Complaints

• Initial Complaint

  12/13/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  In early January 2023, I contacted this health care provider after I had billing issues with another provider. I stated that I was seeking treatment that I would be the sole payee for. Specifically, I didn't want any billing to go to any insurance companies. I received treatment through the end of May 2023. At that time, I terminated my treatment. As I didn't feel that the treatment was further helping with my recovery. I still had about 4 treatment visits left that had already been prepaid. A month or so later, I contacted the business to request a refund for the treatments that I had never received. I was told by an officer of the business that they did not offer refunds for unused prepaid ************* the early months of 2024, my attorneys' offices contacted the business to request copies of both my treatment and my billing histories. Simply to provide that information in order to settle my claim with the responsible parties that caused my injuries.Rather than simply complying with the request and giving them my treatment records and stating that all billing had been paid in full during the course of my treatment. The company created a new and completely fraudulent series of billing documents stating that they were owed additional monies for services provided by them to **** have full documentation that I paid this company everything that was agreed upon, prior to the termination of my treatment. In fact, having paid for treatment that I never received. I would appreciate the Better Business Bureau's assistance, in either helping to resolve this issue, or at a minimum, providing a negative reflection of this business practices in its ratings.

  Business response

  12/21/2024

  December 20, 2024
  
  Response to Better Business Bureaus Complaint ID#********
  
  To follow is our detailed rebuttal of *** ******** allegation. 
  
  Billing to Insurance Company: 
  From the beginning of *** ******** treatment (starting December 30, 2022), we understood that he wanted to self-pay for his care and that he did not want insurance to be billed. That is how we set up his account and made cash arrangements with him.  However, later the next year on November 11, 2023, we received a fax from ***** ********* with a Letter of Representation for *** ******* along with his signed release (dated 8/20/23).   Their letter instructed as follows:  In order to facilitate payment of all bills, please find below our clients insurance information. It is our goal to ensure all bills are paid promptly by the correct payor.  If your office experiences any billing issues, please contact our office immediately so that we may assist in facilitating any payments.  They then gave detailed claim information for USAA and ********** Blue Shield.   The attorney he chose to represent him sent us a Letter of Representation and instructed us to send all billing to the insurance companies listed.  See the enclosed Letter of Representation and the release he signed on 8/10/23.  As instructed by his attorney, we produced a complete set of billing and submitted that to the insurance company that the attorney has provided.  *** ******* has already been provided with a copy of the above reference fax from his attorney.  As such, he should be aware that we were instructed to bill his insurance in November 2023.  The request from his attorney for copies of medical records and billing records was not received until May of 2024.  ******************* was not aware that his attorney had requested that we do that billing to **** and only found out when this records request was fulfilled.  We have proceeded as instructed by the attorney that *** ******* authorized to represent him.  To characterize our doing so as fraudulent is unjust. 
  
  
  *** ******** claim that we created a new and completely fraudulent series of billing documents..:
  We have a single fee schedule for all *** codes, however,the interoffice codes that are used to enter the services into our computer vary based on whether or not the treatment should be billed to a third party.   When we learned that *** ******* had changed his mind about billing the insurance company, we had to re-enter all his treatment using the interoffice codes that direct the bill to be submitted to insurance.  It should be noted that the *** codes remained the same for each service.  Only the interoffice codes were different for insurance billing.  Even though it was an administrative burden to us, we wanted to assist *** ******* in recovering reimbursement from the at fault insurance company if possible. 
  
  Prior to learning that *** ******* wanted to submit billing to insurance, we had made cash payment arrangement with him.   As is commonplace in the healthcare industry,our office policy is to give a 15% discount on the costs of services when a patient is self-paying and not carrying a balance for a long period of time.  That discount represents the administrative cost savings for 1) not having to submit insurance billing and 2) the costly process of working through all the stipulations required to successfully recover the cost of care from an insurance carrier; and 3) the balance does not sit on the books for months to years.  *** ******* was also extended an additional 3% discount because he agreed to pay his balance in full by the end of his treatment plan.  All that adds up to an 18% difference between what was charged to *** ******* versus what was charged to the insurance company.  Of note, the insurance company never paid anything towards the claims that were submitted to them.  Had they done so, those monies would have been refunded to *** ******* as he had paid all but $575.87. 
  
  
  *** ******** claim that he has prepaid all his treatment in full and is due a refund:
  From December 30, 2022, to May 10, 2023, *** ******* had two treatment plans.  We understand that the financial accounting of the costs of care and payments made can be confusing,especially when payments for the first treatment plan were not completed before the second plan began.  See the spreadsheet summary of the accounting for both of those plans. 
  
  Regarding *** ******** claim that he was told by an officer of the business that they did not offer refunds for unused prepaid treatments:  It is our policy (written and verbal) that refunds are issued for credit balances.  Our written policy is: If you choose to pre-pay for treatment and for any reason treatment is discontinued before completion of the plan, you are entitled to a refund for any services you have not received.  *** ******* signed this statement.  See attached copy of that form.  The rest of our communications with *** ******* were by email & occasional voicemail.  We keep detailed records and have read over all documents and documentation and find no instances of our saying that we do not issue refunds for unused prepaid treatments. If he has evidence to the contrary, he should provide that. 
  
  In *** ******** case, he has not been tendered a refund because he does not have a credit balance. 
  
  I believe all the above addresses *** ******** complaints and allegations.  Please let me know if further clarification is needed. I would be happy to assist in any way that I can.
  
  Sincerely,
  *** *******
  CFO & Business Administrator

  Customer response

  12/24/2024

  Dear Sirs,

   

  Following is my reply to the response offered by Olympic Spine and Sports.

   

  Olympic continually acknowledges the fact that I paid all of my treatment obligations in full. My attorneys simply requested from the practice that they be supplied with documentation of my treatment and billing history. Also, that any outstanding balances be directed to the proper payees. Nobody in any way shape or form, instructed Olympic to deviate from the original agreements that were established between myself and the care provider prior to the beginning of my treatments. Olympic should have simply forwarded my treatment history with a statement saying that all of my payment obligations had been taken care of by me. That there were no outstanding balances owed. Instead, they made a decision to remove discounts and adjust payment terms long after services were provided. There are only two words that I can find to describe their actions. Opportunistic predators!

   

  Who in their right mind would think that it would be okay, to deviate from an agreement an entire year after the services had been rendered and all of the payments had been accounted for? I have spent my entire adult life, creating and executing legal contracts and agreements. I have never once recontacted a client a year later and stated that I was revisiting the original agreement and making changes at my personal benefit.

   

  As for speaking to the statement made by Olympic that there was a balance due from my first treatment plan. I negotiated that balance with the billing manager. Then agreed to make a round number for that balance to be incorporated into the balance of my second treatment plan. Which was paid in full by me, long before I decided to stop being a client. For the next year to follow I never received any notice or communication about breaching or modifying the original agreements. 

   

  As pertains to the refund document that I signed on January 11, 2023. Yes, I do recall signing this document. Being told that it was simply a financial responsibility form that didn't pertain to me as I was paying for all of my treatments myself. However, the sections of the document that are clearly underlined now were certainly not underlined at the time of the document being signed. Yet also continue to substantiate the fact that I am indeed owed and entitled to seek a refund for services that were never rendered.

   

  At this point in this correspondence, I feel that this is a good time to return to the beginning of this business transaction. As at the end of the day, this is was and will always be, simply a business transaction. Nothing more and nothing less.

   

  I decided to seek treatment at Olympic Spine and Sports in early 2023. I was treated well and with respect every time that I was treated there. In early June I decided to terminate that treatment. A few months later I reached out to them in regards to the possibility of a refund for the final visits and treatments that had never taken place. I was told that was never going to happen. So, I simply moved on and decided to consider the matter closed. 

   

  In late 2024, I discovered that the company had made a decision to create a totally new narrative of the agreement that was in place. Stating that they were owed additional monies and proceeded to send these demands to my insurance companies. These actions greatly influenced a change in my attitude regarding the whole business transaction.

   

  In early December I wrote a demand letter to the company. Asking them to remit a refund payment to me in the amount of $1000.00 also to immediately cease and desist from anymore attempts to bill my insurance providers for services rendered. Also to send me a letter stating that all of my accounts had been paid in full.

   

  The response that I received from the company was as follows. "WE ARE OFFENDED". Offended is an emotion obtained by someone after absorbing information. I on the other hand was victimized. Victimization is an action experienced by the actions of others placed upon the wronged party.

   

  I decided my period of letting the matter go was over. I contacted the Better Business Bureau and registered a formal complaint. I also created a few reviews on various websites relating to my experience with this provider.

   

  I have been extremely well pleased with the diligence and professional response and assistance of the BBB. Finding it to be a safe and fair forum for all parties to air their concerns. 

   

  At this time, I am willing to flex from my original demands in order to resolve these issues and put an end to this matter. I will consider a check from this provider in the amount of $500.00 and a letter stating that any accounts that I have with them are paid in full.

   

  If they feel that they would rather not resolve the issue? My next option is to present my testimony to the Office of the Washington State Attorney General. To get their opinion on who has been harmed here? Also to pursue an action in civil court.

   

  Sincerely,

   

  *****  ******* 

  Customer response

  12/24/2024

  
  Complaint: ********
  
  I am rejecting this response because:
  
  Sincerely,
  
  ***** *******

  Business response

  01/26/2025

  Response to Mr. ******** submission on 12/24/24:
  
  Mr. ******** statement that Olympic continually acknowledges the fact that I paid all of my treatment obligations in full.
  No where in my 12/21/24 response do I indicate that he paid all his treatment obligations in full.  In fact, I explain the opposite that there was an outstanding balance.  This topic was also covered in our correspondence to him on December 3, 2024.  He had paid off his first treatment plan but had underpaid the second treatment plan. Even though he did not complete the full 12 visits prescribed, the payments that he did make toward the 2nd treatment plan still left a balance on his account.  With the December letter, I included a complete printout of his ledger that details all charges and all payments.  That would demonstrate that there was a balance still owing not a credit. 
  
  The BBB is asking us to Please provide a response and clarify if there were services that were never rendered as the customer is alleging.
  
  To answer this as clearly as possible, Mr. ******* completed only 8 of the 12 prescribed visits on the second treatment plan, however, he never paid for the 12 visits.  The payments that he did make toward the 2nd treatment plan were $570.11 short by my accounting.  I do see a ledger printout in his medical record that lists his balance as $575.87 which is $5.76 different from my accounting.
  
  Mr. ******* wrote: My attorneys simply requested from the practice that they be supplied with documentation of my treatment and billing history.
  We have supplied documentation from the attorney (copy of the letter) that directly refutes this claim.  The request from the attorney directing us to bill his insurance was received by our office on November 10, 2023.The request from the attorney for documentation of treatment and billing history was received by our office over 6 months later on May 16, 2024. 
  
  Mr. ******* wrote: Also, that any outstanding balances be directed to the proper payees.
  I can only assume that he was referring to the attorneys November 10, 2023, correspondence.  However, it appears that he may have misread that letter.  To reiterate what I have said before in my December 3, 2024, letter and in my December 21, 2024, response to the BBB complaint, ***** Law sent us a letter of representation and provided the ************* information (USAA) and the **************** information (****) and stated It is our goal to ensure all bills are paid promptly by the correct payor. (emphasis added).  If your office experiences any billing issues, please contact our office immediately so that we may assist in facilitating any payments. 
  Learning that Mr. ******* had retained an attorney in August of 2023, it appeared that he had changed his mind about pursuing insurance reimbursement for his medical care. Even with Mr. ******* paying out of pocket for his care, it would have been to his advantage to have any available insurance company reimburse him for those expenses.  When asked by his attorney to assist in that process, we did so. Again, the insurance company never paid anything, but if they had, we could have forwarded those funds to Mr. ******** minus the remaining balance.
  
  To give a simple accounting of all the services and payments,here is a summary:
  
  Total Services Provided from 12/30/22 5/10/23 (included 1st days services): $8143.65
  Total Payments Made (including 1st day):                                                            $7339.62
  Total Credits Applied to Accounts:                                                                        $   233.92

  Remaining Balance:                                                                                            $    570.11

  A full printout of these ledgers has been given to ********** on 6/20/23 & 12/3/24. Those ledgers are still available for review. 
  
  The tone and accusatory nature that Mr. ******* has taken with us since December 2024 has been jarring. Up until that date, all interactions with him had been friendly and pleasant.  Our concern is not the outstanding balance but the attacks on our business practices and on our character.  We would be happy to write off his remaining balance just to get this settled.  However, if he chooses to go forward as he says in his last response, we are prepared to defend ourselves legally.  

  Sincerely,

  *** *******

  CFO & Business Administrator

  
  

  Customer response

  01/31/2025

  This is my final response to this matter. I am very grateful to the BBB for all of their efforts in trying to resolve the issues at hand.

   

  I did receive two conflicting e-mails from the BBB in the past week. One was dated 01/24/25 stating that the BBB was unable to help the concerned parties reach a solution. That my complaint would remain a part of the business's official BBB record for 3 years. Followed by a second e-mail dated 01/25/25 stating that the business would be willing to waive any former balance they state that they are owed. In order to resolve the issue.  I feel that the former option would best serve me as I continue with my course of action.

   

  As I have backtracked over the course of my treatment. I have calculated that had I received everyone one of the treatments that we had negotiated. The average cost of each treatment would calculate out to $305.81 per visit. In my initial demand letter to the company. I requested a refund in the amount of $1000.00 plus a letter stating that the account was paid in full.  Which based on the average cost of treatment was more than fair for both parties. As we all tried to negotiate an amicable resolution. I made a counter offer of a $500.00 refund, before I had actually calculated what each treatment would have cost. But even now that I am aware of this information, I did make the offer and therefore am willing to let it stand.

   

  Even though Ms. ******* continues to put false statements into this record. For example, stating that she presented billing ledgers to me as early as 06/20/23.

  I didn't even terminate my treatment with this company till the first weeks of June 2023. Also, there was no communication between me and the provider until sometime in August 2023 when I enquired about a potential refund and was told that would not be possible. With zero communication between the us until my insurance company had notified me that they began receiving bills from the provider and asking if they were legitimate? 

   

  At this point in time I feel that I will be better served to continue to have my BBB complaint remain on the official business record and move forward with both my Attorney General complaints. As well as the filing of my civil lawsuit, which will be for a lot more compensation than my generous demand letters. If the company decides that is a better value for them. Then simply accepting my gracious offer. I will be tendering my complaint to the ** in the next 14 days. With the filing of my lawsuit to follow shortly thereafter.

   

  Once again, I am truly grateful for all of the support and effort of the BBB. In trying to resolve this issue. I never perceived you to be such a valuable consumer and business advocate. 

   

  Thanks again,

   

  ***** ******* 

  Customer response

  01/31/2025

  
  Complaint: ********
  
  I am rejecting this response because:
  
  Sincerely,
  
  ***** *******

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩