April 2023 by DP Ko
The therapist was great with my child but billing has been a nightmare to work with. They keep pushing payment of a claim submitted for the wrong service. They have good providers but the 1 star is for dealing with the hospital and billing.Our child was assessed at the Children’s Speciality Center Preston and was recommended Occupational Therapy for approximately 12 weeks to help them. The clinic ran our EOB and verified our coverage for the sessions, stating that there was a $30 copay per visit for OT with their providers, which insurance verified. At the end of January we received a bill for over $2k for 5 sessions with the OT department for November and December. Called our insurance and were told Children’s had billed the insurance for out-patient habilitative Speech Therapy so the claim was denied. After explaining why we were seen, insurance said we need to reach out to Children’s billing and tell them about the error and to resubmit the claim correctly. We were told by the clinic that the hospital manages billing. We reached out to the billing dept. who stated they would not be able to do that as insurance has to initiate it, again we told them what insurance had just told us and they refused to help. We called insurance again and they said they received the wrong code and the claim has to be resubmitted by Children’s. After multiple calls between the Childrens’ billing dept. and insurance, billing did absolutely nothing to look into the issue and kept pushing that we pay up. We were told Children's doesn't have a patient advocate when we asked for one to talk with. We filed for an appeal with the insurance and were just notified in writing that the code Childrens’ billing sent insurance was for out-patient habilitative Speech Therapy (a service we did not get) and so the appeal was denied and to contact the Childrens’ billing dept. to resubmit for Occupational Therapy.Children’s secondary billing office continues to ask us to set up a payment plan for the incorrect service that was charged to us and we are still getting the runaround for getting this fixed. Both my husband and I have talked to the secondary billing office and they have said they can't help with that. The number they provided to reach billing is the same one that has told us they can't change coding (though it appears they coded for the wrong service). We get bills with no due date but are told we have to start paying for this incorrect bill within 10 days while we can’t get a hold of anyone to help us fix it so we can pay the correct bill for the correct service. We had previously tried calling the 214-456-CARE number and were directed to billing again. Asked for a patient advocate at least 3 times over the last 3 months and they claim they have no patient advocates, which is hard to believe being such a big health care provider. We keep getting sent back to ‘guest relations’ who don’t really seem to care and have been unhelpful to fix this coding issue. We have no issues paying the correct bill, but to be billed for the wrong service and then having our arms twisted to pay up for the wrong bill while getting the run around to have the issue fixed has left us with a bad taste of working with a Children's Health.
