Gene Sweetnam O.D. P.C.

l.The complaint filed above was in reference to *** sent to an outside collections agency for two family membersThe patient states that the office said that the exams would be covered at the time of service, Insurance is a private matter between the patient and the insurer and we must follow the
insurer's rulesThe examinations were covered but were subject to the patients DEDUCTIBLE so the patient was responsible for the allowed amountAs a courtesy, much of the charges were written off and only per patient was charged instead of the allowed amount of eachWe went the extra mile to see if the two-family members were covered by his vision planThe complainant has a MEMBER only vision plan, thus the complainant, as the sponsor for the two-family members is responsible for paymentThese allegations are very serious, in fact, they are criminal complaintsHis family member accounts were referred to a collection agency for non-payment but was only done so with extreme hesitance and after we sent letters on Jun 2016, Aug 2016, Oct 2016, Dec 2.0iand on Jan (we spoke to a family member and father can be heard in the background and the person on the line said a check would be sent)On Feb and March final bills were sent to the patientI sent two personal emails from me on March and March stating that if payment arrangements were not made by March both accounts would go to collectionsThe complainant never responded to requests for paymentContrary to the complainant's statements he did not speak to anyone in the office concerning paymentThe payment the complainant references was not cashed by us but was sent to the collection agency *** *** on April Under no circumstances would I knowingly or willingly alter, change or fabricate any instrument used to pay a billThe services for which the complainant is referring to occurred in March over a year ago and every effort was made to give adequate time to pay for the billThe complainant states a check was sent and was cashedWe have no record of a check deposited in our accounts to cover the outstanding balances Once an account is sent to collections then we are no longer involved and the patient must then work with the Collection Agency directlyI have no knowledge of any allegations to "forge' or create a check as the patient alleges and there is no way anyone in my office would do that, I have detailed information of our attempts to contact this patient including dates bills were sent and my emails to the patient on March and March to the registered email the patient listedI also have patient signed copies of directives that authorize us to bill the patient's insurance and that in the event the insurance does not cover the patient is responsible for paymentI also have the explanation of benefits for the two family members from the complainant's insurance showing that all charges for procedures were applied to the patient's deductible, which by the way, a copy of the EOB is always sent to the patientAt the time of service the complainant did NOT enroll either beneficiary in his member only vision plan which forced us to bill the patient for the balanceHe states correctly that in the past visits he was not billed because family members were covered under different plans which paid for those past visitsPlease refer to *** *** *** ** for disposition in this matter.Respectfully, Gene S*** *** ***

l.The complaint filed above was in reference to *** sent to an outside collections agency for two family membersThe patient states that the office said that the exams would be covered at the time of service, Insurance is a private matter between the patient and the insurer and we must follow the
insurer's rulesThe examinations were covered but were subject to the patients DEDUCTIBLE so the patient was responsible for the allowed amountAs a courtesy, much of the charges were written off and only per patient was charged instead of the allowed amount of eachWe went the extra mile to see if the two-family members were covered by his vision planThe complainant has a MEMBER only vision plan, thus the complainant, as the sponsor for the two-family members is responsible for paymentThese allegations are very serious, in fact, they are criminal complaintsHis family member accounts were referred to a collection agency for non-payment but was only done so with extreme hesitance and after we sent letters on Jun 2016, Aug 2016, Oct 2016, Dec 2.0iand on Jan (we spoke to a family member and father can be heard in the background and the person on the line said a check would be sent)On Feb and March final bills were sent to the patientI sent two personal emails from me on March and March stating that if payment arrangements were not made by March both accounts would go to collectionsThe complainant never responded to requests for paymentContrary to the complainant's statements he did not speak to anyone in the office concerning paymentThe payment the complainant references was not cashed by us but was sent to the collection agency *** *** on April Under no circumstances would I knowingly or willingly alter, change or fabricate any instrument used to pay a billThe services for which the complainant is referring to occurred in March over a year ago and every effort was made to give adequate time to pay for the billThe complainant states a check was sent and was cashedWe have no record of a check deposited in our accounts to cover the outstanding balances Once an account is sent to collections then we are no longer involved and the patient must then work with the Collection Agency directlyI have no knowledge of any allegations to "forge' or create a check as the patient alleges and there is no way anyone in my office would do that, I have detailed information of our attempts to contact this patient including dates bills were sent and my emails to the patient on March and March to the registered email the patient listedI also have patient signed copies of directives that authorize us to bill the patient's insurance and that in the event the insurance does not cover the patient is responsible for paymentI also have the explanation of benefits for the two family members from the complainant's insurance showing that all charges for procedures were applied to the patient's deductible, which by the way, a copy of the EOB is always sent to the patientAt the time of service the complainant did NOT enroll either beneficiary in his member only vision plan which forced us to bill the patient for the balanceHe states correctly that in the past visits he was not billed because family members were covered under different plans which paid for those past visitsPlease refer to *** *** *** ** for disposition in this matter.Respectfully, Gene S*** *** ***