Advanced Spine & Sports Care

Initial Business Response /* (1000, 5, 2014/11/26) */
Dear Ms. [redacted]
Thank you for giving me the opportunity to provide you with information on this matter. This patient presented to our office with an [redacted] Policy of which our office is not a participating provider. On his...

initial visit, I explained to the patient that our office was out-of-network of his [redacted] policy. The patient's [redacted] policy requires him to satisfy a $1,000 deductible prior to receiving services for $40 co-payment. As such, I informed the patient of the following:
1. That if he presented to an office that is an in-network healthcare provider under his[redacted] policy, then he would have to satisfy the $1,000 deductible for any care he received before he was able to receive healthcare services with $40 co-payments.
2. On the other hand, if he decided to present to us, an out-of-network provider under his[redacted] policy, then we could offer a point of service discount that would allow our office to provide services at a discounted rate than is usual and customary for chiropractic care in the area, but would not go towards his[redacted] deductible.
I also provided the patient with our office's financial policy that states in part the following with regards to his insurance:
Your insurance policy is a contract between you and your insurance company. We are not party to that contract. Deductibles and/or co-payments are due upon services rendered. As a courtesy we will file your insurance for you. Upon receiving payments, those funds will be credited to your account.
The patient verified that he read and fully understood our office financial policy by signing and dating it. Furthermore, on his initial visit, I informed the patient of the point of service discount that he would receive if he received care from our office. I explained that we would charge $58 for chiropractic adjustments, which included any and all therapies also provided with a visit. I also explained to the patient that charges for an initial consultation, examination, as well as any x-rays would be higher than the charges for a regular visit. The patient acknowledged my explanations and agreed to receiving treatment from our office.
The patient came in to see me for six (6) visits and was thus charged for six (6) visits only. For the first visit, I provided the patient with a new patient consultation, examination, and an x-ray. The patient was charged $135 for the consultation and examination, and $110 for the x-ray. For each of the remaining five (5) visits, the patient was charged $58 for adjustments and therapies.
On or about October 9, 2014, I received a notification from the patient's credit card company informing me that the patient was disputing the above-referenced charges from my office. As requested by the credit card company, I submitted documents supporting the credit card charges. The patient's credit card company conducted an investigation and determined that the charges were appropriate and valid. The credit card charges were not reversed. This appears to have upset the patient and led him to file this Revdex.com complaint.
I care deeply about my patients and strive to create the best patient experience in my office. I am regretful that this patient did not understand his policy with[redacted] and that he feels we were not forthright about our billing practices. We would have happily provided further explanations of our billing practices to the patient had he asked. I am certain that[redacted] would also provide a thorough explanation of the workings of his insurance policy.
The health, wellbeing, and customer satisfaction of my patients are my foremost concern. It appears that this patient is seeking a $250 refund. Because the patient has expressed dissatisfaction with my office's administrative practices, I will gladly refund the $250 he feels was billed in error.
I hope that I have provided sufficient information for your investigation. Please do not hesitate to contact me if you have any questions or require further information.
Sincerely,
Dr. [redacted] W [redacted]
Initial Consumer Rebuttal /* (3000, 7, 2014/12/07) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I have excepted the refund of $250.00 but this doctors explanation of what had happen is not correct! His business practices are just out of context of how a doctors office occurs. First after my visits I not he informed him that he was not in my insurance network! I asked him on my initial visit about insurance coverage and was told that I was! I contacted my insurance after the 6 th visit and found out different. Second, this doctor does not provide any sort of detailed billing or receipt. I personally asked the receptionist and was told that it's not a normal practice for providing such.
Before I contacted my credit card for the dispute, I tried to reason and tried to get a better understanding with this doctor, but it failed. Only when U wrote to the Revdex.com did he actually respond and did something about it! Thanks