Dr. Albert C. La Torre, Jr.

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because: Services were only accepted based on the business stating that the services would be covered by insurance While I understand that they may have "thousands of patients" only one patient was being offered services at that time There was no EOB available when the office assured my wife that services would be covered If they cannot be expected to know patients insurance, then their staff should not make claims regarding such when talking patients into accepting services. I do recall the phone call with the office manager as I initially attempted to reach an amicable resolution, however I absolutely recall the "hostility" spoken of coming from the office manager Their position was that since they successfully talked my wife into allowing exorbitant services in excess of lifetime insurance limits, they expect full payment In good faith I have offered a reasonable settlement, and the office has again restated their refusal to move at all from an unacceptable position
Regards,
*** ***

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because: Services were only accepted based on the business stating that the services would be covered by insurance While I understand that they may have "thousands of patients" only one patient was being offered services at that time There was no EOB available when the office assured my wife that services would be covered If they cannot be expected to know patients insurance, then their staff should not make claims regarding such when talking patients into accepting services I do recall the phone call with the office manager as I initially attempted to reach an amicable resolution, however I absolutely recall the "hostility" spoken of coming from the office manager Their position was that since they successfully talked my wife into allowing exorbitant services in excess of lifetime insurance limits, they expect full payment In good faith I have offered a reasonable settlement, and the office has again restated their refusal to move at all from an unacceptable position
Regards,
*** ***

December 10, 2015Dear *** ***,I received your inquiry from the parent *** *** regarding the patient *** ***I do not agree with this complaint and feel it is totally unfairPlease allow me to explain.It is our policy for our practice to check eligibility of the insurance that
is supplied to us by the patient along with a breakdown of benefits although it is not our responsibility to keep track of all lifetime maximums for thousands of patientsIt is usual and customary for the patient to know their insurance benefits that they receive from their employerIn addition to that, the insurance company supplies what is called an E.O.B., explanation of benefits, which clearly states the remaining yearly maximum with each visit.*** *** called and spoke with me, Darlene M*** on July 22, complaining of his balanceHe was unprofessional and hostile informing me that he will never pay his bill and that it is not his responsibilityWe have multiple signed financial agreements from the *** *** *** stating that whatever the insurance does not cover is their responsibility.We sent statements with no attempt to pay anything towards his balanceSo therefore, we are asking for payment in full.If you need any additional information, please inform me in writing and I will forward it to you.Sincerely, Darlene MManager

December 10, 2015Dear [redacted],
I received your inquiry from the parent [redacted] regarding the patient [redacted]. I do not agree with this complaint and feel it is totally unfair. Please allow me to explain.
It is our policy for our practice to check...

eligibility of the insurance that is supplied to us by the patient along with a breakdown of benefits although it is not our responsibility to keep track of all lifetime maximums for thousands of patients. It is usual and customary for the patient to know their insurance benefits that they receive from their employer. In addition to that, the insurance company supplies what is called an E.O.B., explanation of benefits, which clearly states the remaining yearly maximum with each visit.[redacted] called and spoke with me, Darlene M[redacted] on July 22, 2014 complaining of his balance. He was unprofessional and hostile informing me that he will never pay his bill and that it is not his responsibility. We have multiple signed financial agreements from the [redacted] stating that whatever the insurance does not cover is their responsibility.We sent 5 statements with no attempt to pay anything towards his balance. So therefore, we are asking for payment in full.
If you need any additional information, please inform me in writing and I will forward it to you.
Sincerely,
Darlene M.
Manager

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:  Services were only accepted based on the business stating that the services would be covered by insurance.  While I understand that they may have "thousands of patients" only one patient was being offered services at that time.  There was no EOB available when the office assured my wife that services would be covered.  If they cannot be expected to know patients insurance, then their staff should not make claims regarding such when talking patients into accepting services.  I do recall the phone call with the office manager as I initially attempted to reach an amicable resolution, however I absolutely recall the "hostility" spoken of coming from the office manager.  Their position was that since they successfully talked my wife into allowing exorbitant services in excess of lifetime insurance limits, they expect full payment.  In good faith I have offered a reasonable settlement, and the office has again restated their refusal to move at all from an unacceptable position.
Regards,
[redacted]

December 10, 2015Dear [redacted],I received your inquiry from the parent [redacted] regarding the patient [redacted]. I do not agree with this complaint and feel it is totally unfair. Please allow me to explain.It is our policy for our practice to check eligibility of the insurance that...

is supplied to us by the patient along with a breakdown of benefits although it is not our responsibility to keep track of all lifetime maximums for thousands of patients. It is usual and customary for the patient to know their insurance benefits that they receive from their employer. In addition to that, the insurance company supplies what is called an E.O.B., explanation of benefits, which clearly states the remaining yearly maximum with each visit.[redacted] called and spoke with me, Darlene M[redacted] on July 22, 2014 complaining of his balance. He was unprofessional and hostile informing me that he will never pay his bill and that it is not his responsibility. We have multiple signed financial agreements from the [redacted] stating that whatever the insurance does not cover is their responsibility.We sent 5 statements with no attempt to pay anything towards his balance. So therefore, we are asking for payment in full.If you need any additional information, please inform me in writing and I will forward it to you.Sincerely, Darlene M. Manager