Greg I Dash MD

This is in response to complaint ID [redacted] by the mother of a patient who I saw as an emergency in the hospitalThe patient came to StCatherine of Siena Emergency Department for an emergency [redacted] She was seen and treated by me in the emergency room, and she was admitted for further care and observationHer condition improved, and I saw her in the hospital for a follvisit, and I cleared her for discharge and further treatment on an outpatient basis We billed her insurance company, GHI, for these two visitsI am a nonparticipating physician for GHI, and therefore out of network billing rules applyUnfortunately, GHI does not send payment directly to a nonparticipating physician but instead sends the payment to the patientThey also refuse to send an Explanation of Benefits report, or anything in writing, to a nonparticipating physician(Incidentally, I had contacted GHI last year to submit an application to participate in their network, but they told me that they were happy with their current network and that it was closed and that they were not accepting any more applications.) Therefore, we billed the patient for the medical services I provided The patient’s mother later called our office and complained that I had never seen her daughter for the second, follow-up, visitShe said that she was with her the whole time and she does not remember my coming in to see herMy office explained that I did, in fact, see her for the visit and that this is documented in the hospital’s electronic medical records which are dated and time stampedShe continued to insist that I did not see her on that day, and my office staff told me that she became quite rude and belligerentI happened to be at the desk at the time, and I heard the conversation, and I can confirm that my office staff remained calm and professionalThey again told her that we have electronic records documenting the visitWe also told the mother that I have a direct recollection of seeing her daughter for follow-upSince I only occasionally have a patient admitted to StCatherine’s, I had to make a special trip in to see her that day, driving minutes each way, and I distinctly remember the visitAdditionally, the patient would not have been discharged from the hospital without my seeing her and clearing her for dischargeThe mother was again quite angry, accused us of lying and of doing improper, fraudulent billing, and she absolutely refused to pay We subsequently learned through GHI’s automated phone system that payment for the two visits had been made by GHI, and a check had been sent to the patientMy billing company contacted the patient, by billing statements and phone calls, and told her that we were aware that the insurance company had paid her and that this payment is now due to the doctorThe billing company told me that the patient’s mother was extremely argumentative, still refused to pay and seemed to be “bending the truth” to avoid payingSeveral additional phone calls were made, and messages were left for the patient or her mother to call the billers, but they failed to return these callsUltimately, they were told that if payment was not made, the bill would go to a collections agency, and an additional collections charge would be incurredAgain, there was no responseTherefore, the account was sent to collections It was only after the collections company contacted the patient that the mother finally sent us payment for the original amount, without paying the collections chargeThe mother then called my office angrily and said that she had spoken to the collections company and that they had told her that there was no collections charge, and she again refused to pay(I later spoke with the collection agents and they assure me that they did not and would never make such a statement to a person in collections, especially since it is not trueThis, again, seems to be another incidence of the mother’s “bending the truth” to avoid paying.) We told her that she had been informed that a collections fee would be due and that, at this point, she must deal directly with the collections companyShe hung up and instead of paying her balance, she contacted you Let me address some of the other inconsistencies and untruths in the mother’s statementFirst of all, I do not believe that I ever spoke directly with the patientSince it was the mother who called my office with complaints, I spoke with the motherShe stated that she knew that I had not seen her daughter for a second visit, since she was with her in the hospital the whole timeNo one is ever at the bedside with a patient in the hospital the whole time, 24/7, during a three-day hospital stay(Note that the patient is a young woman in her 20s, not an infant.) She also insisted that I could not have seen her daughter, since her daughter does not remember seeing meI did explain to the mother that people who are in the hospital are not always aware of or may not remember everything that was going on in the hospital and who visited themI told her that it is possible that she did not realize who I was at the timeShe may have been awakened from sleep and then have g one back to sleep without remembering the visitShe may have been taking pain medicationsThere are many reasons that a hospitalized patient may not remember a specific visit a few months laterI did not say that her “memory was not good” or that she was “mentally incapacitated”These are inflammatory statements, probably written by the patient’s mother to anger whoever reads her complaint The mother states that she kept us in the loop, telling us that she was requesting copies of the medical records from the hospital, and that we should have put all billing on holdIn fact, she did ignore multiple calls from the billers, and each time that she did speak with my office or the billers, she just insisted that she was not going to pay because there was no second hospital visitShe did not tell us that she was trying to obtain hospital records until after she had already been sent to the collection agentsPlease realize that in her complaint, the mother states that she received two checks from the insurance company, presumably one for each visitShe could have sent us the check for the emergency room visit (which she did not dispute), and she could have then told us that she was looking into the second visitHowever, instead, she just continued to refuse to send us any payment, only paying after she was in collections Perhaps the most blatant untruth in the mother’s statement is saying that the records that she received from the hospital were not legibleAll records from StCatherine of Siena Medical Center, including doctor’s notes and nurse’s notes, are electronic medical recordsThis means that they are typed into the computer, not handwrittenWhen a patient requests a copy of the medical records, they are printed from the computer on a laser printer and then mailed to the patientThere is no conceivable way that they could be “not legible”That’s the advantage of electronic medical recordsThey are ALWAYS legibleI suspect that the reason that the mother said that the records were not legible is that she did not want to admit that the hospital medical records do document my two visits to see the patient and that, therefore, my office was correct (and the billing was correct) the whole timeIn fact, the mother states in her complaint that eve n after receiving the records, she still does not believe that I saw her daughter for the second visitThis is simple denial and the refusal to admit that she is wrong So in summary, we have a patient who went to the emergency room, had emergency medical care and follby me, got better, received payment for my services from her insurance company, and then refused to send the payment to meShe states that I never saw her for a second visit despite clear, legible documentation in the dated, time stamped hospital electronic medical records that I did see herShe only paid after she forced us to send her to collections, incurring a collection fee which she now refuses to payInstead of doing the right thing and paying her balance, she contacted the Revdex.comHer accusations, distortions of the truth, and refusal to forward the insurance company checks to my office have cost my staff, my billers, and myself considerable time and effort, in addition to stress, headaches, and aggravation, and they have resulted in significant financial expense for me by forcing me to send her account to an outside collections agencyThe coll ection fee stands

Revdex.com: I have reviewed the response made by the business in reference to complaint ID# [redacted] , and have determined that my complaint has NOT been resolved because: All the doctor did was to dispute my concerns, he never waived the collection fee Lets respond to his comments:My daughter was cleared for discharge by our primary doctor: [redacted] I know this because I waited about hours for her to do it He might have had to sign off on it, but he wasn't the one with the final sign off When I received the checks from the insurance company I called the doctors office to ask questioning the second visit The guy I spoke to told me I HAD to send in the checks that I received I did tell him I was not sending in checks for a follow up that I nor my daughter recall I did use a loud voice but NEVER was I belligerent Yes we then called the doctors office and when we questioned it with the staff they had the doctor call my daughter back He absolutely spoke to her She remembers how he made the comment that maybe she was medicated at the time She explained she was on [redacted] not pain meds Never once did we receive a paper bill I never disputed that we received a phone call When we received the call I called them back immediately and I was told they couldn't speak to me they ONLY needed to talk to my daughter So I had her call them back, since at the time she worked in with me During those conversations we did inform them we were questioning the second visit and we were requesting paperwork from the hospital Yes the hospital finally sent me the paperwork However if you are not in the medical profession it is hard to understand I do not believe in bending the truth, it goes against my beliefs, I have nothing to hide and told it like it was I have no problem with paying for services that were rendered Yes my daughter is years old, but this is the first time something like this has ever happened to her and I was holding her hand through it like a tight nit family should do this is why I spent every moment I was allowed with her in the hospital I would arrive at 8am and leave at 10:-11pm each day Collections NEVER contacted us directly I was the one who initiated the phone calls after getting the number from the office who directed me to billing who directed me to collections I was told by the office I could only speak to billing billing then told me I could only speak to collections Collections would not give me anything in writing stating that they do not add anything to the amount They only collect what the doctors office sends to them I only contacted Revdex.com after I was given the run around and was only getting more upset because no one wanted to work with me on resolving the issue I stated in my original complaint "she told him she wasn't prescribed nor given any mind altering drugs She was only on [redacted] not pain killers So basically it was her word against his and ended the conversation" No he did not say my daughter was "mentally incapacitated" he applied it.I was NOT sent to collections until the [redacted] of February (ironically it was the same day I called to say the checks were being mailed) Knowing that they were kept in the loop this should have never happened There were also multiply phone conversations informing them the original checks were lost and we were obtaining the records from the hospital No checks were going to be mailed until I confirmed the charges with the insurance company When the medical records were received we read through them, but because we are not in the medical field they were hard to understand, NOT that they were illegible I was NEVER forced to pay, I paid when the checks were received by me the second time and I after I received the medical records Why is it that ONLY I or my daughter are not telling the truth??? I have a doctor who was paid for his services and who is unwilling to remove a fee for a collection bill that is charged by him NOT the collection company I know for a fact that the fee could have been removed the same day it was supposedly issued but he would rather collect another $from someone for nothing done In order for the Revdex.com to appropriately process your response, you MUST answer the question above (Sorry for the late response as I am in Florida dealing with [redacted] .) Sincerely, [redacted]

This is in response to complaint ID *** by the mother of a patient who I saw as an emergency in the hospitalThe patient came to StCatherine of Siena Emergency Department for an emergency *** ***She was seen and treated by me in the emergency room, and she was admitted for further care and observationHer condition improved, and I saw her in the hospital for a follvisit, and I cleared her for discharge and further treatment on an outpatient basis
We billed her insurance company, GHI, for these two visitsI am a nonparticipating physician for GHI, and therefore out of network billing rules applyUnfortunately, GHI does not send payment directly to a nonparticipating physician but instead sends the payment to the patientThey also refuse to send an Explanation of Benefits report, or anything in writing, to a nonparticipating physician(Incidentally, I had contacted GHI last year to submit an application to participate in their network, but they told me that they were happy with their current network and that it was closed and that they were not accepting any more applications.) Therefore, we billed the patient for the medical services I provided
The patient’s mother later called our office and complained that I had never seen her daughter for the second, follow-up, visitShe said that she was with her the whole time and she does not remember my coming in to see herMy office explained that I did, in fact, see her for the visit and that this is documented in the hospital’s electronic medical records which are dated and time stampedShe continued to insist that I did not see her on that day, and my office staff told me that she became quite rude and belligerentI happened to be at the desk at the time, and I heard the conversation, and I can confirm that my office staff remained calm and professionalThey again told her that we have electronic records documenting the visitWe also told the mother that I have a direct recollection of seeing her daughter for follow-upSince I only occasionally have a patient admitted to StCatherine’s, I had to make a special trip in to see her that day, driving minutes each way, and I distinctly remember the visitAdditionally, the patient would not have been discharged from the hospital without my seeing her and clearing her for dischargeThe mother was again quite angry, accused us of lying and of doing improper, fraudulent billing, and she absolutely refused to pay
We subsequently learned through GHI’s automated phone system that payment for the two visits had been made by GHI, and a check had been sent to the patientMy billing company contacted the patient, by billing statements and phone calls, and told her that we were aware that the insurance company had paid her and that this payment is now due to the doctorThe billing company told me that the patient’s mother was extremely argumentative, still refused to pay and seemed to be “bending the truth” to avoid payingSeveral additional phone calls were made, and messages were left for the patient or her mother to call the billers, but they failed to return these callsUltimately, they were told that if payment was not made, the bill would go to a collections agency, and an additional collections charge would be incurredAgain, there was no responseTherefore, the account was sent to collections
It was only after the collections company contacted the patient that the mother finally sent us payment for the original amount, without paying the collections chargeThe mother then called my office angrily and said that she had spoken to the collections company and that they had told her that there was no collections charge, and she again refused to pay(I later spoke with the collection agents and they assure me that they did not and would never make such a statement to a person in collections, especially since it is not trueThis, again, seems to be another incidence of the mother’s “bending the truth” to avoid paying.) We told her that she had been informed that a collections fee would be due and that, at this point, she must deal directly with the collections companyShe hung up and instead of paying her balance, she contacted you
Let me address some of the other inconsistencies and untruths in the mother’s statementFirst of all, I do not believe that I ever spoke directly with the patientSince it was the mother who called my office with complaints, I spoke with the motherShe stated that she knew that I had not seen her daughter for a second visit, since she was with her in the hospital the whole timeNo one is ever at the bedside with a patient in the hospital the whole time, 24/7, during a three-day hospital stay(Note that the patient is a young woman in her 20s, not an infant.) She also insisted that I could not have seen her daughter, since her daughter does not remember seeing meI did explain to the mother that people who are in the hospital are not always aware of or may not remember everything that was going on in the hospital and who visited themI told her that it is possible that she did not realize who I was at the timeShe may have been awakened from sleep and then have g one back to sleep without remembering the visitShe may have been taking pain medicationsThere are many reasons that a hospitalized patient may not remember a specific visit a few months laterI did not say that her “memory was not good” or that she was “mentally incapacitated”These are inflammatory statements, probably written by the patient’s mother to anger whoever reads her complaint
The mother states that she kept us in the loop, telling us that she was requesting copies of the medical records from the hospital, and that we should have put all billing on holdIn fact, she did ignore multiple calls from the billers, and each time that she did speak with my office or the billers, she just insisted that she was not going to pay because there was no second hospital visitShe did not tell us that she was trying to obtain hospital records until after she had already been sent to the collection agentsPlease realize that in her complaint, the mother states that she received two checks from the insurance company, presumably one for each visitShe could have sent us the check for the emergency room visit (which she did not dispute), and she could have then told us that she was looking into the second visitHowever, instead, she just continued to refuse to send us any payment, only paying after she was in collections
Perhaps the most blatant untruth in the mother’s statement is saying that the records that she received from the hospital were not legibleAll records from StCatherine of Siena Medical Center, including doctor’s notes and nurse’s notes, are electronic medical recordsThis means that they are typed into the computer, not handwrittenWhen a patient requests a copy of the medical records, they are printed from the computer on a laser printer and then mailed to the patientThere is no conceivable way that they could be “not legible”That’s the advantage of electronic medical recordsThey are ALWAYS legibleI suspect that the reason that the mother said that the records were not legible is that she did not want to admit that the hospital medical records do document my two visits to see the patient and that, therefore, my office was correct (and the billing was correct) the whole timeIn fact, the mother states in her complaint that eve n after receiving the records, she still does not believe that I saw her daughter for the second visitThis is simple denial and the refusal to admit that she is wrong
So in summary, we have a patient who went to the emergency room, had emergency medical care and follby me, got better, received payment for my services from her insurance company, and then refused to send the payment to meShe states that I never saw her for a second visit despite clear, legible documentation in the dated, time stamped hospital electronic medical records that I did see herShe only paid after she forced us to send her to collections, incurring a collection fee which she now refuses to payInstead of doing the right thing and paying her balance, she contacted the Revdex.comHer accusations, distortions of the truth, and refusal to forward the insurance company checks to my office have cost my staff, my billers, and myself considerable time and effort, in addition to stress, headaches, and aggravation, and they have resulted in significant financial expense for me by forcing me to send her account to an outside collections agencyThe coll ection fee stands

This is in response to complaint ID [redacted] by the mother of a patient who I saw as an emergency in the hospital. The patient came to St. Catherine of Siena Emergency Department for an emergency...

[redacted]. She was seen and treated by me in the emergency room, and she was admitted for further care and observation. Her condition improved, and I saw her in the hospital for a follow-up visit, and I cleared her for discharge and further treatment on an outpatient basis.
We billed her insurance company, GHI, for these two visits. I am a nonparticipating physician for GHI, and therefore out of network billing rules apply. Unfortunately, GHI does not send payment directly to a nonparticipating physician but instead sends the payment to the patient. They also refuse to send an Explanation of Benefits report, or anything in writing, to a nonparticipating physician. (Incidentally, I had contacted GHI last year to submit an application to participate in their network, but they told me that they were happy with their current network and that it was closed and that they were not accepting any more applications.) Therefore, we billed the patient for the medical services I provided.
The patient’s mother later called our office and complained that I had never seen her daughter for the second, follow-up, visit. She said that she was with her the whole time and she does not remember my coming in to see her. My office explained that I did, in fact, see her for the visit and that this is documented in the hospital’s electronic medical records which are dated and time stamped. She continued to insist that I did not see her on that day, and my office staff told me that she became quite rude and belligerent. I happened to be at the desk at the time, and I heard the conversation, and I can confirm that my office staff remained calm and professional. They again told her that we have electronic records documenting the visit. We also told the mother that I have a direct recollection of seeing her daughter for follow-up. Since I only occasionally have a patient admitted to St. Catherine’s, I had to make a special trip in to see her that day, driving 25 minutes each way, and I distinctly remember the visit. Additionally, the patient would not have been discharged from the hospital without my seeing her and clearing her for discharge. The mother was again quite angry, accused us of lying and of doing improper, fraudulent billing, and she absolutely refused to pay.
We subsequently learned through GHI’s automated phone system that payment for the two visits had been made by GHI, and a check had been sent to the patient. My billing company contacted the patient, by billing statements and phone calls, and told her that we were aware that the insurance company had paid her and that this payment is now due to the doctor. The billing company told me that the patient’s mother was extremely argumentative, still refused to pay and seemed to be “bending the truth” to avoid paying. Several additional phone calls were made, and messages were left for the patient or her mother to call the billers, but they failed to return these calls. Ultimately, they were told that if payment was not made, the bill would go to a collections agency, and an additional collections charge would be incurred. Again, there was no response. Therefore, the account was sent to collections.
It was only after the collections company contacted the patient that the mother finally sent us payment for the original amount, without paying the collections charge. The mother then called my office angrily and said that she had spoken to the collections company and that they had told her that there was no collections charge, and she again refused to pay. (I later spoke with the collection agents and they assure me that they did not and would never make such a statement to a person in collections, especially since it is not true. This, again, seems to be another incidence of the mother’s “bending the truth” to avoid paying.) We told her that she had been informed that a collections fee would be due and that, at this point, she must deal directly with the collections company. She hung up and instead of paying her balance, she contacted you.
Let me address some of the other inconsistencies and untruths in the mother’s statement. First of all, I do not believe that I ever spoke directly with the patient. Since it was the mother who called my office with complaints, I spoke with the mother. She stated that she knew that I had not seen her daughter for a second visit, since she was with her in the hospital the whole time. No one is ever at the bedside with a patient in the hospital the whole time, 24/7, during a three-day hospital stay. (Note that the patient is a young woman in her 20s, not an infant.) She also insisted that I could not have seen her daughter, since her daughter does not remember seeing me. I did explain to the mother that people who are in the hospital are not always aware of or may not remember everything that was going on in the hospital and who visited them. I told her that it is possible that she did not realize who I was at the time. She may have been awakened from sleep and then have g one back to sleep without remembering the visit. She may have been taking pain medications. There are many reasons that a hospitalized patient may not remember a specific visit a few months later. I did not say that her “memory was not good” or that she was “mentally incapacitated”. These are inflammatory statements, probably written by the patient’s mother to anger whoever reads her complaint.
The mother states that she kept us in the loop, telling us that she was requesting copies of the medical records from the hospital, and that we should have put all billing on hold. In fact, she did ignore multiple calls from the billers, and each time that she did speak with my office or the billers, she just insisted that she was not going to pay because there was no second hospital visit. She did not tell us that she was trying to obtain hospital records until after she had already been sent to the collection agents. Please realize that in her complaint, the mother states that she received two checks from the insurance company, presumably one for each visit. She could have sent us the check for the emergency room visit (which she did not dispute), and she could have then told us that she was looking into the second visit. However, instead, she just continued to refuse to send us any payment, only paying after she was in collections.
Perhaps the most blatant untruth in the mother’s statement is saying that the records that she received from the hospital were not legible. All records from St. Catherine of Siena Medical Center, including doctor’s notes and nurse’s notes, are electronic medical records. This means that they are typed into the computer, not handwritten. When a patient requests a copy of the medical records, they are printed from the computer on a laser printer and then mailed to the patient. There is no conceivable way that they could be “not legible”. That’s the advantage of electronic medical records. They are ALWAYS legible. I suspect that the reason that the mother said that the records were not legible is that she did not want to admit that the hospital medical records do document my two visits to see the patient and that, therefore, my office was correct (and the billing was correct) the whole time. In fact, the mother states in her complaint that eve n after receiving the records, she still does not believe that I saw her daughter for the second visit. This is simple denial and the refusal to admit that she is wrong.
So in summary, we have a patient who went to the emergency room, had emergency medical care and follow-up by me, got better, received payment for my services from her insurance company, and then refused to send the payment to me. She states that I never saw her for a second visit despite clear, legible documentation in the dated, time stamped hospital electronic medical records that I did see her. She only paid after she forced us to send her to collections, incurring a collection fee which she now refuses to pay. Instead of doing the right thing and paying her balance, she contacted the Revdex.com. Her accusations, distortions of the truth, and refusal to forward the insurance company checks to my office have cost my staff, my billers, and myself considerable time and effort, in addition to stress, headaches, and aggravation, and they have resulted in significant financial expense for me by forcing me to send her account to an outside collections agency. The coll ection fee stands

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

All the doctor did was to dispute my concerns, he never waived the collection fee.  Lets respond to his comments:My daughter was cleared for discharge by our primary doctor: [redacted].  I know this because I waited about 2 hours for her to do it.  He might have had to sign off on it, but he wasn't the one with the final sign off.    When I received the checks from the insurance company I called the doctors office to ask  questioning the second visit.  The guy I spoke to told me I HAD to send in the checks that I received.  I did tell him I was not sending in checks for a follow up that I nor my daughter recall.  I did use a loud voice but NEVER was I belligerent.  Yes we then called the doctors office and when we questioned it with the staff they had the doctor call my daughter back.  He absolutely spoke to her.  She remembers how he made the comment that maybe she was medicated at the time.  She explained she was on [redacted] not pain meds.   Never once did we receive a paper bill.  I never disputed that we received a phone call.  When we received the call I called them back immediately and I was told they couldn't speak to me they ONLY needed to talk to my daughter.  So I had her call them back, since at the time she worked in with me.  During those conversations we did inform them we were questioning the second visit and we were requesting paperwork from the hospital.  Yes the hospital finally sent me the paperwork.  However if you are not in the medical profession it is hard to understand.  I do not believe in bending the truth, it goes against my beliefs,  I have nothing to hide and told it like it was.  I have no problem with paying for services that were rendered.  Yes my daughter is 24 years old, but this is the first time something like this has ever happened to her and I was holding her hand through it like a tight nit family should do.  this is why I spent every moment I was allowed with her in the hospital.  I would arrive at 8am and leave at 10:30 -11pm each day.
Collections NEVER contacted us directly I was the one who initiated the phone calls after getting the number from the office who directed me to billing who directed me to collections.  I was told by the office I could only speak to billing.  billing then told me I could only speak to collections.  Collections would not give me anything in writing stating that they do not add anything to the amount.  They only collect what the doctors office sends to them.   I only contacted Revdex.com after I was given the run around and was only getting more upset because no one wanted to work with me on resolving the issue.  I stated in my original complaint "she told him she wasn't prescribed nor given any mind altering drugs.  She was only on [redacted] not pain killers.  So basically it was her word against his and ended the conversation".   No he did not say my daughter was "mentally incapacitated" he applied it.I was NOT sent to collections until the [redacted] of February (ironically it was the same day  I called to say the checks were being mailed).  Knowing that they were kept in the loop this should have never happened.   There were also multiply phone conversations  informing them the original checks were lost and we were obtaining the records from the hospital.  No checks were going to be mailed until I confirmed the charges with the insurance company.     When the medical records were received we read through them, but because we are not in the medical field they were hard to understand, NOT that they were illegible.   I was NEVER forced to pay, I paid when the checks were received by me the second time and I after I received the medical records.   Why is it that ONLY I or my daughter are not telling the truth???  I have a doctor who was paid for his services and who is unwilling to remove a fee for a collection bill that is charged by him NOT the collection company.  I know for a fact that the fee could have been removed the same day it was supposedly issued.  but he would rather collect another $250 from someone for nothing done.           
 
In order for the Revdex.com to appropriately process your response, you MUST answer the question above.
(Sorry for the late response as I am in Florida dealing with [redacted].)
 Sincerely,
[redacted]

Review: My daughter was rushed to St Catherines Emergency room in September of 2013 for [redacted]. She was seen by a [redacted] in the ER. After about 2 months I received 2 checks from my insurance company for services rendered by the doctor due to being out of network. When I finally realized what the checks were for we called his office to question why there are three visits when we only saw him once. I had an argument with some gentleman in the billing office. He kept referring to the fact that I have the checks I am suppose to send them to the doctor. I explained I would not send the checks if he didnt perform the service. That is considered insurance fraud. I wanted/needed to confirm he actually saw my daughter the second time. After my complaining, [redacted] called my daughter and told her he indeed saw her and maybe her memory wasnt good he insinuated she was unable to remember because she was mentally incapacitated. She told him she wasnt prescribed, nor given any mind-altering drugs. She was only on [redacted] not pain killers. So basically it was her word against his and ended the conversation. We then called the office and were directed to the billing department who we told we were disputing the charges for the second visit. At this point the account should have immediately been put on hold. According to [redacted] she claims she told us that we were still responsible to pay both the amounts. Those words never came out of her mouth. She called our house and left messages according to her and we never returned any of the calls. It took 2-3 weeks for the hospital to send us the nurses station notes. During this time we kept the office informed of our concerns and complaints. We received phone calls requesting payments in which we responded. We told the office (On January [redacted] contact person was [redacted]) that we were waiting for documents from the hospital. We were advised that day to ignore payment phone calls until we received the hospital documents. When I finally got the documents from the hospital to see if the doctor really came in the hospital the second time they were not legible. Prior to this I realized I misplaced the two checks from the insurance company. I contacted the insurance company to request they resend me the checks. I was told it will take about 2-3 weeks. Again I told the doctors office this and explained after I get the checks and the proof the doctor saw her the second time I would send the money. I didnt have $563 just lying around to lay it out and wait for the checks from the insurance company. When I received the checks from the insurance company I wrote out my check to send in the money to the doctor right away. Even though I still dont believe he saw my daughter the second time. At this point it just wasnt worth my time anymore for the $47 co-pay to argue. I called the office on 2/**/14 to confirm the amount I owed and to see where to mail the payment to. Since I didnt have a bill from the Doctor directly I wanted to make sure he received the check from me to the right address. [redacted] at the office told me to call the billing office to confirm the amount to send. [redacted] at the billing office said the amount wasnt correct, because it was turned over to collection today. I asked why did that happened when we kept everyone in the loop about what was going on. She told me it didnt matter we were disputing the charges, and she couldnt do anything it was in the hands of the collection department. She then referred me to the collection department. When I questioned the larger amount she told me the collection department charges a 50% fee. This is why I would still have a balance after my $563.00 check I was sending that day. I then called the collections department and spoke to [redacted] at ###-###-#### and asked him who adds on the fee. He told me the doctors office sends over how much to collect. The billing department told me its the collection department who adds the fee and they cannot remove the fee. Only the collection department can remove the fee. The collection department told me to ask billing to get it removed. Billing said because it is in collection they are the only ones who can remove it. I do not understand how a doctors office and this billing department can handle something so poorly. I have been told by them they kept notes. It doesnt matter that their notes are wrong its my problem and I owe them $263.50 for doing NOTHING! All they do is point the finger to the other person. I need help; all I am doing is getting upset and aggravated with this process. Not only have [redacted] been unhelpful, but ruse as well. [redacted] has insinuated that we took the insurance checks, which my daughter did not appreciate. I asked the collection department to put in writing they do not add on the fee. [redacted] said he needs to speak to the billing/doctors office. So I am waiting for the collection department to put it in writing that they do not add on the fee.I have tried to speak to the insurance company but because he is out of network there is nothing they can do. They asked me to contact the doctors office again, who put me back to the collections department. As of today 3/** I still do not have anything from [redacted] regarding the additional fee stating that the doctors office adds the amount.Desired Settlement: The collection fee to be removed from the account.

Business

Response:

This is in response to complaint ID [redacted] by the mother of a patient who I saw as an emergency in the hospital. The patient came to St. Catherine of Siena Emergency Department for an emergency [redacted]. She was seen and treated by me in the emergency room, and she was admitted for further care and observation. Her condition improved, and I saw her in the hospital for a follow-up visit, and I cleared her for discharge and further treatment on an outpatient basis.

We billed her insurance company, GHI, for these two visits. I am a nonparticipating physician for GHI, and therefore out of network billing rules apply. Unfortunately, GHI does not send payment directly to a nonparticipating physician but instead sends the payment to the patient. They also refuse to send an Explanation of Benefits report, or anything in writing, to a nonparticipating physician. (Incidentally, I had contacted GHI last year to submit an application to participate in their network, but they told me that they were happy with their current network and that it was closed and that they were not accepting any more applications.) Therefore, we billed the patient for the medical services I provided.

The patient’s mother later called our office and complained that I had never seen her daughter for the second, follow-up, visit. She said that she was with her the whole time and she does not remember my coming in to see her. My office explained that I did, in fact, see her for the visit and that this is documented in the hospital’s electronic medical records which are dated and time stamped. She continued to insist that I did not see her on that day, and my office staff told me that she became quite rude and belligerent. I happened to be at the desk at the time, and I heard the conversation, and I can confirm that my office staff remained calm and professional. They again told her that we have electronic records documenting the visit. We also told the mother that I have a direct recollection of seeing her daughter for follow-up. Since I only occasionally have a patient admitted to St. Catherine’s, I had to make a special trip in to see her that day, driving 25 minutes each way, and I distinctly remember the visit. Additionally, the patient would not have been discharged from the hospital without my seeing her and clearing her for discharge. The mother was again quite angry, accused us of lying and of doing improper, fraudulent billing, and she absolutely refused to pay.

We subsequently learned through GHI’s automated phone system that payment for the two visits had been made by GHI, and a check had been sent to the patient. My billing company contacted the patient, by billing statements and phone calls, and told her that we were aware that the insurance company had paid her and that this payment is now due to the doctor. The billing company told me that the patient’s mother was extremely argumentative, still refused to pay and seemed to be “bending the truth” to avoid paying. Several additional phone calls were made, and messages were left for the patient or her mother to call the billers, but they failed to return these calls. Ultimately, they were told that if payment was not made, the bill would go to a collections agency, and an additional collections charge would be incurred. Again, there was no response. Therefore, the account was sent to collections.

It was only after the collections company contacted the patient that the mother finally sent us payment for the original amount, without paying the collections charge. The mother then called my office angrily and said that she had spoken to the collections company and that they had told her that there was no collections charge, and she again refused to pay. (I later spoke with the collection agents and they assure me that they did not and would never make such a statement to a person in collections, especially since it is not true. This, again, seems to be another incidence of the mother’s “bending the truth” to avoid paying.) We told her that she had been informed that a collections fee would be due and that, at this point, she must deal directly with the collections company. She hung up and instead of paying her balance, she contacted you.

Let me address some of the other inconsistencies and untruths in the mother’s statement. First of all, I do not believe that I ever spoke directly with the patient. Since it was the mother who called my office with complaints, I spoke with the mother. She stated that she knew that I had not seen her daughter for a second visit, since she was with her in the hospital the whole time. No one is ever at the bedside with a patient in the hospital the whole time, 24/7, during a three-day hospital stay. (Note that the patient is a young woman in her 20s, not an infant.) She also insisted that I could not have seen her daughter, since her daughter does not remember seeing me. I did explain to the mother that people who are in the hospital are not always aware of or may not remember everything that was going on in the hospital and who visited them. I told her that it is possible that she did not realize who I was at the time. She may have been awakened from sleep and then have g one back to sleep without remembering the visit. She may have been taking pain medications. There are many reasons that a hospitalized patient may not remember a specific visit a few months later. I did not say that her “memory was not good” or that she was “mentally incapacitated”. These are inflammatory statements, probably written by the patient’s mother to anger whoever reads her complaint.

The mother states that she kept us in the loop, telling us that she was requesting copies of the medical records from the hospital, and that we should have put all billing on hold. In fact, she did ignore multiple calls from the billers, and each time that she did speak with my office or the billers, she just insisted that she was not going to pay because there was no second hospital visit. She did not tell us that she was trying to obtain hospital records until after she had already been sent to the collection agents. Please realize that in her complaint, the mother states that she received two checks from the insurance company, presumably one for each visit. She could have sent us the check for the emergency room visit (which she did not dispute), and she could have then told us that she was looking into the second visit. However, instead, she just continued to refuse to send us any payment, only paying after she was in collections.

Perhaps the most blatant untruth in the mother’s statement is saying that the records that she received from the hospital were not legible. All records from St. Catherine of Siena Medical Center, including doctor’s notes and nurse’s notes, are electronic medical records. This means that they are typed into the computer, not handwritten. When a patient requests a copy of the medical records, they are printed from the computer on a laser printer and then mailed to the patient. There is no conceivable way that they could be “not legible”. That’s the advantage of electronic medical records. They are ALWAYS legible. I suspect that the reason that the mother said that the records were not legible is that she did not want to admit that the hospital medical records do document my two visits to see the patient and that, therefore, my office was correct (and the billing was correct) the whole time. In fact, the mother states in her complaint that eve n after receiving the records, she still does not believe that I saw her daughter for the second visit. This is simple denial and the refusal to admit that she is wrong.

So in summary, we have a patient who went to the emergency room, had emergency medical care and follow-up by me, got better, received payment for my services from her insurance company, and then refused to send the payment to me. She states that I never saw her for a second visit despite clear, legible documentation in the dated, time stamped hospital electronic medical records that I did see her. She only paid after she forced us to send her to collections, incurring a collection fee which she now refuses to pay. Instead of doing the right thing and paying her balance, she contacted the Revdex.com. Her accusations, distortions of the truth, and refusal to forward the insurance company checks to my office have cost my staff, my billers, and myself considerable time and effort, in addition to stress, headaches, and aggravation, and they have resulted in significant financial expense for me by forcing me to send her account to an outside collections agency. The coll ection fee stands

Business

Response:

This is in response to complaint ID [redacted] by the mother of a patient who I saw as an emergency in the hospital. The patient came to St. Catherine of Siena Emergency Department for an emergency [redacted]. She was seen and treated by me in the emergency room, and she was admitted for further care and observation. Her condition improved, and I saw her in the hospital for a follow-up visit, and I cleared her for discharge and further treatment on an outpatient basis.

We billed her insurance company, GHI, for these two visits. I am a nonparticipating physician for GHI, and therefore out of network billing rules apply. Unfortunately, GHI does not send payment directly to a nonparticipating physician but instead sends the payment to the patient. They also refuse to send an Explanation of Benefits report, or anything in writing, to a nonparticipating physician. (Incidentally, I had contacted GHI last year to submit an application to participate in their network, but they told me that they were happy with their current network and that it was closed and that they were not accepting any more applications.) Therefore, we billed the patient for the medical services I provided.

The patient’s mother later called our office and complained that I had never seen her daughter for the second, follow-up, visit. She said that she was with her the whole time and she does not remember my coming in to see her. My office explained that I did, in fact, see her for the visit and that this is documented in the hospital’s electronic medical records which are dated and time stamped. She continued to insist that I did not see her on that day, and my office staff told me that she became quite rude and belligerent. I happened to be at the desk at the time, and I heard the conversation, and I can confirm that my office staff remained calm and professional. They again told her that we have electronic records documenting the visit. We also told the mother that I have a direct recollection of seeing her daughter for follow-up. Since I only occasionally have a patient admitted to St. Catherine’s, I had to make a special trip in to see her that day, driving 25 minutes each way, and I distinctly remember the visit. Additionally, the patient would not have been discharged from the hospital without my seeing her and clearing her for discharge. The mother was again quite angry, accused us of lying and of doing improper, fraudulent billing, and she absolutely refused to pay.

We subsequently learned through GHI’s automated phone system that payment for the two visits had been made by GHI, and a check had been sent to the patient. My billing company contacted the patient, by billing statements and phone calls, and told her that we were aware that the insurance company had paid her and that this payment is now due to the doctor. The billing company told me that the patient’s mother was extremely argumentative, still refused to pay and seemed to be “bending the truth” to avoid paying. Several additional phone calls were made, and messages were left for the patient or her mother to call the billers, but they failed to return these calls. Ultimately, they were told that if payment was not made, the bill would go to a collections agency, and an additional collections charge would be incurred. Again, there was no response. Therefore, the account was sent to collections.

It was only after the collections company contacted the patient that the mother finally sent us payment for the original amount, without paying the collections charge. The mother then called my office angrily and said that she had spoken to the collections company and that they had told her that there was no collections charge, and she again refused to pay. (I later spoke with the collection agents and they assure me that they did not and would never make such a statement to a person in collections, especially since it is not true. This, again, seems to be another incidence of the mother’s “bending the truth” to avoid paying.) We told her that she had been informed that a collections fee would be due and that, at this point, she must deal directly with the collections company. She hung up and instead of paying her balance, she contacted you.

Let me address some of the other inconsistencies and untruths in the mother’s statement. First of all, I do not believe that I ever spoke directly with the patient. Since it was the mother who called my office with complaints, I spoke with the mother. She stated that she knew that I had not seen her daughter for a second visit, since she was with her in the hospital the whole time. No one is ever at the bedside with a patient in the hospital the whole time, 24/7, during a three-day hospital stay. (Note that the patient is a young woman in her 20s, not an infant.) She also insisted that I could not have seen her daughter, since her daughter does not remember seeing me. I did explain to the mother that people who are in the hospital are not always aware of or may not remember everything that was going on in the hospital and who visited them. I told her that it is possible that she did not realize who I was at the time. She may have been awakened from sleep and then have g one back to sleep without remembering the visit. She may have been taking pain medications. There are many reasons that a hospitalized patient may not remember a specific visit a few months later. I did not say that her “memory was not good” or that she was “mentally incapacitated”. These are inflammatory statements, probably written by the patient’s mother to anger whoever reads her complaint.

The mother states that she kept us in the loop, telling us that she was requesting copies of the medical records from the hospital, and that we should have put all billing on hold. In fact, she did ignore multiple calls from the billers, and each time that she did speak with my office or the billers, she just insisted that she was not going to pay because there was no second hospital visit. She did not tell us that she was trying to obtain hospital records until after she had already been sent to the collection agents. Please realize that in her complaint, the mother states that she received two checks from the insurance company, presumably one for each visit. She could have sent us the check for the emergency room visit (which she did not dispute), and she could have then told us that she was looking into the second visit. However, instead, she just continued to refuse to send us any payment, only paying after she was in collections.

Perhaps the most blatant untruth in the mother’s statement is saying that the records that she received from the hospital were not legible. All records from St. Catherine of Siena Medical Center, including doctor’s notes and nurse’s notes, are electronic medical records. This means that they are typed into the computer, not handwritten. When a patient requests a copy of the medical records, they are printed from the computer on a laser printer and then mailed to the patient. There is no conceivable way that they could be “not legible”. That’s the advantage of electronic medical records. They are ALWAYS legible. I suspect that the reason that the mother said that the records were not legible is that she did not want to admit that the hospital medical records do document my two visits to see the patient and that, therefore, my office was correct (and the billing was correct) the whole time. In fact, the mother states in her complaint that eve n after receiving the records, she still does not believe that I saw her daughter for the second visit. This is simple denial and the refusal to admit that she is wrong.

So in summary, we have a patient who went to the emergency room, had emergency medical care and follow-up by me, got better, received payment for my services from her insurance company, and then refused to send the payment to me. She states that I never saw her for a second visit despite clear, legible documentation in the dated, time stamped hospital electronic medical records that I did see her. She only paid after she forced us to send her to collections, incurring a collection fee which she now refuses to pay. Instead of doing the right thing and paying her balance, she contacted the Revdex.com. Her accusations, distortions of the truth, and refusal to forward the insurance company checks to my office have cost my staff, my billers, and myself considerable time and effort, in addition to stress, headaches, and aggravation, and they have resulted in significant financial expense for me by forcing me to send her account to an outside collections agency. The coll ection fee stands

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID# [redacted], and have determined that my complaint has NOT been resolved because:

All the doctor did was to dispute my concerns, he never waived the collection fee.

Lets respond to his comments:

My daughter was cleared for discharge by our primary doctor: [redacted]. I know this because I waited about 2 hours for her to do it. He might have had to sign off on it, but he wasn't the one with the final sign off.

When I received the checks from the insurance company I called the doctors office to ask questioning the second visit. The guy I spoke to told me I HAD to send in the checks that I received. I did tell him I was not sending in checks for a follow up that I nor my daughter recall. I did use a loud voice but NEVER was I belligerent.

Yes we then called the doctors office and when we questioned it with the staff they had the doctor call my daughter back. He absolutely spoke to her. She remembers how he made the comment that maybe she was medicated at the time. She explained she was on [redacted] not pain meds.

Never once did we receive a paper bill. I never disputed that we received a phone call. When we received the call I called them back immediately and I was told they couldn't speak to me they ONLY needed to talk to my daughter. So I had her call them back, since at the time she worked in with me. During those conversations we did inform them we were questioning the second visit and we were requesting paperwork from the hospital. Yes the hospital finally sent me the paperwork. However if you are not in the medical profession it is hard to understand.

I do not believe in bending the truth, it goes against my beliefs, I have nothing to hide and told it like it was. I have no problem with paying for services that were rendered. Yes my daughter is 24 years old, but this is the first time something like this has ever happened to her and I was holding her hand through it like a tight nit family should do. this is why I spent every moment I was allowed with her in the hospital. I would arrive at 8am and leave at 10:30 -11pm each day.

Collections NEVER contacted us directly I was the one who initiated the phone calls after getting the number from the office who directed me to billing who directed me to collections. I was told by the office I could only speak to billing. billing then told me I could only speak to collections. Collections would not give me anything in writing stating that they do not add anything to the amount. They only collect what the doctors office sends to them. I only contacted Revdex.com after I was given the run around and was only getting more upset because no one wanted to work with me on resolving the issue.

I stated in my original complaint "she told him she wasn't prescribed nor given any mind altering drugs. She was only on [redacted] not pain killers. So basically it was her word against his and ended the conversation". No he did not say my daughter was "mentally incapacitated" he applied it.

I was NOT sent to collections until the [redacted] of February (ironically it was the same day I called to say the checks were being mailed). Knowing that they were kept in the loop this should have never happened. There were also multiply phone conversations informing them the original checks were lost and we were obtaining the records from the hospital. No checks were going to be mailed until I confirmed the charges with the insurance company.

When the medical records were received we read through them, but because we are not in the medical field they were hard to understand, NOT that they were illegible.

I was NEVER forced to pay, I paid when the checks were received by me the second time and I after I received the medical records. Why is it that ONLY I or my daughter are not telling the truth???

I have a doctor who was paid for his services and who is unwilling to remove a fee for a collection bill that is charged by him NOT the collection company. I know for a fact that the fee could have been removed the same day it was supposedly issued. but he would rather collect another $250 from someone for nothing done.

In order for the Revdex.com to appropriately process your response, you MUST answer the question above.

(Sorry for the late response as I am in Florida dealing with [redacted].)

Sincerely,