I work for a nationwide physical therapy company as a front office coordinator. It’s a good job and I have some great relationships with my patients. But this guy… Oh lord… This guy had become the thorn in my side recently.
I had surgery over the summer and this particular patient had treated at my clinic while I was on leave. He came back right after I returned to work. I set up his account and as a courtesy, we have a team verify patient benefits. No matter how well benefits are explained, people can’t grasp the concept that their insurance really sucks and therapy is very expensive.
So benefits come back and dude has a very high deductible and high out of pocket maximum (which he’d already know since he’s been here already) which he has met neither. Another stipulation to his insurance is he has a 30 visit limit per episode (which means he can come to therapy multiple times per year for multiple body parts) instead of 30 visit limit per year like most insurances. I explain this to him and he is convinced this is per year. I tell him this is what we are quoted and it is up to him to verify that the quote is true and accurate. He tells me to call his insurance. I tell him I cannot do that because our team has already been quoted and it is up to him now to verify his policy.
Instead of calling his insurance, he calls his MD multiple times and says they need to request a peer to peer review and give all kinds of info to his insurance. Several members of the MD staff call me throughout the day because they’re confused. I tell them they wouldn’t even have anything to do with his insurance authorizations for physical therapy. I said I explained to patient what he was supposed to do and ask for. The MD has already done their part by giving the referall for PT. Now there are multiple hands in the cookie jar and people are becoming more and more confused. I finally give in and call his insurance again. Between myself and my assistant, we are on the phone for an hour, which is why we aren’t supposed to call after benefits are originally quoted. We have a team for that and it takes time away from my office to sit on the phone all day like that. We verify everything once again and square it away and patient is scheduled and starts.
As of September 23rd, our company has had a major change in policy. We have always been very lax in collecting co-pays. We realize someone who has a $50 copay is going to be hurting bad to be spending $600/month in copays to go to therapy. However, people are getting hit with huge bills after therapy ends because they don’t understand how their insurance works and pays out and we are labelled the bad guys (YOU PICKED YOUR SHITTY INSURANCE, NOT US). So now we are demanding copays and partial payments towards co-insurance. Most people are paying somewhere around $20/visit when they walk in and being billed the rest. Almost all the patients who are now required to pay up front have taken it well and understand the policy…
Except for this same dude.
He comes in today and I stop him at the desk and explain to him about our new policy change and based on his insurance, he is required to pay $7.50 every time he comes in, which will apply to his overall bill. I hadn’t had a chance to stop him when he was in earlier this week to tell him then, so today he would he required to pay $15 to be seen today.
He more or less ignores me and starts to go into therapy. I tell him no, we cannot see you until you pay this. He argues and tells me that we are double billing him. I say no, this is a down payment to the final bill/there is no double billing. We argue some more and he tells me he’s not paying. I tell him I’m getting my clinic director, who tells him the exact same thing. He argues with him and continues to refuse to pay. He walks out of the clinic and comes back a few minutes later.
He asks if he can still be treated today. I say you can when you pay the $15. He said he called the corporate office who says they are waiving the payment. I say I cannot proceed until I get confirmation of that. The phone rings a minute later. It’s the corporate office who says they have taken a very upset phone call from this guy. Rep says she explained to him that this is new company policy and he is required to pay like every other doctor’s appointment now. So dude blatantly lied to me. I call the director over again and tell him that was corporate and what they said. Director talks to dude again and says this is policy. Dude still refused and ultimately left and looks like will he discharged.
All over $7.50.
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