David C. Brodner, M.D.

Summary: Dr. and staff tried to circumnavigate procedures for submission of services provided at Surgicenter to benefit me, but without my knowledge. During the process they made a mistake and were not successful, exposing the client to an additional $11,414 worth of charges. The nurse involved in the communication with Surgicenter is no longer with Dr. and the new nurse is stating that they will not be held accountable for her actions. I would have never had the elective procedure performed if I had known of $11,414 of charges.Details: I attended an appointment at Dr.office in Boynton Beach on October 21, 2011 to find out if I was a candidate for fixing my deviated septum. After allergy tests and scans, Dr. suggested surgery to fix my deviated septum(Septoplasty), turbinates and sinuses. His nurses contacted my insurance to verify everything would be covered, but found out that the sinus portion would not be. They said it was odd, and they said that usually the sinuses are covered and they have more difficulty with getting the Septoplasty or turbinates confirmed. I asked them why the sinuses wouldn't be covered. They said they didn't know and that it may require further alternative treatments before my insurance would cover the sinus surgery. I asked if it was crititcal that I also get the sinus surgery, explaining to them that I couldn't afford to do the sinus surgery if it wasn't covered. Dr. then stepped into the conversation and looked over the documents. He then stated that they would do the surgery for what I would have paid as a co-pay for the sinus surgery, $200. He also told the nurse not to submit the sinus surgery to Surgicenter, and to make sure to put a note down to remind him "that morning", the morning of the surgery, that he was to also perform the sinus surgery. This was my first real surgery where I would be going under anesthesia, so I'm not familiar with the process and didn't catch on to what he was doing until much later. After the surgery(Dec.1, 2011) I received Explanation of Benefits(EOB) for services, which were in line with what they told me I would be charged. Then I received the EOB from the surgery center( Surgicenter) which showed the covered Septoplasty and turbinate surgeries with the correct amounts, but it also showed $11,414 worth of charges for the sinus surgery that was not covered by my insurance. I thought that this was just a mistake and spent a year trying to get this resolved with Dr. office. I called them every 2 weeks for an update, and they continued to tell me they were still looking into it. It wasn't until a year later that I finally figured out what had happened. Dr. was trying to do me a favor by doing the sinus surgery under the table from the surgery center, but the nurse that was supposed to not submit it to Surgicenter, did submit it. You can see proof of this by comparing the EOB from Dr. office vs. Palms West Surgicenter. Because it was my first surgery, at the time Dr. mentioned they would not submit it to the center and would cover it for $200, I didn't realize what was being done. If I had known, I would have either not received the sinus surgery if it wasn't critical. After all, it wasn't the surgery I had originally come in for. Or I would have contacted my insurance company to find out what needed to be done to get it approved. With this new understanding I contacted Dr. office and spoke with the head attendant. She told me that the nurse that was originally involved with this was no longer with the company and that they would not be held accountable. I tried to speak with Dr.directly, but she would not allow it.Surgicenter noticed there was a discrepancy and has reduced the $11,414 worth of charges to $777.91. I have told Droffice that they are responsible for this charge and should pay for it. They have declined.