Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:06/28/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I made an online appointment to speak to a a doctor and Paid the ****** requested *** for no insurance as I knew my insurance would not cover it. The sight clearly says ****** with no insurance. I provided my insurance info, had my appt and paid the bill as though I had no insurance. This company filed my insurance and said I owed the another ***** even though I paid the bill as though I had no insurance. They are stating my insurance company is billing them??? They refuse to provide a break down in writing that they are truly being billed more from my insurance. It is truly sketchy, Why would I pay more to go through my insurance? I have asked for a sensible explanation but continue to be told my insurance is billing them, which is a first.

  

  Business Response

  Date: 07/05/2023

  PlushCare does try our best to give you the most accurate estimate for your out-of-pocket costs at the time of booking, however, additional fees can be owed based on the complexity of your visit along with what your insurance is willing to cover. The estimate we provide is based on our cost estimator where we pull surface financial information from your insurance provider. However, some questions that you could ask to your insurance provider directly to find out more about your potential after-visit fees are:
  What is my out-of-pocket cost for a primary care visit versus an urgent-care visit?
  What type of insurance plan do I have and is PlushCare in-network?
  What percent of my bill does my plan cover?
  Do I have an existing deductible that could affect coverage?
  Does my plan have an out-of-pocket maximum? If yes, and I reach the maximum, will my claims then be paid in full?
  
  If you have any additional questions regarding your cost estimate or how PlushCare submits claims to your insurance, please do not hesitate to ask! 
  
  When you book an appointment, we try our best to give you an accurate estimate of your out-of-pocket costs based on information from your health insurance provider. However, the final amount can vary based on the complexity of your visit, along with what your specific insurance plan covers. If your insurance replies to your claim stating that you owe a balance, we will send a bill through our payment system called Apero.
  
  In the payment portal, you can view more detailed information for your bill by clicking on View Invoice and entering the patients date of birth.  If you have questions about why specific services were or were not covered, we encourage you to review visits with your insurance company.
  
   If you have additional questions regarding your account balance or bill, please do not hesitate to let us know! 
  
  LINK TO PAY: plushcare.aperohealth.com/pay 

  Customer Answer

  Date: 07/05/2023

   
  Complaint: 20251920
  
  I am rejecting this response because: I paid what the site clearly stated was the total bill without insurance knowing my insurance would not cover the bill. My insurance did not pay you, I did. The full amount as an uninsured patient per your site. My insurance declined to pay and are not billing you. Your answer is inadequate,  I am being told from my adjusterbthat it is because the insurance had an allowance of funds higher than your uninsured rate and your company is trying to meet that out of my pocket.  If you advertise that I owe a certain amount without insurance as you do...someone like myself will pay what they think is the max out of pocket. My insurance company denied my claim..ie, I have no insurance coverage for this. You can jot change the rules after the fact.
  
  Sincerely,
  
  ***************************

  

  Business Response

  Date: 07/11/2023

  Hi *****, thanks for your quick response. As a one time courtesy, we've submitted a request to our RCM team to waive your Apero bill. Please be advised that if you plan to use our services in the future --  you will receive a bill for the remaining balance. Have a great day! 

• Initial Complaint

  Date:06/26/2023

  Type:Billing Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I enrolled in PlushCare in April. When I signed up, I was asked, by online form, whether I wanted to pay with insurance, to which I responded yes. I identified my health insurer and was presented with a list of "in-network" doctors. I selected one, made an appointment, and had a teledoc visit with her. I subsequently was dunned for $100 by PlushCare, after paying a co-pay at the time of the appointment. After far too many email with its horrible customer service department, I was given no explanation of why I owed $100 for an office visit. I checked with my insurer. This was its response:"According to our records, this provider was under review and as a result of the review, the provider is not eligible for coverage and the claim is not payable. No additional information is available at this time."I received a meaningless response from plushcare customer service when I pointed out that it gave me no idea that it was not approved by my health insurer. Its form suggested that the doctor I saw was "in network" when it knew or should have known that it was not approved to receive payment for treatment from my insurer.

  

  Business Response

  Date: 06/28/2023

  Hi *******, thanks for taking the time to provide your feedback! PlushCare does try our best to give you the most accurate estimate for your out-of-pocket costs at the time of booking, however, additional fees can be owed based on the complexity of your visit along with what your insurance is willing to cover. The estimate we provide is based on our cost estimator where we pull surface financial information from your insurance provider. However, some questions that you could ask to your insurance provider directly to find out more about your potential after-visit fees are:
  What is my out-of-pocket cost for a primary care visit versus an urgent-care visit?
  What type of insurance plan do I have and is PlushCare in-network?
  What percent of my bill does my plan cover?
  Do I have an existing deductible that could affect coverage?
  Does my plan have an out-of-pocket maximum? If yes, and I reach the maximum, will my claims then be paid in full?
  
  When you book an appointment, we try our best to give you an accurate estimate of your out-of-pocket costs based on information from your health insurance provider. However, the final amount can vary based on the complexity of your visit, along with what your specific insurance plan covers. If your insurance replies to your claim stating that you owe a balance, we will send a bill through our payment system called Apero.
  
  In the payment portal, you can view more detailed information for your bill by clicking on View Invoice and entering the patients date of birth.  If you have questions about why specific services were or were not covered, we encourage you to review visits with your insurance company.
  
   If you have additional questions regarding your account balance or bill, please do not hesitate to let us know! 
  
  LINK TO PAY: plushcare.aperohealth.com/pay 

  Customer Answer

  Date: 06/29/2023

   
  Complaint: 20236779
  
  I am rejecting this response because: you cant sugarcoat fraud. Plushcare knew, when it told me that its doctor was in network, that my insurer previously rejected it as a provider.  If I try to sign up today, it will collect my insurance information and provide me with a list of supposedly in network doctors, while knowing that those services are not covered.

  
  Sincerely,
  
  ***************************

  

  Business Response

  Date: 07/05/2023

  Hi *******, thanks for taking the time to provide your response. As a one time courtesy, we have submitted a request to our RCM team to waive your bill. Please be advised, this can take at least 4-6 weeks to reflect to your insurance. Have a great day! 

  Customer Answer

  Date: 07/05/2023

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***************************

• Initial Complaint

  Date:06/25/2023

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I scheduled an appointment for 6/25 @ 5:30. No one showed up. I do not want the visit billed and I would like a refund of the money I paid upfront for the appointment. If there are any recurrent fees, cancel my account. Very unprofessional app. I am in a doctorate program and I thought this would be a convenient way of receiving health care but I was wrong. Please just refund me.

  

  Business Response

  Date: 06/28/2023

  Hi *****, thanks for taking the time to provide your feedback! I see that you spoke to a member of our Care Team who cancelled your membership + confirmed that a refund is processing for your visit. Refunds can take **** business days to reflect to your account depending on your bank's processing time. Have a great day! 

• Initial Complaint

  Date:06/23/2023

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Lack of providing transparency with billing. **************** extremely hard to get a hold of. People would call me back and then hang up. Charged me for two visits even though I only was seen once. Asked for itemized bill and they didnt provide it. When I finally got ahold of someone they sent me a bill with little to no detail of what they were charging me for. Was told this service was covered by insurance prior to being seen and it is not. This company should be shut down for fraud. Super sketchy billing process.

  

  Business Response

  Date: 06/28/2023

  Hi *******, thanks for taking the time to provide your feedback. I see that our Care Team has been in contact with you regarding your questions. An itemized bill was sent to you via email alongside an explanation of why a different physician was listed. Please refer to your insurance provide to inquire why they did not cover all costs. Have a great day!

• Initial Complaint

  Date:06/15/2023

  Type:Billing Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  06/15/2023, I was contacting ********** to help me get medication I can not get in my local area. I tried making contact with the company via phone waiting around fifteen minutes, being disconnected around 10/10:30 am. I then tried calling them back around lunchtime. This time I wanted ten minutes at this time my disabled mother needed assistance. I had to hang up. I cancelled the account because I couldnt reach the company via phone. I can not handle stress and additional issues right now in my life.

  

  Business Response

  Date: 06/16/2023

  Hi *****, thanks for taking the time to reach out to us! I went ahead and refunded the $50 fee and it should take **** business days to reflect to your account. Have a great day!

  Customer Answer

  Date: 06/16/2023

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ********************* ****

• Initial Complaint

  Date:06/12/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I went in the website and it said check to see if we accept your insurance..I put all my insurance information in and it said yes we accept your insure schedule and appointment now. I scheduled and appointment got a tele call from a dr and didnt even rectifying the health issue I was having and they charged my credit card $129 I asked customer service why they didnt bill my insurance like I requested there was a box that said bill insurance or pay now The customer service lady said oh sorry they didnt clarify we put your insurance information into the app but we do not contract with that company. I said so why did you say my insurance was accepted she said well let me try to get your money returned made me wait just to tell me I talked to a dr and got my service they are not refunding me. I said I asked before I even went onto to schedule if they accept MY insurance and got a YES. So why was I not informed before the appointment and I want my money back. Its a scam they should not tell you your insurance is acceptable and then say no if they werent contacted with them they should have stated that! I am a single mother that can not afford this I would NEVER HAVE USED THERE WEBSITE IF THEY DISNT TAKE MY INSURANCE WHICH PAYS 100% of my dr visits!

  

  Business Response

  Date: 06/16/2023

  Hi *****, thanks for taking the time to provide your feedback! Can you please email us a PDF copy of your Explanation of Benefits (EOB)? We'd love to take a look at this and will refund the difference if applicable. Thank you! 

• Initial Complaint

  Date:06/09/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I paid the fees and copay. They filed with my insurance incorrectly annd insurance bounced it back saying they missed information needed to cover the claim. plush care keeps sending me a *******************, that is 5x what I should owe (the copay) and they only filed for $20 with insurance. They are billing me an additional $110. I have contacted them several times including the letter where insurance says they forgot to put information on the claim. The company will not respond to me, only sending reminders for the inflated bill.

  

  Business Response

  Date: 06/09/2023

  Hi *****! PlushCare does try our best to give you the most accurate estimate for your out-of-pocket costs at the time of booking, however, additional fees can be owed based on the complexity of your visit along with what your insurance is willing to cover. The estimate we provide is based on our cost estimator where we pull surface financial information from your insurance provider. However, some questions that you could ask to your insurance provider directly to find out more about your potential after-visit fees are:
  What is my out-of-pocket cost for a primary care visit versus an urgent-care visit?
  What type of insurance plan do I have and is PlushCare in-network?
  What percent of my bill does my plan cover?
  Do I have an existing deductible that could affect coverage?
  Does my plan have an out-of-pocket maximum? If yes, and I reach the maximum, will my claims then be paid in full?
  
  When you book an appointment, we try our best to give you an accurate estimate of your out-of-pocket costs based on information from your health insurance provider. However, the final amount can vary based on the complexity of your visit, along with what your specific insurance plan covers. If your insurance replies to your claim stating that you owe a balance, we will send a bill through our payment system called Apero.
  
  In the payment portal, you can view more detailed information for your bill by clicking on View Invoice and entering the patients date of birth.  If you have questions about why specific services were or were not covered, we encourage you to review visits with your insurance company.
  
   If you have additional questions regarding your account balance or bill, please do not hesitate to let us know! 
  
  LINK TO PAY: plushcare.aperohealth.com/pay 
  

• Initial Complaint

  Date:06/08/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I scheduled an appointment with a provider on 4/2/2023 to obtain medication guided weight loss treatment. The provider advised that she would not be able to assist me and stated I would need to schedule an appointment with another physician. No medical guidance was given no treatment was provided I was advised to seek another provider. The company billed my insurance for service I did not receive and when the insurance would not pay they billed me even though no care was provided and I was told to seek an another provider. My time was wasted and I received no treatment or recommendation for treatment whether it be counseling or medication. I contacted them to advise of this and they refuse to assist and continue to try to make me pay for service I did not receive. My insurance company has advised me to open a fraud request which I am willing to do but was trying to give the company an opportunity to rectify the situation before taking drastic messages. I am only seeking a billing adjustment of the ****** to remove the charges I am being billed for inspire of not receiving any services. Look up code NOZD5IS

  

  Business Response

  Date: 06/09/2023

  Hi ********, thanks for taking the time to provide your feedback. As a one time courtesy, we have submitted a request to waive your Apero bill. Please be advised that this can take 6-8 weeks to reflect. Let ** know if you have additional questions! 

• Initial Complaint

  Date:06/07/2023

  Type:Billing Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was in need of a primary care physician and PlushCares marketing (free annual visit! $30 doctor visits!) combined with convenience made it seem like a good option for someone who is young and healthy like myself. I provided PlushCare with my insurance information and they confirmed coverage with an in-network provider. Imagine my surprise when my insurance denied the claims because preventative care is not covered when delivered by telehealth. Insurance will not pay on them, and PlushCare is still claiming to be in-network. Ive received a $200 bill (with no actual details!) and I believe Ill be on the hook for another $105 soon, for a total of $305, or almost 10x the price I was quoted (1 free annual visit and one $30 follow up). Its impossible to get ahold of anyone on their billing line. This is a shame, as the quality of care I received from the doctor was fantastic, and Id love to continue seeing her, but not for hundreds of dollars per visit. I would like these charges voided and for PlushCare to be much more transparent in their pricing, especially now that telehealth rules are changing due to the end of the ******19 emergency. I will certainly not be extending my free trial.

  

  Business Response

  Date: 06/09/2023

  Hi ****, thanks for taking the time to provide your feedback and we apologize that you're had a less than stellar experience. I took a look into your account and see that your request has been forwarded to our Billing Manager to review. They'll take a look at your account and follow-up with you in a few business days. Have a great day! 

  Customer Answer

  Date: 06/15/2023

   
  Complaint: 20156836
  
  I am rejecting this response because:  I have not heard anything from the billing manager since the company responded to the complaint.
  
  Sincerely,
  
  *******************

  

  Business Response

  Date: 06/16/2023

  Hi ****, I see that our ****************** reached out to you via our in-app messaging system. Please feel free to respond at your earliest convenience. Thanks!

  Customer Answer

  Date: 06/16/2023

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.  PlushCare waived the fees they claimed would be covered by insurance. 
  
  Sincerely,
  
  *******************

• Initial Complaint

  Date:06/07/2023

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was seen by a great PlushCare doctor on February 9. On March 16, I noticed PlushCare charged me for the visit as if I were uninsured. I sent a message to them asking them to submit the claim to ***** so that I can be reimbursed (as I had been reimbursed a month prior after my 1st appt with a PlushCare doctor). I was told that they would send the request to their billing department. I followed up on March 31, April 7, and most recently June 5. The first time I received a response (April 12) saying that their department was backlogged and it may take up to 30 days to complete. And the most recent message I received (April 7) said that they were experiencing higher volumes of requests and I will be "notified as soon as they have an update on your request.". I would like for PlushCare to submit my claim to my insurance so that they can reimburse me what I am owed. I do not know what else to do at this point.

  

  Business Response

  Date: 06/09/2023

  Hi there, thanks for writing in and we apologize for the delay in response. I took a look into your account and see that your request has been forwarded to our billing department. I've gone ahead and escalated your request and to the billing supervisor to review and advise. Have a great day! 

  Customer Answer

  Date: 07/26/2023

  RE: Complaint ID: ******** I still do not have a resolution to my complaint. PlushCare has not submitted the February 9, 2023 claim to *************** (I checked 7/26/2023). 

  

  Business Response

  Date: 07/31/2023

  Hi *******, thanks for reaching out. Per our email to you in March, we submitted this request to our RCM team to submit this and they are still taking a look. Thanks! 

  Customer Answer

  Date: 07/31/2023

   
  Complaint: 20155200
  
  I am rejecting this response because I have been getting the same runaround messages for the last 6 months with no resolution. The latest was on July 27 stating, Thank you for reaching out to our ******************* We apologize for the delay. I went ahead and marked your concern as urgent and also reached out to RCM to follow up. We'll make sure to keep you posted! In the mean time, please let us know if you have any more questions or concerns! But I still havent heard anything back. My request is definitely not being treated as urgent. It does not take this long to file a claim with an insurance company. All I want is for PlushCare to file my Feb 9 claim with my insurance company (Aetna) so that I can send PlushCare back a copy of the Explanation of Benefits (EOB) so that I can be reimbursed. Thats it. I would like what is owed to me. 
  
  Sincerely,
  
  ***********************************

  

  Business Response

  Date: 08/02/2023

  Hi *******, unfortunately our RCM team is experiencing a higher than normal volume. Rest assured, that your request has been marked as Urgent and we'll keep you updated as soon as we hear back. 

  Customer Answer

  Date: 08/02/2023

   
  Complaint: 20155200
  
  I am rejecting this response because I have been hearing this for 6 months! I just want a resolution not a run around. 
  
  Sincerely,
  
  ***********************************