This is for the Charlotte location - I was looking for a physical therapist to treat my sprains and utilized the Anthem BCBS website and in-network provider tool to identify a doctor that was in-network. The website listed Physical Therapy Center as a provider that was in-network and conveniently located close to my residence. When making my first appointment with Physical Therapy Center, I confirmed with the provider that they were in network for Anthem Blue Cross Blue Shield and scheduled my appointment.
On the day of service (first appointment) - The front desk of the clinic processing my payment, confirmed that they are in network with Anthem Blue Cross Blue Shield and that I have met the in-network deductible maximum amount. Then she asked me to make the co-pay payment of $19 for the first visit.
I visited the office thereafter on 7/13/17, 7/20/17, 8/7/17, 8/10/17 and 8/24/17. The claims through august (8/7/17, 8/10/17 and 8/24/17) were all processed correctly as in-network - using the provider name "Physical Therapy Center". However, the provider wrongly processed 3 claims in July 2017 as out of network using the provider name "Physical Therapy Center Two" even after confirming multiple times on the day of service that were indeed in-network.
Anthem Blue Cross Blue Shield confirmed with me that the provider was in-network the entire time (as Physical Therapy Center) but they purposely chose to use a different group code (out of network code) when submitting the claims. This is an unfair, deceptive and abusive practice! Physical Therapy Center lied to me that my claims were going to be processed in-network and used an out of network code to bill 3+ visits in July 2017. 5 Months later they then sent me a surprise bill (Surprise billing is illegal) for over $900+ and are lying again and putting the blame on the insurance provider for processing the claims as "Physical Therapy Center Two".
Note all visits were at the S. Blvd location but July claims were processed as Physical Therapy Center Two (out of network) and August claims were processed as "Physical Therapy Center" (in-network) read more
