Doctor's MediCenter

Review: I recently had a tonsillectomy and went in to be seen due to pain. The "doctor" came in and stated that there really isn't anything he can do because he doesn't specialize in tonsils and doesn't know how they should look after a surgery but my tonsils look bad. I said how can tonsils look bad if the tonsils are no longer there, and then he said well the site looks bad and that I need to go to my ENT. I called my ENT office while in the room and they told me to come in. I feel as though I deserve my copay back because they didn't help me and I left they're to go to my ENT.Desired Settlement: I want my $10 copay back

Business

Response:

The patient in question was seen and evaluated by a MD at our clinic on 12/21/2015 after she presented with severe sore throat and the inability to fully mobilize her jaw. At the time of the visit, patient was status post tonsillectomy five days prior. The patient was evaluated by our medical staff; a chief complaint, history of present illness and past medical history was obtained, as well as a full set of vitals. Patient was then evaluated by our MD, during which the chief complaint and medical history was thoroughly reviewed. Upon examination, patient was found to have multiple pertinent findings related to her recent surgical procedure. Patient had significantly reduced ROM of her jaw; inflammation and erythema of her pharynx as well as exudates were noticed. Patient displayed no immediate respiratory distress. Patient also reported she was taking amoxicillin but did not know the dose and did not bring the bottle. Upon further examination, it was determined by our MD that best course of action would be to follow up with her current ears, nose and throat specialist (ENT). The ENT performed the procedure and would be the most qualified to revise and explore the recent tonsillectomy and make further determination for further treatment. Our MD informed the patient of his decision, with which she agreed. A call was then placed by our staff to the ENT’s office prior to the patient leaving our office. The patient as well as our MD related the issue to their medical staff who then agreed to see the patient right away. The patient left our office with no complaint. She returned later to question if she had bloodwork if there would be another copay to be made, which we answered no. There was no mention at the time of this not being an office visit, nor a request for a copay refund. The total length of visit with the doctor on date of service was 17 minutes. The President of our clinic later addressed the patient’s copay issue when it was brought to our attention by the patient’s mother a few days later. After fully reviewing the case, he explained how the above details outline a doctor’s visit under the eyes of the insurer and that co-pays are required as part of the agreement between the doctors, the patient and the insurance company. If we can be of further assistance, please do not hesitate to contact us