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:12/27/2023

  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.

  This business owner operated by *********************** signed an agreement to work as a ****** and submit all medical claims for payment for ********************** Services, PLLC. She also was hired to credential with ****************** and has failed to respond to communications for the status of this approval. She was also hired to check insurance claims and has failed to respond to the last 6 patients that have been sent to her for approval. ******* must have learned that she was not knowledgeable enough actually to perform the services she agreed to complete. In the last two months of 2023, ******* stopped responding to any form of communication when called and left messages and multiple emails. However, she continued to **** ********************** for her services. Services were paid since the payment also included the electronic health records system to document all patient encounters. Very unprofessional way to conduct business and she has broken all aspects of the contracted agreement for services.

  Business Response

  Date: 01/11/2024

  When *************** switch over to **********, I was did not change her invoice amount. I keep it the same and ********** is more expensive system and her payments when switching over to ********** paid for that system. To cover ********** and for my buisness to be paid, I would have to charge *************** $1600.00 a month. I tried to keep this cost low for her by not increasing. My work did increase and I brought on help to cover her account. According to the assistant that help with her account,she did not state she had any issues.  *************** did not pay her November statement for ********** and I paid to conitinue to have that service continue. I did reach out to ********** to have her account assigned to her. I did send an email out also this month explaning, that we will no longer cover the cost of billing/EHR systems for sites any more due to this is a big financial budern to the company when sites to do not pay. I was also still covering the billing system from Kareo as well to as my assistane was working all remaing claims and pull EOB/Remits from that system that did not transfer to **********. This was another expensive that I was covering out of my pocket. I mailed off and email her application to Ambetter and provided them with her infomation as well to contact provider with questions if they needed anything. I have not recieved any communication from Ambetter about her application. I was always told when ******* sent emails about benefits and I would also provide my assistant with patient coverage information for her to email back. I was under the impression my assistant was ******* everything, since that was the only account I assigned to her. 

  Customer Answer

  Date: 01/12/2024

   
  I am rejecting this response-because ******* reported to billing insurance for my services. After speaking with the insurance companies personally, there were multiple steps not completed and the insurances never received the claims. According to ******** representatives, not even one claim was received for my services. I have on video, our conversations that she was provided me with false statements regarding that she has a year to file claims and in fact the time is 90 days. And her reports of crying to her children  because of all the barriers she has faced . She reported the reason claims were not paid were due to treatment plans that needed to be uploaded and that was her last communication with this provider. She did not send a bill for November because she stopped responding to me in October. So, when I learned she owned my EHR system and was not paying the bills to ***********, I did sent her a payment in December so my EHR would not be cut off and I would be forced to stop seeing patients and could not send in their medications. I had to resort to send her messages saying I would report her to Health and ***** services to even get her to release my patients records that I no longer had access to in the Kareo system she was still using. I will be more than happy to provide documentation from Vaya, and Partners ******** on how she incorrectly filed a claim but never sent anymore after February to their system. This does not even address the private insurances that she never billed and there were 30 time limits to send this. Felicias lack of knowledge and hiring other employees that did not know the job any better than she did is not my problem. She is still the business owner and responsible for her actions as well as her employees. It is one thing for her to see that she was in over her head obviously,  it is another to stop communicating with me when we still had a legal binding contract. 

  Business Response

  Date: 01/23/2024

  My first repsond from this said the files were to big and was not accpected. These are the files and post office slips to show this set was being ************** never approved her claims to go through **********. 

  Customer Answer

  Date: 01/24/2024

   
  I am rejecting this response because: The documents that were uploaded by the business owner -***********************, do not show proof that the claims were ever submitted to Vaya or Partners for payments.  Please pay special attention to the documents that *********************** uploaded for the initial requests to even begin to consider trying to bill for services, in July 2023 and in August- what was done from October 2022 until July 2023? Our contract for services started in October of 2022, which I uploaded. The documents she uploaded were a request to start billing but this in no way is proof that she billed. Partners and ********************* entity for ********* reports that they never received any claims for services. Insurance companies require claims to be submitted within 30 days for some and up to 90 days for Partners and Vaya. Therefore,patients that I began to see from November 2022 until October 2023 will not be able to be billed because of her error in filing promptly. Her lack of filing these claims has resulted in over $100,000.00 in revenue lost for my business.Her decision to stop responding to me is a breach of her contract and I do plan to file with her licensure board. This is the most unprofessional excuse for how to run a business that I have ever seen. Again, please request copies of the Zoom video sessions of our meetings for all of the false information that was provided, intentional or unintentional, still will be considered negligence in a court of law. 
  
  

  Business Response

  Date: 02/07/2024

  
  I have dedicated myself to prioritizing the needs of ************** over my own company, but I don't want to discuss this matter any further. In an attempt to ease the financial burden on **************, I took on the responsibility of paying for two billing systems. However, the person I hired to assist me did not fulfill their duties, leaving me in a difficult situation. To cover the expenses of **********, I even had to take on another job. Currently, I am struggling to pay for the months of November and January, which has hindered my ability to run my own business effectively. The payment I received from ************** only covered the costs I incurred for **********, and I did not make any profit from the services provided to her. In fact, I spent over $600 solely on her ********** subscription, in addition to $350 for Kareo until I could no longer afford it. Despite this financial strain, I decided to keep the billing system active at $150 per month, just in case ************** required any additional support or if any missing information needed to be uploaded to **********. This experience has taught me the importance of thoroughly vetting and ensuring that those I hire possess the necessary skills and understanding of their job responsibilities. Consequently, I am currently in the process of closing my books and discontinuing this service.