the planThis amount represents dollars associated with the pre-certification not obtained for the services renderedThe provider is prohibited from billing the patient for this amountIf you have already paid this amount, please request reimbursement from your providerI can provide the Revdex.com the insurance documentation backing up my accountI am not claiming that I do not owe any money right now I owe two hundred and fifty dollars for the Physical therapy sessions and two speech sessions, 9/23/and 9/30/that were filed correctlyWe should not be responsible are just looking for the rest of the speech sessions to be billed correctly

Initial Business Response /* (1000, 5, 2014/04/09) */
Contact Name and Title: [redacted] owner
Contact Phone: XXXXXXXXXX
Contact Email: [redacted]@gmail.com
Thank you for the opportunity to address this client's concerns.
The facts are as follows:
Child was being seen by our office for...

ST and PT. Child was covered by the Illinois Early Intervention Program until she turned 3 years old. At the time the parents requested that the therapy would continue even though we might be considered "out-of-network" providers for the new insurance company.
I had a conversation with the Mother and she verbally agreed to pay out-of-pocket for continuing PT and adding ST. She verbally agreed to pay $100.00 per session.
When their insurance changed, our office contacted them to request the new insurance information. These requests were made 3 times from June, 2013 to August, 2013 even though it is the clients responsibility to inform the office of any changes to their insurance benefits. In September, 2013 both parents came to the office and gave us their new insurance information, at which time we promptly submitted the past due amounts through the new insurance plan. This new insurance plan advised us that we needed to call them for pre-certification which we did promptly. As a result of parent's delay in getting us the insurance information, the insurance company would only back-date the pre-certification by one week. As a result pre-certification approval began 9-11-2013 and therefore did not cover the previous 12 sessions of Speech Therapy that the child received in her home. We have exhausted all appeals to the insurance company to cover these charges. Had parents provided our office with the insurance information in a timely manner, these charges would have been covered.
Over the past 6 months, our office has attempted to contact parents by phone and mail to set up a payment plan so as to not cause them a hardship. We understand the stress of having a special needs child and have always been kind and patient with them, however, medical offices quickly send patients into collections one month after their bill is delinquent.
They currently have an outstanding bill of $1206.25 which I can supply the Revdex.com with, and which has been mailed to the parents 4 times. I am willing to reduce their bill to $1000.00. At this time we have not been contacted by them to set up a payment plan and they do not answer our phone calls or return messages. We have no other recourse than to have our collections attorney contact them. We have always been patient and kind towards this family and the care they received from our therapists has always been focused on the child's best interest.
Initial Consumer Rebuttal /* (3000, 7, 2014/04/10) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The office was made aware of the change in insurance in May 2013. They were informed several times since May 2013 of the change in insurance and given the information. They never contacted us about the new insurance. The new insurance information was given to them over the phone in May, June and July. In September we finally drove down to the office to give them the new information in person in September. The office was well informed in advance that the insurance was changing over in June. Plus both the physical therapist and speech therapist were given copies of the updated insurance as well in May. There was no delay in getting the new insurance information to them and it was given in a timely manner. On 6/5/2013 they did not bill the right insurance company for speech and I paid them one hundred dollars. 6/26/2013 and 7/10/2013 they billed the wrong insurance company again for speech therapy and they are looking for me to pay for those two sessions. On 9/16/2013 they were paid one hundred seventy five dollars by the insurance company for physical therapy but are billing me for 56.25. The statement that I received from the insurance company for 7/17/2013, 7/24/2013, 7/31/2013,8/07/2013, 8/14/2013 and 8/26/2013 about services billed for speech explained that the reason these dates were not covered was as follows: These benefits were reduced due to failure to obtain pre-certification approval as outlined in the plan. This amount 1050.00 represents dollars associated with the pre-certification not obtained for the services rendered. The provider is prohibited from billing the patient for this amount. If you have already paid this amount, please request reimbursement from your provider. I can provide the Revdex.com the insurance documentation backing up my account. Billing and disorganization seem to be a problem for this business. I am not disagreeing that I owe this business money I would just like the billing done correctly.
Final Business Response /* (4000, 9, 2014/04/20) */
Our office has not made mistakes with our billing and we have always dealt with this client in a professional manner.
The facts are as follows:
Child was being seen by our office for ST and PT. I had a conversation with the mother at which time she verbally agreed to pay out-of-pocket for continuing PT and adding ST. She verbally agreed to pay $100.00 per session.
When their insurance changed, our office contacted them to request the new insurance information. These requests were made 3 times from June, 2013 to August, 2013. In September, 2013 both parents came to the office and gave us their new insurance information, at which time we promptly submitted the past due amounts through the new insurance plan. This new insurance plan advised us that we needed to call them for pre-certification which we did promptly. As a result of parent's delay in getting us the insurance information, the insurance company would only back-date the pre-certification by one week. As a result pre-certification approval began 9-11-2013 and therefore did not cover the previous 12 sessions of Speech Therapy that the child received. We have exhausted all appeals to the insurance company to cover these charges. Had parents provided our office with the insurance information in a timely manner, these charges would be covered.
Over the past 6 months, our office has attempted to contact parents by phone and mail to set up a payment plan.
They currently have an outstanding bill of $1206.25 which I can supply the Revdex.com with, and which has been mailed to the parents 4 times. I am willing to reduce their bill to $1000.00. At this time we have not been contacted by them to set up a payment plan and they do not answer our phone calls or return messages. We have no other recourse than to have our collections attorney contact them.
Final Consumer Response /* (4200, 11, 2014/05/01) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The facts are as follows:
Pediatric Therapy Partners was informed well in advance of the change in insurance. They were told in May 2013 the insurance would switch over in June. They were given the updated information over the phone as well as it was given to them through e-mail,sent to them and given to them in person. It was also given to the Physical Therapist [redacted] and the Speech Therapist [redacted] There was no delay in getting the new insurance information to them and it was given in a timely manner. I have documentation supporting my claim. My wife agreed to pay one hundred dollars a session after the insurance was billed and if they would not pay for the sessions. On 6/5/2013 they did not bill the right insurance company for speech and I paid them one hundred dollars. 6/26/2013 and 7/10/2013 they billed the wrong insurance company again for speech therapy and they are looking for me to pay for those two sessions. On 9/16/2013 they were paid one hundred seventy five dollars by the insurance company for physical therapy but are billing me for 56.25. The statement that I received from the insurance company for 7/17/2013, 7/24/2013, 7/31/2013,8/07/2013, 8/14/2013 and 8/26/2013 about services billed for speech explained that the reason these dates were not covered was as follows: These benefits were reduced due to failure to obtain pre-certification approval as outlined in the plan. This amount 1050.00 represents dollars associated with the pre-certification not obtained for the services rendered. The provider is prohibited from billing the patient for this amount. If you have already paid this amount, please request reimbursement from your provider. I can provide the Revdex.com the insurance documentation backing up my account. I am not claiming that I do not owe any money right now I owe two hundred and fifty dollars for the Physical therapy sessions and two speech sessions, 9/23/13 and 9/30/13 that were filed correctly. We should not be responsible are just looking for the rest of the speech sessions to be billed correctly.