FAQ

This section is twofold, firstly questions related to my case and secondly questions relating to patients.

The health system is often challenging to navigate, so it is my hope to answer the most common questions that come up. 

Frequently asked questions

Patient: What do I do when my health insurance claim is declined?


When your health insurance claim is declined, consider following these simple suggestions: - Contact the health fund and discss the matter - Have the matter escalated if there is no satisfaction - Enlist the assistance of your practitioner - Contact the PHIO - If you have exhausted all these avenues without luck, contact me and I'd be happy to discuss possibilities.




My Case: Why didn't you ignore (HF) and work with other funds?


1. I have a belief to address your issues and don't let them manifest. I often deal with challenges until it is completed or resolved. That is why I continue to this day to uphold (HF) to honesty and fairness. 2. (HF) were the first insurance company that started Group Physiotherapy claims, they were the leaders. On this basis I wanted to partner with the leaders in the industry. 3. I was very overwhelmed at the time, due to the extreme stress I was sbjuected to and may not have made the best decisions. In hindsight, I would not change much in the way I processed the sitaution and conducted my approach. 4. I beleive it is important to stand up to bullies. 5. I wanted to know with a certain degre of confidence what Group Physiotherapy was and why my business was targeted when I doing the right thing, whilst at the same time (HF) were switching codes. 6. In the end I was scared out of business, because another health fund could do the same thing. I felt I had little rights. I was petrified. The whole occorance was gastly.




My Case: What was the impact it has had on you?


The depth of the effect has been significant. Loosing everything you worked for is tough to live with. I don't have much left. The impact included, but not limited to personal affects, health, relationship affects, motivation, loss of innocence, business related, financial, reputation affects. At the time of writing, I have not worked as a clinician for over 12 months. The way I have been treated does bode well to start another business.




My case: What do you hope to do?


I hope to resolve my case with (HF) and be compensated for their mistakes and treatment. Once this occurs, I will decide whether to continue with Group Physiotherapy. If, this strategy fails. I would be open to being an investigator or working within the health industry as an investigative journalist.




My Case: What do you want from HF?


I beleive I did everything within my knowledge and capability to fulfil everything HF wanted. I beleive HF unfairly targeted me, isolated me and discriminated against me as compared to favouring busines X. It treated all other practitioners differtently than me. I say this as (HF) did an audit on me 40 days before distributing educational information to the whole industry. I invested 16 years and two million dollars into my business and was forced to sell under extreme duress. I beleive that HF exercised an abuse of power, was aggressive and this directly caused the demise of my business. I should compensate for that.




My Case: What is stopping you from starting a business again?


When I started my business it took me almost 1 year to get a referral. I have lost my innocense I don't have the financial resources I am not first to market I don't have a clean collection of collecting contacts and mentors I don't have my youthful energy. Starting a business takes time and energy. I just don't have that. The biggest reason, is the lack of confidence of working in a system that is unfair and unjust.




What do the acryonms and coding stand for on this website


(HF) - Generic code which stands for Health Fund Jody- name used that replaces the real name Business X- A mostly Class Physio business that as close by to my business, that I shared patients with. [blanked out areas on the evidence on this website is either (HF)'s real name, it employees names, its identifying details, my previous business name and/or idetifying details and/or other peoples names hidden for confidentiality and legal reasons. PHIO - Private Health insurance Ombudsman APA - Australia Physiotherapy Association HCCC - Health care Complaints Commission APRAH-Australian Health Practitioner Regulation Agency





Group Physiotherapy

Group Physiotherapy

Sydney, Australia

Email: Upon request.

Mob: 0410 675 545

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Founder and former owner of a multi award winning service, is forced out of business due to bad faith health insurance.

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© 2018 by Monte Elissa. 

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