Doctors' Pediatric, P.C.

Review: I called to make a new patient sick visit back in February 2013. Since I have a HDHP, I always verify office charges before I come in, so I can be prepared for the costs. This was my second sick visit, but with another child. We are new in the area, and have previously visited this pediatric group months before with satisfactory results. However, a few weeks after the visit I got my insurance statement showing that I had been charged a new patient comprehensive exam fee of $250.00. When I called to make the appointment, the office lady on the phone quoted me a $98.00 office charge for a new patient sick visit. She informed me that upon my next visit for a well child, I will be charged a higher fee for a comprehensive exam. This was consistent with the information I received months earlier when I took my daughter in for a new patient sick visit. I complained about the charge to the billing office lady, who retorted back with a lecture on why I chose an HDHP in the first place. I was rather offended as this health plan is not a choice but instead, the only health plan option my husband's employer offers. I was also told that I should not ask the front office gals any billing information or ask to verify a charge as they are not qualified to provide that information! The billing lady referred me to the office manager, who took weeks to call me on this issue. In the end, the office manager apologized for the misinformation, and stood by the charge, citing that the first doctor we saw months ago didn't mark the form correctly. I told him I disagreed with this assessment and they ought to deduct the difference from my bill. His only response was that he appreciated me bringing the discrepancy to his attention and that although it wouldn't help my situation, it will help others. What kind of customer service is this?Upon being transferred to the billing department to settle my bill, I asked again about the coding for my son's visit. I asked the billing lady what the code is for a new patient sick visit and she replied with the code 99203. On my bill I have the code 99204 for a new patient comprehensive exam. I inquired if the charges would be different on those codes and she replied yes. Why then am I not being charged for the appropriate code, and why as a business would they not honor the information I received and make the situation right?

Desired Settlement: I would like the office charge of $98.00 to be honored and applied to my bill, so the total will be adjusted and reflect this change. They have already billed my insurance, so other adjustments need to be made. Despite the error, they should honor the information provided as a matter of principle and good customer service. They should evaluate how they communicate as a business and how they can better communicate with patients and their families to provide the optimal service they advertise.

Business

Response:

Consumer Response /* (-5, 8, 2013/04/22) */

Doctor's Pediatric sent me a letter threatening to turn my account over to collections until I paid the full amount. I paid the full amount to protect my credit, but still dispute their charges and unprofessional service.

Business Response /* (1000, 17, 2013/05/08) */

The issue is we erroneously charged the first child we saw a lesser fee. When we saw the second child, we billed the correct, higher charge. The error was in her favor and we did not seek to collect the difference. Instead of being grateful, the parent was the lesser charge for both patients.

The Center for Medicare and Medicaid services sets the "work" a healthcare provider can charge per visit. It is the foundation for which charges are established. We adhere to these guidelines. So the charge for the second child, which is the issue here, is the correct charge.

Our "office Ladies" do not have our fee schedule, so the claim the "office Lady" quoted a charged is false.

As far as to the codes of 99203, 99204, there are a couple of issues. These are charges for new patients. Her argument is she does NOT want the new patient code (the higher charge), but rather the existing patient visit, so this is irrelevant. However, the 99204 is the correct code, it is based on time spent with the NEW patient.

As far as customer service, all she wanted was credit. To ask a customer what the issue is with the purpose of helping others is good customer service

Consumer Response /* (3000, 19, 2013/05/09) */

(The consumer indicated he/she DID NOT ACCEPT the response from the business.)

The statement issued by Doctor's Pediatric is incorrect. There is great subjectivity between doctors as to what they charge in a visit. I only paid the balance owed as they sent a letter indicating they would turn me into collections. The office manager was unprofessional and unable to mitigate the issue effectively. The statement indicates that the office ladies do not have the fee schedule, yet when I called to make two separate appointments, I asked the office ladies what the office charge would be. Both times I was given a fee amount. It is apparent that they made a mistake and overcharged me on my second visit to make up for a charge they say is incorrect from my first visit. There is no consistency in their billing policy, and since they bill insurance most of the time, I believe they get away with extra charges. I am unsatisfied with my experience with them and feel that they are very dishonest with their billing practices.

I called to make a new patient sick visit back in February 2013. Since I have a HDHP, I always verify office charges before I come in, so I can be prepared for the costs. This was my second sick visit, but with another child. We are new in the area, and have previously visited this pediatric group months before with satisfactory results. However, a few weeks after the visit I got my insurance statement showing that I had been charged a new patient comprehensive exam fee of $250.00. When I called to make the appointment, the office lady on the phone quoted me a $98.00 office charge for a new patient sick visit. She informed me that upon my next visit for a well child, I will be charged a higher fee for a comprehensive exam. This was consistent with the information I received months earlier when I took my daughter in for a new patient sick visit. I complained about the charge to the billing office lady, who retorted back with a lecture on why I chose an HDHP in the first place. I was rather offended as this health plan is not a choice but instead, the only health plan option my husband's employer offers. I was also told that I should not ask the front office gals any billing information or ask to verify a charge as they are not qualified to provide that information! The billing lady referred me to the office manager, who took weeks to call me on this issue. In the end, the office manager apologized for the misinformation, and stood by the charge, citing that the first doctor we saw months ago didn't mark the form correctly. I told him I disagreed with this assessment and they ought to deduct the difference from my bill. His only response was that he appreciated me bringing the discrepancy to his attention and that although it wouldn't help my situation, it will help others. What kind of customer service is this?Upon being transferred to the billing department to settle my bill, I asked again about the coding for my son's visit. I asked the billing lady what the code is for a new patient sick visit and she replied with the code 99203. On my bill I have the code 99204 for a new patient comprehensive exam. I inquired if the charges would be different on those codes and she replied yes. Why then am I not being charged for the appropriate code, and why as a business would they not honor the information I received and make the situation right?