Delgado Orthodontics

We have received multiple emails and on-line notifications from Revdex.com in the past weeks and have attempted to respond to each oneUpon receiving the signed HIPPA release, we sent the original response letter as an attachment, which addressed the original complaints with an apology and confirmation that the credit was issued by check to [redacted] in DecemberIn a separate email to the Revdex.com, we have requested instruction on submitting documentation, and will follow up to determine how to proceedIt should be noted that [redacted] has also stated that she is seeking legal counsel regarding her complaintWhile we do feel confident we have addressed the complaints, sincerely apologized as requested, and reviewed our policies in processing insurance overpayment and refunds, we must take her statement seriously and will seek legal advice on proceeding further, alsoI do feel it is very important to add, in response to [redacted] concerns regarding her daughter's treatment, [redacted] and his staff will only treat her, as we do all of our patients, with the best in patient care and courtesy, regardless of any outside actions or issues

[redacted] Per your response [redacted] did acknowledge that you have an internal policy regarding insurance payment that is why I asked per your current policy right now, how long you need to hold a patient’s credit? You did not answer this questionOr can you just simply admit that you do not have a policy right now regarding this particular issue? You quoted “was never our intent for you not to know”My credit was way back July but had I not checked my EOB on December and called your office, I WOULD NOT KNOW that I have a creditYou quoted “on 12/19/16, when it was brought to her attention that OSI never received a check request, she went through sent e-mails and found the request had not sent properly and was in her draftShe IMMEDIATELY sent a follcheck request on 12/19”I am sure you have read all my e-mails to her and through that it is not hard to understand WHY she sent a follrequest on 12/It was not because of her intention to handle this matter appropriatelyLet me give you a timeline of events so you will understand what really happened instead of responding this way just to cover up the failure of your office to handle this ethically12/5/2016- I spoke to [redacted] and informed her about what my insurance told me and she sent me the invoice that day showing my $credit12/7/2016- I followed up about my refund via e-mail and informed [redacted] to call me back so I can give her my new debit card informationShe did not call me back12/8/2016- [redacted] e-mailed me and informed me that I will receive a check via mail which I responded if I can pick up the check instead from your office since my daughter had an appointment on 12/11/She said no as the check will come from management company12/12/16- I called her twice and left her a voicemail but she did not call me backI sent her an e-mail afterwards and asked if my refund check was mailed alreadyShe replied “ it will be processed this week”12/13/16- I called her and left her a voicemail to call me back, she did not call me back12/14/16- I e-mailed her and asked if my check has already been sent and I stated I should be refunded via debit card as this is how I paid Never heard a response from her12/15/16- I called her again and left a voicemail and also left the front desk a message to have [redacted] call me backShe did not call me back12/16/16- I sent her another e-mail to follmy refund and at this time I told her I am giving her an opportunity to respond to me before I file a legal actionAfter sending this e-mail, I called her afterwards and this was the time she answered the phone very rudelyI asked questions she did not want to address then hung up the phone on meAfter our conversation, I sent her another e-mail ( cc [redacted] ) and has expressed my frustration how things were handled from the startI called the front desk and left a message to have [redacted] call me backI did not hear from him neither [redacted] 12/19/16- After numerous e-mails I sent to [redacted] then [redacted] on December , at this time [redacted] finally realized the pressure on her to check this which she did on December when she found she did not send the request at allIn summary [redacted] your claim that [redacted] “immediately sent a follrequest on 12/19/16” is correct but you made it look like she did it as part of your good customer service and I am sure you know this is not the caseI have attached all the copy of my e-mails mentioned above for Revdex.com referenceMy second follquestion again was not addressed with your recent responseMy question was why my refund was not credited back to my debit card/ Your reply was “it is standard for us to request a check from OSI to be sent for any insurance credit or overpayment when an account is settled”Firstly when I spoke to your management company I was told that when a patient has a refund and they paid via debit card, the refund must be returned through that as well and this refund can be processed in-house or in your officeYour management company only process check refund request If you disagree with this, let me know and I will call your management company and get to the bottom of this because what you are telling me is opposite to what your management company has told meI have made a complaint to your office so you are aware what is going on and so other consumers will not experience what I experienced but to respond to me with cover-ups and conflicting information this just tell me even more how you run your businessTo end, I do not think my original complaints have been addressed [redacted]

Complaint: [redacted] I just sent the signed HIPAA form today via fax [redacted] Attached is the fax transmission report that it went through [redacted]

We received the HIPPA information release from [redacted] Attached is the letter [redacted] sent to [redacted] in response to her complaints, on December We will be happy to provide further documentation and explanation for Revdex.com review, if neededThank you, [redacted] ***Delgado Orthodontics

I wanted to reiterate that first and foremost though I appreciate the apology I received from the owner and orthodontist himself *** ***, I knew that I won't get this apology had I not made a complaint to Revdex.com and requested your office to ask him to send me an apology and explanations in writingDuring this incident, I have e-mailed him twice and called his office and left him a message through their front desk to reach out to me but never heard from him at all
On the letter that he sent on December 28, 2016, he quoted that their office policy on insurance overpayments and credits does"require a holding period"If they have an existing policy on this I wanted to see it to see what holding period they currently haveAlso my other main concern was never addressedI paid the initial deposit of $via debit card which is considered cash but why my refund was returned via check instead which took three weeks upon request before I receive itWhy my refund was not returned the way how I paid it? They hold my refund for almost five months and I am currently checking also on my end if they have violated any laws and regulations on thisThis is not about moneyThis is about principleI am a good consumer and a client of theirsI paid on time what was asked from me and they were paid on time on the services they rendered but to hold my refund for five months and when I realized I have a refund and requested for it,a horrible customer service was added on thatTheir Business Office Manager *** made me feel like I had to beg for my OWN money, rude and refused to handle it properly to the point of avoiding to communicate with me for days then when I finally got hold of her, she hung up the phone

We have responded directly to *** *** regarding the original complaints and issues, as requested, including an apology for her dissatisfactionWe have also confirmed that a check was issued to *** ***, on 12/21/for the amount specifiedIn order to further address her original complaint and share our original response, as well as any additional documentation or explanation, we will need the HIPPA release form returned that was sent and requested via certified mail to *** *** on 12/28/See attached docwith certified mail receiptsIf you have any questions or I can help in any way, you may contact me or *** *** at ***.Thank you,*** ***

Addendum to response & apology letter dated 12/28/2016*** ***,On December 7, one day after your inquiry regarding the UMR Insurance overpayment on your account, *** *emailed Orthosynetics (OSI), our management company which handles our Insurance and Accounts Payables, to determine if the insurance refund should go back to the insurance company or patientSee email (*1a) for inquiry and response from OSI on how the various insurance payments were posted, based on the change in insurance since original contract dateIn *** ***s letter he did acknowledge why we have this internal policy regarding insurance overpayments and that the patient credit notification process will be evaluated as a result of your complaintEach insurance payment, dating back to July, show(ed) on your active account ledger as credits and was never our intent for you not to know*** *emailed a check request (*2) to OSI on 12/8/for the amount of $and notified youOn 12/19/16, when it was brought to her attention that OSI never received check request, she went through sent emails and found the request had not sent properly and was in her Draft folder (screen shot attached *2a)She immediately sent a follow up check request (ck 32870) on 12/19, which was processed on 12/and mailed on 12/21/(days, eight D.Obusiness days)*** acknowledged the error in following up and not knowing email did not go through and the heated phone callShe was reprimanded, as stated in *** ***s letterWe understand that you wanted the overpayment applied to your debit cardIt is standard for us to request a check from OSI to be sent for any insurance credit or overpayment when an account is settled (*3).*** ***o genuinely intended to address your concerns in his letter to youAnd it is very important to him that you know your daughter will only be treated professionally and with the highest level of patient care, as are all of his patients, regardless of any extenuating circumstancesThis is very important to him, which is why he wanted to personally respond to your complaint during the holidays.Due to your specific complaints regarding *** (*4a), *** ***o felt that this correspondence should come from another member of our teamWe feel that your original complaints have been addressed to the best of our ability.Sincerely,*** ***Documentation referenced is attached to this response and noted by *numbers

I am still waiting for a response from 1/9/16 e-mail I sent to Delgado Orthodontics through Revdex.com as "reject business response".
[redacted]

[redacted] Per your response [redacted] did acknowledge that you have an internal policy regarding insurance payment that is why I asked per your current policy right now, how long you need to hold a patient’s credit? You did not answer this question. Or can you just simply admit that you do not have a policy right now regarding this particular issue? You quoted “was never our intent for you not to know”. My credit was way back July 2016 but had I not checked my EOB on December 2016 and called your office, I WOULD NOT KNOW that I have a credit. You quoted “on 12/19/16, when it was brought to her attention that OSI never received a check request, she went through sent e-mails and found the request had not sent properly and was in her draft. She IMMEDIATELY sent a follow-up check request on 12/19”. I am sure you have read all my e-mails to her and through that it is not hard to understand WHY she sent a follow-up request on 12/19. It was not because of her intention to handle this matter appropriately. Let me give you a timeline of events so you will understand what really happened instead of responding this way just to cover up the failure of your office to handle this ethically. 12/5/2016- I spoke to [redacted] and informed her about what my insurance told me and she sent me the invoice that day showing my $660 credit. 12/7/2016- I followed up about my refund via e-mail and informed [redacted] to call me back so I can give her my new debit card information. She did not call me back. 12/8/2016- [redacted] e-mailed me and informed me that I will receive a check via mail which I responded if I can pick up the check instead from your office since my daughter had an appointment on 12/11/16. She said no as the check will come from management company. 12/12/16- I called her twice and left her a voicemail but she did not call me back. I sent her an e-mail afterwards and asked if my refund check was mailed already. She replied “ it will be processed this week”. 12/13/16- I called her and left her a voicemail to call me back, she did not call me back. 12/14/16- I e-mailed her and asked if my check has already been sent and I stated I should be refunded via debit card as this is how I paid . Never heard a response from her. 12/15/16- I called her again and left a voicemail and also left the front desk a message to have [redacted] call me back. She did not call me back. 12/16/16- I sent her another e-mail to follow-up my refund and at this time I told her I am giving her an opportunity to respond to me before I file a legal action. After sending this e-mail, I called her afterwards and this was the time she answered the phone very rudely. I asked questions she did not want to address then hung up the phone on me. After our conversation, I sent her another e-mail ( cc [redacted]) and has expressed my frustration how things were handled from the start. I called the front desk and left a message to have [redacted] call me back. I did not hear from him neither [redacted]. 12/19/16-  After numerous e-mails I sent to [redacted] then [redacted] on December 16 , at this time [redacted] finally realized the pressure on her to check this which she did on December 19 when she found she did not send the request at all. In summary [redacted] your claim that [redacted] “immediately sent a follow-up request on 12/19/16” is correct but you made it look like she did it as part of your good customer service and I am sure you know this is not the case. I have attached all the copy of my e-mails mentioned above for Revdex.com reference. My second follow-up question again was not addressed with your recent response. My question was why my refund was not credited back to my debit card/ Your reply was “it is standard for us to request a check from OSI to be sent for any insurance credit or overpayment when an account is settled”. Firstly when I spoke to your management company I was told that when a patient has a refund and they paid via debit card, the refund must be returned through that as well and this refund can be processed in-house or in your office. Your management company only process check refund request.  If you disagree with this, let me know and I will call your management company and get to the bottom of this because what you are telling me is opposite to what your management company has told me. I have made a complaint to your office so you are aware what is going on and so other consumers will not experience what I experienced but to respond to me with cover-ups and conflicting information this just tell me even more how you run your business. To end, I do not think my original complaints have been addressed. [redacted]

Due to HIPPA Privacy Rules, we have replied directly to [redacted] regarding her complaintand addressed her specific requests, in hopes of resolving her issues with our office. We would very much like the opportunity to share our response and provide further documentation to the Better...

Business Bureau. Therefore, we have requested [redacted] return a signed Authorization to Release information. We did confirm that the insurance refund requested by [redacted] on Tuesday, December 6th, was processed on 12/20/2016 and mailed from our management company 12/21/2016, prior to receiving the Revdex.com complaint letter.We appreciate the opportunity to address and resolve this complaint against Delgado Orthodontics and hope to have authorization to provide more information, if needed. If you need anything else or have any questions, please call [redacted], Business Manager, ormyself at [redacted].

Complaint: [redacted]
I just sent the signed HIPAA form today via fax [redacted]. Attached is the fax transmission report that it went through. [redacted]

We received the HIPPA information release from [redacted]. Attached is the letter [redacted] sent to [redacted] in response to her complaints, on December 28. We will be happy to provide further documentation and explanation for Revdex.com review, if needed. Thank you,[redacted]Delgado Orthodontics

We have received multiple emails and on-line notifications from Revdex.com in the past weeks and have attempted to respond to each one. Upon receiving the signed HIPPA release, we sent the original response letter as an attachment, which addressed the original complaints with an apology and confirmation that the credit was issued by check to [redacted] in December. In a separate email to the Revdex.com, we have requested instruction on submitting documentation, and will follow up to determine how to proceed. It should be noted that [redacted] has also stated that she is seeking legal counsel regarding her complaint. While we do feel confident we have addressed the complaints, sincerely apologized as requested, and reviewed our policies in processing insurance overpayment and refunds, we must take her statement seriously and will seek legal advice on proceeding further, also. I do feel it is very important to add, in response to [redacted] concerns regarding her daughter's treatment, [redacted] and his staff will only treat her, as we do all of our patients, with the best in patient care and courtesy, regardless of any outside actions or issues.

I want a clear explanations why Delgado Orthodontics is asking a permission from me to release the health information of my daughter and need to sign the HIPAA form? My complaint has got nothing to do with personal information of my daughter. It is about the billing services I receive. Please respond.
Thank you.
[redacted]