ComplaintsforSpence Counseling Center, PC

• Initial Complaint

  01/19/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  We started counseling at Spence 1/24/23. We are still clients there. We authorized them to charge our credit card for our deductible amount, as they required. In March we started calling a ***** ******** to tell them that we were almost at stop loss. Then the messages changed to “We are at stop loss.” Approximately 9 calls were ignored. One phone call was finally accepted, but the charges continued. They overcharged our card by $858. It took them 4 months to refund all our money. In the meantime, while trying to resolve this with them, they continued to debate portions of the amount. By us protesting several of their decisions, they finally agreed with us. This came at personal cost, as ****** Spence, the Director of Operations, became very aggressive in some of her e-mail communications, attacking ****** personally. Several phone calls were “set up” but to this day a phone call has never taken place between us and ******. The only conversation was the one in person at their office in August between ****** and ******. Another issue is that mid year of 2023 they started putting the wrong tax ID number on their claims to our insurance company. That has caused great problems for our insurance company and for us, as ****** complained to us about the difficulties Spence was having getting reimbursed from our insurance. This was still going on last week when we last spoke to our insurance. We have tried to involve the Executive Director by sending 2 e-mails and once being advocated for by our therapist. He refuses to respond to us. Last week we received an e-mail in which ****** said, “we do apologize for the unfortunate factors that happen to cause miscommunication and misunderstanding from the billing department in 2023…” The problems were not miscommunication and misunderstanding. There were over 90 documented errors in accounting and billing, as well as horrible customer relations. We don’t know how else to resolve this. We do not want to change therapists.

  

  Business response

  01/27/2024

  To the Better Business Bureau - Dispute Resolution Team:

  I have attached the original complaint along with my letter response.

  Thank you. ****** ******

  Customer response

  02/03/2024

   
  Complaint: ********
  
  I am rejecting this response because:

  See attached letter.
  
  Sincerely,
  
  ******* * ****** *******

  Customer response

  04/04/2024

  We have received the response letter from Spence Counseling to your office, regarding the complaint referenced above.  We have concerns that some of their issues may not be clear and/or documented.  We do not understand the phrase “false accusations.”   We are only speaking from facts that have been documented.  We will first address Spence’s response, in order of paragraphs.  Then we will make some additional/summary comments.

   

  But before we go start, we apparently need to clarify that this complaint is from both of us, husband and wife, R and B.  The only complainant named by the Director of Operations [DoO] was B.  The DoO wrote very unprofessionally a few times to B.  Yet, each of the couple’s accounts at Spence had the same problems.  Again, to clarify: two accounts, not one.  We each had one session per week, with very occasional missed weeks.

   

  As for the emotion wrapped up in all this, our response is this: who would not experience some emotion when their charge card continues to be charged repeatedly without their specific approval, even after Spence was asked to stop? We trusted Spence to charge our credit card with only legitimate charges, yet they broke that trust over and over and over again.

   

  To complicate an already difficult situation, Spence has submitted 40+ claims, between the two accounts, with the wrong tax ID number on them to our insurance company.  This problem developed in late spring or early summer of 2023.  It has continued into January 2024.  Just yesterday we received an Explanation of Benefits [EOB] which showed another claim with the same problem from August, and was therefore denied.  Yes, our insurance company contacted them before our insurance company contacted us about that problem.  Spence and our insurance eventually agreed that all claims with the wrong ID number on them had to be resubmitted, and to our understanding, Spence eventually is still working on that for the insurance fiscal year (Oct. 1 – Sept. 30) and they are working on resubmitting the ones for October 1 and after.  Our insurance [C] did accept a few of the first ones by attaching a copy of Spence’s tax ID which Spence provided them, but when it became clear to C that this was an ongoing problem, they required the claims to be resubmitted correctly.

  We clearly understood that we were responsible for our 20% deductible until we hit “stop loss.”  Before we started counseling we signed paperwork for our VISA card to be charged for our deductible after each session. The statement “B was insistent that their “stop loss” was met before they started counseling and that the company refund all co-pays on their account” is not accurate.  What B did say was that they were very close to meeting their “stop loss” and that she would let them know when that happened.  In early March B started leaving messages (9 in total) on the voice mail for the Executive Administrative Assistant [EAA] that said that we were very close to hitting “stop loss.”  After the first week of April those voice mails changed to “We have hit ‘stop loss.’”  We have receipts from Spence that show that the last time they charged our VISA $37 x two sessions was on May 4 (for sessions on April 25), nearly two months after B started leaving the voice mails.  Finally, on the tenth phone cal the EAA answered her phone and B was able to convey the message directly to her.  We object that our first 9 calls were ignored and never returned.  As a result, we were charged for at least five weeks’ worth of session deductibles (times 2 people), for a total of $370.  And, adding to this the customary lag time in health care billing, and then reimbursement to the provider by insurance, it got to the point that Spence owed us an accumulated $854.  Some more errors were made, and at one point the total we were erroneously charged was over $1,000.

   

  Spence did some refunding to us in May, but then the refunds stopped until late August, after B’s one spontaneous meeting with the DoO on about the 22^nd.  After e-mails discussions going back and forth, our final refund came on January 18, with that amount of $37 being applied to our account.

   

  This was all further complicated by the fact that Spence somehow created an error in the email address in R’s records, and so he stopped receiving emails and receipts that were directed to him.  That was corrected in mid September.

   

  The DoO writes in the 3^rd from last paragraph of her response to the BBB, “At one point, B called all the administrative assistants on our staff to express her concerns and complaints about the issues happening with their accounts and wasting their time when they had other work to do.”  This needs to be clarified.  Please allow me to copy text from my email response to the DoO on October 15, 2023:

  I wish that you had asked for an explanation for my actions.  I would have told you this: You had told me that going forward I should talk with K about our accounts.  I told you that come October 1 that it was a new fiscal year for our insurance company.  I tried to call K on Wednesday [Oct 4] for two reasons: 1) To tell her what I just learned that morning from my insurance company. What I learned is that Spence has continued, for months, to have the wrong tax ID number on every claim they have submitted to them.  I was trying to intercept that, as my insurance rep told me that she had managed to get temporary approval from her supervisor to process many of the later claims, but that could not continue.  I was trying to help ensure that Spence gets paid promptly.  I do find it interesting that both K and L O knew you had faxed/e-mailed C four W-9s, but did not know that it was because of errors Spence made, and continues to make.  2) To find out if any claims had yet been made by Spence since October 1.

   

  But I could not reach K because Spence’s automated directory only went by last name and I did not know K’s last name.  That is why I called L O, to get connected to K.  Both ladies were very professional and asked some probing questions.  I did not call them to complain to them.  I was simply trying to intercept more mistakes being made.

  Apparently the DoO does not accept my explanation, but it is truth.  [The automated phone directory at Spence now asks for first name.]  I have never spoken with any other staff member at Spence about anything, except with our therapist, the one meeting I had with the DoO and the one phone call with L T.  Yet, the DoO told me that “this behavior would not be tolerated.”  We never intended to “split staff.” 

   

  Spence has a type of confidential email communication, where the emails are no longer

  accessible to us after 30 days.  Before we realized this, we lost access to several emails DoO

  sent us.  She sent us a particularly harsh email on Oct. 12 that is now lost to us.  She has

  complained at least twice to our therapist.  We question the ethics of this.  She is so careful to

  stress that she is on the business side of the practice and that Charles is on the therapeutic side,

  yet she has crossed to the therapeutic side at least twice.

   

  The DoO has also said these things to B in emails:

                  “I also don’t appreciate you reciting to me how many times you called L (9 times) without a returned phone call, how many days (22) that I did not get back to you in this process.” [We responded with: ‘[we] always use facts when dealing in business issues.  I have simply recited the facts.  Using facts is the only way we know to resolve this business issue.’] ( Oct. 13 email.)

   

  You are trying to micromanage me, my assistants, and S (My Billing Manager) and I am not going to stand for that.  [Neither one of us has ever spoken to S, and we have told the DoO that.]  ( Oct. 13 email.)

   

  You did cross the line B and you don’t like the fact that I called you out on it.  This is not abusive….you just don’t like that I am setting a VERY HARD boundary.  [our response: Please do not write phrases to me in all capital letters.  In email etiquette this is shouting.  There is no reason for you to shout at me.]  ( Oct. 13 email.)

   

  I (DoO) met with [your therapist] yesterday and told him everything that has been happening with your accounts, how often you are calling, e-mailing, and getting overly involved with this process,… [At one time Spence owed us $1,100.  Then, Spence has credited us, additional errors included, $1,575.  These figures represent the volume of errors that have been made.  We both feel that we have shown a lot of restraint.]  …so this is a therapeutic issue for the level of control you are exhibiting. (Oct. 13 email.)

   

  One of the things we have done in trying to resolve all this was to speak to the Executive Director [ED] of Spence.  We tried three different times to reach out to him, once through email, once through our therapist and again by a letter sent through email.  We have learned the hard way that, in practice, he is not the “Executive Director” as used in business.  We understood the ED to be the senior operating director of an organization.  It is now clear to us that he does not fill this role as understood usually in the business world.  We now understand why this upset the DoO.

   

  In the midst of all this, over a year’s time we received only one statement, dated 9/28/23, showing that we owed $266.  When we contacted Spence about it we were told it was wrong and to ignore it.  We had just reached an agreement with Spence that no charges would be made to our VISA after October 1, yet on October 9 a $266 charge was made without our approval.  We were shocked and, yes, angry.  Our trust was finally totally broken in the administrative side of Spence.

   

  Over these months we have learned some valuable lessons.  We should have asked in writing for Spence to stop charging our VISA.  We should have also cancelled the document we signed giving them permission to do so.  Finally, we should have instructed our credit card company to stop accepting their charges.  This would have, at least, gotten Spence’s attention sooner and prevented the large amount of money they had to refund us from continuing to accumulate.

   

  We are both retired executives from a worldwide Christian human services organization.  We have received invaluable help from our therapist at Spence and we want to do what we can to help Spence help others better.  We have confided our issues with Spence to a couple of good friends, who are also colleagues, asking their advice.  Those professionals have suggested that we pursue this, citing that it is possible that Spence was trying to double dip from us, by taking our deductible and receiving full reimbursement from our insurance.  They also suggested that Spence could be committing fraudulent billing by repeatedly having the wrong tax ID number on their claim forms to our insurance. 

   

   We do not believe either of these suspicions to be the case, but we firmly state that the DoO’s client relationship with us was horrible.  She excused poor staff response, broke many promises to us (the offer to resolve the problems ASAP, three phone call appointments that were broken), harsh accusations were made to B repeatedly in emails, complaining to our therapist at least twice about B, not observing email etiquette, making clinical judgements of B and expressing those in emails, and appearing to have terminated our therapy.  To borrow verbiage from a two month old Yelp review, “bullying and combative customer service” was what we also experienced with the DoO.  Spence has now lost income of $380/week from our business.

   

  We simply want this to be resolved.  As stated above, Spence has made many, many errors.  We have documented over 90.  As of January, they have now paid us back all they money they overcharged us.  We would like a formal apology, but instead they continue to not admit to all their errors and try to shift the blame to us and to our insurance company.  The errors are couched in the words “misunderstanding and miscommunication.”  We would like our relationship with our therapist to be restored, as he wrote us a letter on January 20 discontinuing our relationship as our complaint had been filed the day before.  We have invested one year in this therapeutic relationship, and between us and our insurance company we have invested over $16,000.  Starting over with another therapist would be extremely difficult.  Regardless of her opinion in her last paragraph, “I do not believe that anything our counseling center nor any other therapist could do that would appease them,” we were extremely pleased with our therapist and never complained to anyone about him.  We would like to reestablish our relationship with him.

   

  We had a plan with Spence going forward.  Starting October 1 we paid our deductible periodically as we had our sessions. Spence owes us nothing.  As of January 1, 2024,  Spence was working on getting our therapist Medicare approved, so our insurance would be secondary and we would then pay even a smaller deductible.  We would like to see Spence give “better business” to the community at large, instead of the bad business we experienced.  Instead of going forward with the agreed upon plan, as a result of our complaint to you Spence has decided to end their services to us.  If this is what happens to complainants, the Better Business Bureau of Omaha will have difficulty fulfilling its role of holding businesses to high standards.

   

  We appreciate this opportunity to respond and hope to move forward to resolution.

   

   

  Sincerely,

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

  

  Business response

  04/04/2024

  I responded to this complaint on January 27, 2024 and there is no new information to be added that has not already been addressed.  I did place a call to my Billing Manager for an  update on a few outstanding claims on both accounts and these are getting resolved.  If there are monies owed to the client, we will refund them once all have settled.

  

  Business response

  04/05/2024

  Thank you for closing out this file.  The clients would continue to dialoguing and dispute anything that was said by myself or my staff.  We will continue settling up all of their outstanding claims and ensure that any monies due are reimbursed.  It takes time for insurance companies to settle claims especially when they were processes with some issues and insurance companies do not turn these around immediately.  I know these clients do not agree with my response, but both my Billing Manager and I are personally working on their accounts and will get everything processed.  Thank you.

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