Now-defunct Laser Spine Institute under fire over insurance handling — 5 key details

Angie Stewart - Print  |

Florida authorities have received six complaints about Laser Spine Institute since the Tampa, Fla.-based practice abruptly shuttered in March, according to local station WBTV News.

Five key details:

1. The complaints filed with the Florida Attorney General's office include one from Norman Towell, who received treatment at Laser Spine Institute for debilitating back pain.

2. A Laser Spine Institute representative allegedly told Mr. Towell that the procedure would cost $13,400 up front and that two financing companies could provide loans to cover the expenses.

3. After Mr. Towell acquired the loans and underwent surgery, he contacted his insurance company, Aetna. A payer representative reportedly told him that Laser Spine Institute hadn't filed for coverage for the claim, and that Mr. Towell shouldn't have paid more than $275 after preauthorization.

4. Aetna told WBTV via email that it would forward Mr. Towell's case to its "executive response team." Laser Spine Institute didn't return the outlet's request for comment.

5. A separate complaint alleges Laser Spine Institute cashed checks from a patient's insurer that were intended for the beneficiary. WBTV did not provide details on the other four complaints.

January 2020, prohibits insurers from billing patients seeking emergency care in an out-of-network emergency room and from billing patients for a non-emergency procedure at an in-network hospital. Insurers also can't balance bill patients seeking emergency care in an out-of-network facility in a state that borders Washington.

The Washington law also stipulates that insurers pay out-of-network providers and facilities for the care their enrollees receive.

More articles on coding, billing and collections:
3 ways ASCs can improve cash flow
3 ASC surgery coding errors to avoid
HOPD payments higher in states with percent-of-charge fees or no fee schedule — 3 insights

© Copyright ASC COMMUNICATIONS 2020. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.