Polly Badt owner of Body Rehab Center (physical therapy) overcharges her clients and refuses to credit your account when confronted. Physical therapists charge in 15 minute increments also known as (1) unit. My treatments were 45 minutes and she is charging 75 minutes to my insurance company and me resulting in an overcharge of 30 minutes.
Every Medical Provider has a negotiated contract rate with all health insurance companies Example: Standard rate $175, Insurance rate $125 savings of $50. Every insurance company issues an Explanation of Benefits document to your Medical Provider and yourself. It is imperative that you compare your EOB with your billing statement. The EOB explains exactly how much the Medical Provider is to be paid which is the contracted rate. Another type of overcharge is if the Medical Provider charges you the $50 difference after your insurance company pays $125. It is the obligation of the Medical Provider to charge and collect the contracted rate of $125 ONLY.
I have a deductible with my insurance of $1,000 and Ms. Badt was charging me the full rate of $175 and not the contracted rate of $125 as required by my insurance company. An overcharge of $50 per treatment.
Every time your insurance pays a claim, it is deducted from your lifetime benefits. Example: Lifetime Maximum $500,000 and the medical claim is for $2,000. Your lifetime benefit is now decreased $2,000 to $498,000. In my case, my insurance company was paying the 75 minute rate instead of the 45 minute rate, resulting in a decrease to my lifetime maximum. It doesn't sound like a lot but it adds up and can cause future medical costs.
If your Medical Provider refuses to abide by the Insurance rates, contact your Insurance Company and file a claim. This is what I had to do and I have spoken to several other clients of Body Rehab who were charged the same way I was. They are filing complaints also. The above examples also apply to Medicare.
Again, file a complaint with your Insuance Company, The Physical Therapy Board and/or Medicare.
santa monica, California