NC speech therapist resolves years-long insurance billing dispute with help of ABC11 Troubleshooter

SANFORD, N.C. (WTVD) -- A Sanford speech therapist says a years-long fight with an insurance company over nearly $14,000 in medical claims is finally over, but she says the ordeal ultimately led her to close her practice.

Jeanine Morton, owner of Theraplay NC, says she first learned in 2024 that Humana Military was seeking to recoup $13,930 for more than 130 claims dating back to 2020, during the COVID-19 pandemic.

According to Morton, the claims had originally been paid, but she was later told they needed a Telehealth modifier because the services were provided virtually. Morton says, "Once I was informed, I corrected the claims, mailed and faxed them multiple times every 30 days. I would check on the process. Hey, did you receive these claims? No, we haven't received them. Go ahead and mail them again."

Despite those efforts, she says Humana Military began taking back the money. "It's caused so much stress in my life. It has. It's hard to balance, planning sessions for my kids, being creative and then having to pull time away from my day to work on this every single day," Morton said to ABC11 Troubleshooter Diane Wilson.

Feeling out of options, Morton contacted ABC11 Troubleshooter for help.

After Wilson reached out to Humana Military, Morton says she received a call the next day acknowledging that her corrected claims had been received.

In a statement, Humana Military said:

"The Humana Military team is working with Ms. Morton to resolve her concerns quickly and accurately and acknowledges the frustration that she has experienced. We remain committed to providing excellent care for TRICARE East beneficiaries and the providers who serve them."

After several weeks of additional communication, the dispute was resolved. Morton says Humana Military reimbursed her for the money it had recouped and confirmed she does not owe anything on the claims from 2020.

"Thank you, Diane, for your efforts and your work." While grateful for the outcome, Morton says the prolonged battle took a significant emotional and financial toll. She has since made the difficult decision to close Theraplay NC.

"This has taken the joy of it. It totally has. Taken the joy. It's burnt me out. I hate this for my families because I have great families and kids that I work with. So, it's actually a season of grieving that I have to close this chapter and move," Morton said.

Morton hopes sharing her story encourages other healthcare providers to keep detailed records, save copies of all correspondence, and continue advocating for themselves when billing disputes arise.