ComplaintsforPeak Sports & Spine Physical Therapy - Renton, P.S.

• Initial Complaint

  09/26/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My 8 year old daughter went to this clinic 3 times to receive physical therapies for her lumbar strain on 8/2, 8/6 and 8/8. We received medical bill on 9/3/24 in the amount of $449.90. It was shocking to see how expensive it was as she didn't break her bone and it was just muscle strain which prevented her from doing certain gymnastics moves. I first thought the clinic didn't bill insurance because the bill didn't show item costs. It only showed how much deductibles that I have to pay. Then I received claims detail from our insurance. The clinic billed $455 for initial evaluation which took 45 mins and $210 for 1st follow up visit and another $210 for 2nd follow up visit which took about 25 mins each. I couldn't understand why the service charge was so high. All the therapist did was to have my daughter do some exercises which we can easily look up online. Since it is muscle strain, I thought giving muscle massage would be the logical thing to do but he didn't. She hasn't improved at all after 3 visits. The therapist mentioned at one point that her symptoms were very tricky and she would need to go back to the doctor if she doesn't improve. We found a different clinic. My daughter fully healed with 2 visits with this new therapist and this therapist only charged us $50 per each visit. I tried to talk to someone at the clinic that I could discuss why the charges were so high. Called on 9/18. The front desk person transferred me to ****** as per her ****** could handle billing question. ****** said I would need to talk to the owner and she said owner will be in office on 9/19 afternoon and would tell him to call me back. Didn't receive a call so I called the clinic back on 9/23. ****** said the owner was out sick but he will be back on 9/24 afternoon so he would call me then. Didn't receive a call. I called back on 9/25 but they transferred me to the therapist. After he heard me he said I need to talk to the owner but I can't trust the owner would ever call me back.

  Business response

  09/26/2024

  I apologize for not calling you back. I was sick with flu like symptoms for multiple days last week and this week my kids have had it and I have not been in to the office very much.

  I'm sorry that you were not pleased with the billing of the visits. You had 1 visit with an evaluation and 2 follow up visits. On the first visit, your insurance was reviewed with you. At the time of that visit, you were told you had a $3,200 deductible but only $545.49 was met. Which meant that you would be responsible for 100% of what insurance would normally pay per visit. Once your deductible is met, you are only responsible for 10% of what insurance pays. What is charged per code that is used to insurance is not what is paid. The unfortunate practice of billing insurances is that we need to bill almost double what they will pay. Typical follow up visits are billed with 3 codes, and then the insurance companies pay us based on their fee schedule of reduced rates from what we bill. If your deductible has not been met, you are responsible for 100% of what they cover as you can see in the **** provided by the insurance company. Evaluation visits are typically the same with an added evaluation charge, that is why the first visit is higher.

  Again, I am sorry you don't agree with what was billed to insurance. Our therapists appropriately bill for what they do during the visits. I talked with your therapist and reviewed his notes and what was billed was appropriate for what he did during the time with your daughter, and was billed to insurance accordingly.

   

  Sincerely,

  ******* **********

  Customer response

  09/30/2024

   
  Complaint: 22341945
  
  I am rejecting this response because: owner hasnt answered my question. I am questioning that the value of service was no where near what the provider billed to insurance. What owners response is to explain how insurance billing and deductibles work, which I already know. My serious concern is why this provider have to bill 
  $875 and couldnt fix my daughter vs another provider billed $100 and was able to fix her. If I have to pay more for the service than the other, that service needs to provide more value than the other or at least bill at the price thats reasonably acceptable. I cant help but think Im a victim to an extreme case of price gouging.
  

  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. ↩