Howard S. Bookbinder, O.D.

May 14, 2015The following is in response to the information provided in the above noted complaint regarding this patient’s experience in my office:The patient referenced in this matter presented for eye health and vision examination 4/9/with concerns regarding poor distance
visionThis was her first visit to our office.Refractive examination indicated a change in glasses prescription which significantly improved her distance visionShe was given the option of distance vision or multifocal correction, took her written Rx with her, and had a distance correction filled which helped clear her distance visionDuring the eye health examination a small depigmented area was noted on the retina of the right eyeIt was explained to the patient that this could be a drusen which is a benign degenerative change to the retina or it could be indicative of future concerns as a precusrsor to macular degenerationThis was visible in the central area of the retina which does not require dilationOur office standard has always been to schedule dilation visits, when necessary, at a separate visit so as not to compromise vision measurements and to allow the patient to plan for the vision effects of the dropsThe patient was instructed to return in about one month to re-evaluate the retina for changesShe was scheduled and returned 5/11/to note the appearance of the central right retina, she was dilated at that time to also check peripheral retinaThe primary purpose of this visit was recheck the suspicious areaShe was scanned using an OCT (Optical coherence tomography), which affords an MRI like view of the retinaFortunately, this confirmed the drusen diagnosis (which can still potentially lead to macular degeneration) as opposed to an active macular degenerative changeThe patient was advised of such and told of the importance of routine yearly check-ups and to notify our office should she experience any vision changesAs in most offices, our practice routinely charges fees for patient visits and ancillary testingIn this case we typically present the patient with a charge slip indicating the office visit and the test procedure itself (much like a primary care physician suggesting a blood test or stress test and then scheduling an appointment to go over the results)I do not know where or when this patient was told there would be no charge for subsequent visitsI have discussed the matter with each of my three staff members (who share a combined experience of better than years here), and none recall this conversation with the patientAt check-out the patient was presented with a fee slip for her office visit and for the OCT scan which calmed our concerns regarding eye healthThe patient claimed, at that time, that she was told there would be no charge for this follvisitMy staff member came to me with this information and verified that she has no recall of patient being told there would be no feesI instructed my staff to tell the patient that we typically do charge for office visits here but if she feels that she was misinformed we’ll chalk it up to a miscommunicationI instructed front desk staff to waive our office fee ($70), and limit the patient charge to the test procedure ($90)Patient paid the fee and leftMy next communication came via email at 12:(5/11/2015) telling me that the she would have “come back every year”However, because we charged her she considers this to be “a scam” and will report us to “*** ***”We tried to contact the patient via phone and left a message to discuss her concerns and to confirm with her that we had indeed waived the visit portion of the feeI received another email 4:am (5/13/2015) advising that there is “nothing to talk about”, “this is a scam”, and that she is reporting this scam to TV newsYour Revdex.com letter arrived later in the mailIn Synopsis, if during a routine examination a suspicious retinal defect is detected I feel obliged to have the patient return and look furtherI utilize the latest examination equipment to evaluate eye health and do routinely charge for additional test proceduresI typically charge patients for our office visits which go beyond the routine examinationMy office staff does not recall telling this patient she would be seen at no charge but did waive our office visit fee in view of the patient’s claimsI did not waive the test fee for the OCT which was necessary to evaluate this patient as it is certainly not part of a routine eye examinationThe patient refused to respond to our phone call to discuss her concernsI trust the above offers a different light to this situationI had thought we had resolved this issue by waiving the office visit fee for this patientI cannot operate an up-to-date office on a no charge basisHoward SBookbinder, O.D

[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: I was indeed told twice that there would be no charge for recheck - once by Ann when checking out and again when the office called me at home- because I did not schedule the exam when paying my bill at first visit. Yes, I was told that it was part of initial routine eye exam. And I did report it to [redacted] and [redacted] at Channel 3 because I feel so strongly that this was a very misleading way to have a patient come back and get more money from them. If he knew that they where going to do an MRI of the eye and there would be extra charges, I should have been given an estimate of what the extra charges would be at follow up visit, instead of being told twice that there would be no charge. He is an optician- basically someone that you go to for eye glass prescriptions. If some type of serious eye abnormality is suspected like "risk of macular degeneration"  he should have referred me to an opthomologist and my employee health insurance would have paid for the tests that I needed. 
Regards,
[redacted]

May 14, 2015The following is in response to the information provided in the above noted complaint regarding this patient’s experience in my office:The patient referenced in this matter presented for eye health and vision examination 4/9/2015 with concerns regarding poor distance vision. This was her...

first visit to our office.Refractive examination indicated a change in glasses prescription which significantly improved her distance vision. She was given the option of distance vision or multifocal correction, took her written Rx with her, and had a distance correction filled which helped clear her distance vision.During the eye health examination a small depigmented area was noted on the retina of the right eye. It was explained to the patient that this could be a drusen which is a benign degenerative change to the retina or it could be indicative of future concerns as a precusrsor to macular degeneration. This was visible in the central area of the retina which does not require dilation. Our office standard has always been to schedule dilation visits, when necessary, at a separate visit so as not to compromise vision measurements and to allow the patient to plan for the vision effects of the drops. The patient was instructed to return in about one month to re-evaluate the retina for changes. She was scheduled and returned 5/11/2015 to note the appearance of the central right retina, she was dilated at that time to also check peripheral retina. The primary purpose of this visit was recheck the suspicious area. She was scanned using an OCT (Optical coherence tomography), which affords an MRI like view of the retina. Fortunately, this confirmed the drusen diagnosis (which can still potentially lead to macular degeneration) as opposed to an active macular degenerative change. The patient was advised of such and told of the importance of routine yearly check-ups and to notify our office should she experience any vision changes.As in most offices, our practice routinely charges fees for patient visits and ancillary testing. In this case we typically present the patient with a charge slip indicating the office visit and the test procedure itself (much like a primary care physician suggesting a blood test or stress test and then scheduling an appointment to go over the results).I do not know where or when this patient was told there would be no charge for subsequent visits. I have discussed the matter with each of my three staff members (who share a combined experience of better than 35 years here), and none recall this conversation with the patient. At check-out the patient was presented with a fee slip for her office visit and for the OCT scan which calmed our concerns regarding eye health. The patient claimed, at that time, that she was told there would be no charge for this follow-up visit. My staff member came to me with this information and verified that she has no recall of patient being told there would be no fees. I instructed my staff to tell the patient that we typically do charge for office visits here but if she feels that she was misinformed we’ll chalk it up to a miscommunication. I instructed front desk staff to waive our office fee ($70), and limit the patient charge to the test procedure ($90). Patient paid the fee and left.My next communication came via email at 12:08 (5/11/2015) telling me that the she would have “come back every year”. However, because we charged her she considers this to be “a scam” and will report us to “[redacted]”. We tried to contact the patient via phone and left a message to discuss her concerns and to confirm with her that we had indeed waived the visit portion of the fee. I received another email 4:26 am (5/13/2015) advising that there is “nothing to talk about”, “this is a scam”, and that she is reporting this scam to TV news. Your Revdex.com letter arrived later in the mail.In Synopsis, if during a routine examination a suspicious retinal defect is detected I feel obliged to have the patient return and look further. I utilize the latest examination equipment to evaluate eye health and do routinely charge for additional test procedures. I typically charge patients for our office visits which go beyond the routine examination. My office staff does not recall telling this patient she would be seen at no charge but did waive our office visit fee in view of the patient’s claims. I did not waive the test fee for the OCT which was necessary to evaluate this patient as it is certainly not part of a routine eye examination. The patient refused to respond to our phone call to discuss her concerns.I trust the above offers a different light to this situation. I had thought we had resolved this issue by waiving the office visit fee for this patient. I cannot operate an up-to-date office on a no charge basis.Howard S. Bookbinder, O.D.