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FARMINGDALE PHYSICAL THERAPY Complaint - SCAM BILLING- PATIENTS BEWARE

Review by PATIENTS BEWARE on 2010-06-12
FARMINGDALE, NEW YORK -- Two years ago, my daughter was treated at Farmingdale Physical Therapy. Months after she was no longer a patient, they billed me for $1000.00, and a few months after that, the bill grew to almost $2000.00. They claimed that my insurance benefits for physical therapy had run out, however that made absolutely no sense at all. First of all, they carefully screen all patients (I was also a patient at one time at Farmingdale Physical Therapy, so I know exactly how this works) prior to letting them be seen by any therapist. They won’t even let you past the waiting room until all of your paperwork is cleared with your insurance company. They have a wall of windows and you are called and they screen your script; they look up your coverage on the computer, and they take your co-pay. It is impossible that our benefits had run out while my daughter was still a patient and that no one told us. This seems like a scam to me to wait until the patient is no longer a patient and THEN to send a bill for $2000.00. I, however, did pay $1000.00 of that outstanding phony bill because I don’t like debts over my head but I have been writing letters to them for a year. Since that time, money has been very tight, and I have begged them to forgive the (phony) balance of $965.00. They sent the bill to a collection agency! PATIENTS Beware!
Comments:4 Replies - Latest reply on 2010-06-19
Posted by yoke on 2010-06-12:
Did you contact your insurance company to see what was going on?
Posted by Anonymous on 2010-06-12:
Did you receive EOBs (Exaplanation of Benefits) from your insurance company? I get those after every medical visit, though sometimes it takes a while for them to come in. I wonder if this medical place is slow on getting their billing out, so these are just the last of the bills you had incurred? EOBs are great at helping customers/patients figure out what's going on it (what the charges are for, what was covered by insurance, what the discounts were, what the patient owes, etc.).

Like yoke said, check with your insurance provider. They will explain everything. Certain types of treatments have certain insurance caps (plan dependent, of course), so it is feasible your kid's treatment exceeded coverage for that specific thing.
Posted by Skye on 2010-06-12:
Insurance companies limit the amount of times they will cover physical therapy. They are not unlimited. Did they tell you how many appointments had been approved? You may have gone over the limit. You need to find out. Usually the referral from the doctor will say how many you need, then the insurance will tell you how many they will cover. Example, if your referral you gave to the physical therapy location, when filling out all the forms, had say 12 visits needed, then they would see her for 12 visits. This is not saying the insurance had approved those 12 visits, it's just what the doctor ordered. It may have been when they submitted the bill to your insurance for payment, that they found out you had so many visits that had not been covered. So now they bill you. When you signed all the documentation and forms on the first visit, did you notice if you signed something that said anything that the insurance did not cover, you as the patient would agree to be responsible for? This sounds like something that may have happened. I don't think they are running a scam. Go over all the paperwork your insurance company sent you, and find out what percentage you financially you may be responsible for. It's a sad, but insurance companies often overide what the doctor orders. Even though he says your daughter needs this amount of visits, they in the end, have the final say on how many they will pay for. It's always about the money, and their goal is to always pay out the least amount of claims, in order to keep as much moneyo on their end as possible. Just because they kept accepting your co-pay, did not mean all those physical therapy visits were going to be covered by your insurance company. It's so important to know what your benefits are, what will be covered, and how much in the end you will be responsible for. You have to remember that someone that is deciding what amount of visits your daugher needs, has no medical background what so ever. Their job is to pay the least amount possible, to save the insurance company money. After all, money that the insurance company pays out, is not a profit for them, and they will do the least amount for you, in order not to cut into their own profit margin. It makes me crazy that someone working a desk, has this type of power. In end, the least amount paid out in claims, is all they care about.

Good luck.
Posted by PATIENTS BEWARE on 2010-06-19:
I never received any EOBs regarding the additionaly monies owed. I was extremely careful with payment and everything matched up; that is why it was so frustrating to me. I spent countless hours on the phone trying to figure it out. You are correct- it was much later, though, they billed me way after she was a patient. The insurance company did not understand what they had done and I kept going back and forth on it; but the therapists were so nice and I didnt want a bill over my head and I WAS AN IDIOT FOR PAYING ANY OF IT, BUT NOW IT IS BEYONE RIDICULOUS AND MONEY SITUATION HAD CHANGED AND I CANNOT AFFORD ANY MORE AND THEY HAD THE NERVE TO SEND IT TO COLLECTION.

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