San Francisco Sport and Spine Physical Therapy

Criminal and Insurance Fraud Activity

I strongly recommend stay away from this place. The billing people are systematically doing borderline criminal and insurance fraud activity. This insurance fraud scheme on their part will waste lots of your time. I am a busy person, had a bit of back pain and just wanted a quick consultation for an hour. What I didn’t expect and realize that their insurance fraud scheme will waste multiple hours of my time afterwards for a simple 1 hour session. They do this insurance fraud scheme as standard modus operandi, so high chance you will get dragged into that nonsense. The billing folks here are not incompetent, they are doing this fraud scheme deliberately.

This is how their little fraud scheme works:
Their price and quote to you for the initial session/consult is $175, which is good and straightforward. But after your session instead of billing you $175, they will a) send you bill of some randomly exaggerated number ($368 in my case) instead of the $175 that they told you, b) they will file claim on your behalf for $368 to the insurance company for a service that was worth $175.
Their hope is that 50% of the time insurance company will pay $368 for the service which was worth $175, and they can simply make more money. And when the other 50% of the time, insurance company refuses to pay $368 and says the service wasn’t worth that much, and if the patient complains, they will waive the remaining amount from the patient and will still charge the patient the $175. On paper that doesn’t hurt you as a patient as such, but it will basically waste a lot of your time and energy in something you should not be involved in.
The insurance company will send you multiple letters demanding explanation of the service and why it costed $368. In the meanwhile, SF Sport and Spine will send you bill reminders demanding to pay them $368. After bunch of those letters, insurance company will deem that they will only pay a portion of that $368. At that point, you are supposed to call SF Sport and Spine and after some back and forth, they will waive the remaining amount from your bill. If you don’t call them, they will keep sending you bills demanding $368. Just to understand what’s going on and deal with all these letters and bills at your home will waste hours of your time and energy.

And I really think that at some point, some insurance company will press fraud charges against these guys, and as a patient you will have to waste more of your time participating in those investigations.

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Reviews:0
Reported Loss :365 $
Severity of Scam :High
Reported by : JayB
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