Charleston Pediatrics PA

Thank you for notifying me re: the patient complaint from *** ***I would like to clarify certainstatements made by Ms***:She did visit our office for a routine annual examAccording to the thorough documentation by the provider who examined her she complained ofsymptoms that
required certain testing entirely related to the reason for her visitThe specimens were sent to an outside laboratory, as all of our testing are, and the results of thetesting were called to Ms*** on occasions: 4/28/16(Voice mail), 5/3/16- test confirmed asnegativeOur provider talked to her on 6/2/regarding the necessity of her treatment and thecharges associated with itThe cost of the testing is billed by the laboratory to the patient’s insuranceWe do not collectany payments for testing from insurance companies We do have an agreement with them whichhas significantly reduced costs for our patientsOur patients sign an agreement for payment at the time of each visit which Ms*** did at thetime of her visitMs *** has a deductible with her insurance company which she apparently has not yet metItis her responsibility to be aware of her deductible and how much has been applied over thebenefit period.We have sincerely given Ms*** very appropriate care based on her symptomsWe do not feel wehave an obligation to assume the cost of her deductiblePlease let us know if the complaint andresponse will be posted on the Revdex.com Web Site.Thank you for your consideration in this matterIf you have any further concerns, please do not hesitateto call me

March 14, 2017Revdex.com*** *** *** *** *** ** ***Attn:
*** ***RE: Letter from *** ***Dear Ms***:Thank you for making us aware of Mr***'s issuesHis complaint, in our opinion, is not justified and is without merit.We received a letter from Mr***'s mother, via regular mail (copy on file), inquiring about our Medically Supervised Weight Loss Program for her son.DrNeai F*, President and CEO, reached out to her via the phone number she providedShe was interested in helping her son lose weight through a supervised programHe explained the program and what would be involved in the initial evaluationThis evaluation involves an interview with a clinical nutritionist, multiple testing, and an exam by a medical providerHe told her the program was cash based, not insurance based, and the cost for this evaluation would be $and her son could then decide if he wanted to follow through with continued counselingShe readily agreed to pay the $for her son and asked us to invoice her, not her son.Mr*** made his first appointment on August 18, He was interested in continuing the Program and made a follow up visit on 8-22-16.He was given full services on both of these visits with recommendations of continued care in the Weight Loss ProgramThe office made follow up calls multiple times to schedule further appointments with no response.On 9-13-our office reached out to his mother, to let her know we would be sending the invoice for $for the services provided in the initial visit, as agreedWe received payment on 9-23-We did not invoice her for the services provided in the second visit and to date we have not received any payment from Mr***.It is our belief that Mr*** believes we billed his insurance company as well as his motherThis is not true.Again this program is solely cash based and no patient's insurance company would ever be billed.He received quality and appropriate care and his mother was invoiced, as requested, for the services provided.We are sorry he is unsatisfied but his charges of “disservice" are unwarranted.Thank you for your time spent on this matter.SincerelyAllegheny Medical, P.C

The primary issue is I want the claims for the treatment submitted to my insurance that I providedThen, whatever the insurance covers should be refundedPlease note I am a year old male & my mother is

I would like to respond to several of the points made by DrNeil F* and I will respond using his numbers to avoid confusionI would also like to point out that DrF* was not the physician that I saw during my routine exam, nor have I ever talked to or heard of him beforeI would think that, in a situation like this, it would be most appropriate for someone that I actually came into contact with at the business and who is familiar with my complaint to be the one to answer. He is correct in stating that I came in for a routine examI even told the physician specifically that I came for one routine test/exam and denied her request to complete a full physical exam. While we went through the typical questions asked during this yearly routine exam, we did not discuss any specific symptoms that would require further testingI would like to point out that this is the main complaint I have: At no time did the physician ask if I wanted further testing, recommend further testing for any reason, or ask for my consent to receive further testingIf the physician did think I was exhibiting symptoms, she should have explained that to me, told me about further testing that was recommended, and asked for my consentAt no time did she do any of those three things, and I walked out of the appointment thinking that the only test she would run was the routine test that is covered 100% by insurance. The testing sample, as I understand, was sent to an outside laboratoryI was not aware of that until I received a bill from the outside laboratoryI received one call from Allegheny Medical on 4/28, but no voicemail was left even though I indicated to them that they could leave test results in my voicemailWhen I did not receive another call, I called them back on 5/I was told that because it was late in the day, there was nobody there who could give me my test results and that someone would call me backI never received a call back, and because it was a routine test that I was not concerned about, I did not reach out to them again until I received the unexpected bill from the outside laboratoryAgain, my main complaint is not that they did not call to give me the results of the test (because I was not concerned about the one test that I went in for), but that they ran several extra tests without my knowledge or consentAfter many calls back and forth and an in person visit, the treating physician did call and leave a message for meShe said that she ran extra tests because I was exhibiting symptomsShe did not say what symptoms, what extra tests she had to run, or that we had discussed them at all during the appointmentAgain, the issue is that she in no way informed me of the need for extra tests or asked for my consent to run extra tests during the appointment or anytime before the tests were run. Yes, the bill was sent by the outside laboratory and was billed to my insuranceMy insurance covered a majority of the bill, leaving me with a payment to the outside laboratory of $I have no dispute with the outside laboratory or with my insurance company, as they both had no idea that I did not consent to these extra tests until after the tests were runThe issue is not that my insurance company did not cover the entire bill, but that the bill should have only included the one test I requested and had knowledge of, which is a test that every insurance company has to cover yearly. I did sign an agreement to pay for treatmentI did not sign an agreement stating that they could perform whatever tests they wanted, at whatever cost, without my knowledge or consentI paid them a copay at the time of my appointment in case the insurance company would require it, and had I known about and agreed to extra tests if I though they were necessary, I would have no problem paying immediately. I answered the question about insurance above in number fourI am aware of what my insurance does and does not cover, as well as my deductibleI went into the appointment knowing that my insurance company covered the test I requested from the physician, and had any other tests been recommended to me (which they were not) I would have contacted my insurance company to inquire about the cost before giving my consent for further testingAfter I received the bill I did contact my insurance companyThey confirmed that they cover the yearly routine testing, but that, according to the bill, the physician had ordered extra tests. I would also like to take a moment to state that I am not submitting this complaint because I am unable to payI do have the means to pay, and would have paid for extra tests had I thought they were necessary and been told about them/asked for my consent to run them ahead of timeI am simply asking Allegheny Medical to respond ethically by covering the cost of the extra tests that the physician decided to run without my knowledge or consent. Thank you again for your help in resolving this matter.
Regards,
*** ***