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Women's Care Group, PC

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Women's Care Group, PC Reviews (1)

Review: This complaint is to inform Revdex.com that a practitioner is treating their patients terribly. There are other experiences outlined on [redacted] @ [redacted] and [redacted]

My doc is called Women's First Care Group @ ###-###-####. [redacted], VA

[redacted] is the billing lady @ ###-###-####

[redacted] is the "run around" woman

Dr [redacted] is the surgeon

[redacted] is the office manager

Feb 28th I requested and signed for a release for reords. I sent this email with my request :

"Hello,

You all provided great treatment over the years to me. Then in Nov 2013 I started to be in agony from one of my cysts. I went from requesting a hysterectomy, to removal of the ovary, to any type of surgery just to ease the pain. I went to specialist after specialist as you all referred. I past out from the pain in public in December. I called to follow up 3 times since December and no one ever called me back. I am relaying all not to be mean or nasty. But to say that patients sometimes need just a response just so they don't feel like just another number of branded cattle coming into the office. I was in a great deal of pain and I was ignored by your office. I will never, ever, be a patient of your practice again or refer anyone to your practice because I feel that neither [redacted] or Dr. [redacted] actually care what happens to the women that they treat. I feel that the receptionist was always annoyed when I called and simply asked for a call back so that I could know what my next steps should be. I hope that you all will take better steps in the future to make your patients feel as though they matter.

Please see the request for my medical forms to be released. Please notify me of any fees or further needed information.

Thank you"

I then got a phone call from [redacted], P.A. stating that she spoke to the doctor and she would do the surgery. She apologized about how I felt, and the office not calling me back. We made an appointment for me to come in.

March 5th Dr. [redacted] said she would do the hysterectomy surgery for me. No other treatment has worked. No medications, and I've bled for 3 weeks at one time. Because I'm in so much pain and missing work, I was grateful for the surgery. She said that it was a 50/50 chance that it would relieve the pain in my abdomen. She warned me of the start of Menopause. I told her that I will take it and all of the bad that comes with it, if their is a slight chance that I would be pain free. A new P.A. sat in the visit to learn, She said that the next steps would be to clear it with insurance and call me in for a pre-op visit.

March 26th was my 4th call of inquiring about my surgery. I called [redacted] and found out that no claim had yet been put in. I was told that the claim form would be sent in and I would receive a copy of it emailed it me.

I never heard anything after that. I began to worry. On 3/30 I contacted my HR dept for help with getting feedback from my provider and [redacted]. She gave me my advocates information. I called the advocate number, and Carmen was assigned to me. She called both [redacted] and Dr. [redacted]'s office. Same day, [redacted] then called me and asked me if I wanted 4/7, 4/11, or 4/14 as my surgery date. I chose 4/11. I never heard anything else after that call. The office never called me back. The office never called the advocate back either.

On 4/3, I requested my doctor's notes:

"My work and school need documentation of my current medical situation. I've recently been home on self-imposed bed rest to lay on my right side and work remotely due to pain.

Both must have asked me to provide two distinct doctor's notes.

Note 1- Please document that I am currently being treated for pelvic pain stemming from PCOS.

Note 2- Please confirm that I am scheduled to have a total hysterectomy performed on 4/11/14 at Reston Hospital. Please also include what the typical recovery time is (I guessed 6 -8 weeks, but need the approximate time from a professional stated in the note). "

On 4/7 I was very concerned that I still didn't hear anything from the doctor's office. My advocate said that the office wasn't returning her calls either. [redacted] kept saying that they had not gotten any claims form the doctor. I called [redacted] myself, and they said that "the doctor had to call the direct line and request and urgent pre-certification because the surgery date was so close". I then called Dr. [redacted]'s office and told [redacted]. She said "ok" and that she would call shortly. Hours later (around noon) the advocate called and said that the [redacted] STILL had not received the claim. She suggested that I call the office manager and explain the situation.

I called the office and asked for the office manager. The woman on the phone offered to help me, I asked for the office manager, she then transferred me to [redacted] (billing lady). I asked her if she was the office manager, and she said "no". I asked who was the office manager. She said ":[redacted]". I then asked to speak to him and she said that he was busy on a call. I gave her my last name and I told her that it was urgent that he call me back. My husband overheard this and my crying. Frank then called them myself and demanded to speak to [redacted]. He got him on the phone and passed me his cell phone. I told him everything that I had went through in regards to no one answering my email request of doctor's notes that my employer and school needs, no one telling me what time the surgery is, no one telling me the type of hysterectomy, recovery time, or giving me a pre-op visit. His response was tan apology and that he would call me right back.

He called me back and stated that the problem was that the specialist "took forever" to commit to the date. I told him that its not right to be ignored for over a month with no updates. He agreed. He told me that the surgery would be at 1:30pm on Friday, 4/11 and laprascopic but he couldn't tell me recovery time because he has no medical knowledge. He said someone else would call me back about more details.

Shortly after [redacted] called me and told me that [redacted] would not be covering my surgery due to a pre-existing condition. She said the surgery would be about $10,000.00 and I would need to make an immediate deposit of $1,106.00 to secure the surgery date. She said that she would be there until 6pm.

I called [redacted] myself and asked them why my claim was denied. A rep said that it shouldn't be. She said that I would be on the hook for $2880.00 of my dedcutible. She also said that my plan had no pre-exsisiting issue. She said that she would call [redacted] and she put me on hold to call her. When she came back, she said that she explained to [redacted] that the surgery had to be deemed as a medical need to be fully covered. She used an example of having cysts on fallopian tubes and having pain as a medical need. She used an example of a tubal ligation as NOT a medical need. She said that it is up to the doctor. She said the doctor could choose to have a full or partial hysterectomy or choose to have a peer-to-peer review to determine a medical need if need be. She said anything that wasn't a medical need would be treated as contracted treatment and the doctor would be to write off the surgery. She also said their was confusion as to the pre-exsistnig condition because before 1/1/14 that clause did apply but it does not apply anymore and I am covered by [redacted].

I noticed that I missed [redacted]'s call while speaking to [redacted]. I called back and [redacted] was very short with me. She said that [redacted] said that the surgery wasn't covered. I said I just spoke to them and they said that it was. She said that [redacted] can decide what is deemed a medical need and they may not get paid. She said that no one wants to be apart of this surgery anymore, she's spoken to the doctor and the surgery is cancelled. She said "Why would we want to do this surgery and not get paid?" I said "OK. I will just come in for my medical records, she cut me off and said "ok" and hung up.

I made an appointment for Wednesday, 4/9 to see Dr. [redacted] and speak to her in person. I was in so much pain that my sister came from Maryland came to my visit with me. She spoke to us briefly and stated that [redacted] never approves pelvic pain surgeries and that we can speak to [redacted] more about this because she had to go to the ER for another patient. She said that we could speak to her when she came back. [redacted] said the doctor would do a peer review. We asked what that process was and how long it takes and she didn't answer that. We went to the front desk and left our phone number so that someone could call us when Dr. [redacted] returned and we could finish the conversation. She never called. That evening around 6:30pm, [redacted] called me to apologize that the doctor nerve got a chance to call me back. Instead she would call me the next day. She never called me back on Friday 4/10. She still has not called me today on 4/11. I've resigned to the fact that the doctor does not want to deal with me at all. I never get so much as a phone call back. No face to face time, and the only nice person ([redacted]. P.A) is no longer there. I asked the advocate to close my case, and I gave up on the practice just as they gave up on me.

My issue is that I don't have just "pelvic pain". I have severe pain in my lower, left side of my abdomen. It causes me to miss work and I'm desperate to have it out. It is all caused by one of my cysts. My PCOS occasionally causes pain and bloats and that is happening to me. The sad thing is, that in nearly over year, no one ever so much as gave me pain medication.

Advocacy Number ###-###-####Desired Settlement: My desired outcome is for someone to make this doctor explain her business practices. Why does her office not return phone calls to patients in a timely manner. Why is it appropriate to tell a patient "why would we do a surgery if we can't paid?" Why is it appropriate to wait until days before a scheduled surgery to inform a patient that you won't do it. Why is it appropriate to wait over a month to tell a patient surgery details? Why would a patient have to involve HR, an advocate and do all of the "leg work" just to get some type of answers in regards to a surgery. Why would a patient need to be left in the dark regarding procedures and peer reviews. This doctor made me feel alone, ignored and left in excruciating pain. I just want someone to make them be held accountable in answering these questions.

Business

Response:

May 28, 2014Dear [redacted]:In regard to complaint ID [redacted], we are unable to respond to this complaint until the patient signs the attached HIPAA release form. As soon as you return her signed form (a form with our information is attached) we would be happy to send you our complete response.Sincerely,

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Description: Physicians & Surgeons - OB/GYN

Address: 1860 Town Center Dr Ste 240, Reston, Virginia, United States, 20190-5899

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