Kids Doc of Southern California Medical Group Inc

Took my one year old to kids doc urgent care SundayWaited hoursGo back to a room wait more minutesThe dr that "treated" us was very rude! Dismissive of my concernsRolled her eyes! Seemed very sarcastic and just didn't careSaid "virus" nothing they could doEven cold to my very sick child
Next day took her to our pediatrician and she has pneumonia!! Tell me the kids doc dr couldn't have diagnosed something like pneumonia a day prior?!

[redacted]Revdex.comReference # [redacted]September 3, 2015Dear Ms. [redacted]:I appreciate you bringing this issue to our attention.Response to #1As per the chart notes, both patients were diagnosed correctly and treated appropriately with a 5 daycourse of Zithromax which is standard of...

care. There is an option to give the medication for three daysbut this could potentially result In more gastrointestinal upset. Please refer to the following insert fromdrugs.(om for additional information. http://www.drugs.com/dosage/zithromax.htmlResponse to #2:Unfortunately, this is more a reflection of the patient's insurance policy and the amount of his/herdeductible and not the result of any policy KidsDoc Urgent Care may have. It is customary to offer acash discount if the patient does not have insurance or prefers not to utilize his insurance at the time ofthe office visit. However, if the patient presents an insurance policy for us to bill, we ·are obliged to billthe insurance company accordingly. Whether the insurance policy has a nominal copay versus a largedeductible, this is a function of the individual insurance policy and ultimately his or her premium.As per the case(s) in question, Mr. [redacted] has a high deductible plan, for which he is responsible for thefirst 5000$ in medical services rendered per calendar year before the insurance starts to reimburse anymonies for the services billed. Since the deductible for the year 2015 had not been met, his insurancecompany did not reimburse any monies for the services in question. He did however receive anegotiated discount that was applied towards his deductible. No monies were reimburse to our officeand since the patient had not reached his deductible and did not pay a copay, he was billed the amountof 104.11$.To clarify, the bill was for 200$ per occurrence and after an Insurance adjustment or discount, 104.11$was applied towards his deductible. The 95.89 was not reimbursed to our office but rather a negotiateddiscount by his insurance. AS such, Mr. [redacted] is responsible for the full 104.11 $ per occurrence.As per the overall charge, Kidsdoc is an after-hours urgent care and as such, bills accordingly and is at afair market level. Mr. [redacted]'s insurance negotiated a substantial discount from our traditional rate and asthe result, his bill is a reflection of this preferred status. If his children had been seen at the Emergencyroom, the charges would likely have been substantially more.Insofar as a cash discount, this would have been offered to the patient if he had not presented hisinsurance policy for billing at the time services were rendered. If he had paid cash, none of the moniesapplied towards his deductible would have been realized and Mr. [redacted] would still need to satisfy thisportion of his deductible before any monies would be paid towards any future medical services. As itturns out, his contracted rate was lower than our cash rate. He has already received a 95.89$ discountfrom our usual rate and a 45.89$ discount from our cash rate. Simply put, the office visit was $104.11(and not the stated 200$) and any further discount at this time would not be possible.This is an unfortunate situation and often, patients are not aware of the extent of their deductible, norare they aware that they are financially responsible for all payments until the deductible has been met.So, as you can see, this is truly not a reflection of KidDoc policies but more a function of the insurancecompanies and the insurance policies patrons select.Yours Truly,[redacted] MD FAAP

Review: We took our two children to Kids Doc after hours urgent care at the recommendation of a friend. Our service was expedient and appeared on the surface as sufficient to address both children's illness. The physician provided prescriptions for 10 days worth of antibiotic treatment for both girls and sent us home. Within a few days one daughter was becoming increasing sick and we needed to take her to our family physician. Our physician wondered why the Kids doc physician treated her with an 10 day therapy plan instead of a 3 day high dose plan to alleviate the illness. Complaint #1 is regarding additional costs incurred after leaving kids docs.Complaint #2 and the main issue relates to their billing practices. We currently have blue cross and blue shield [redacted]th insurance. Kids doc billed $200 for the office visit, which my insurance paid $95.89. We then received a bill from Kids Doc stating we owe an additional $104.11 which represent the amount of our deductible. Thinking the charges for an office visit which took roughly 15 minutes were out of line I called the Kids Doc office. My question for the office personnel was "How much is an office visit if I have no insurance at all?" She responded $150 flat fee.Two points : one they should have disclosed the options around cash payment verses payment thru an insurance policy. Secondly, it seems ethically wrong with [redacted]thcare as a whole that physicians, hospitals and others can exploit the patient with insurance to increase their bottom line profitability. This is one small example of what's wrong with the [redacted]thcare industry as a whole. Although their unethical billing practices are in line with what others are doing, I refuse to be exploited any longer.Desired Settlement: I'm willing to pay Kids Doc an additional $54.11 to bring the totals up to the cash billing amount of $150.

Business

Response:

[redacted]Revdex.comReference # [redacted]September 3, 2015Dear Ms. [redacted]:I appreciate you bringing this issue to our attention.Response to #1As per the chart notes, both patients were diagnosed correctly and treated appropriately with a 5 daycourse of Zithromax which is standard of care. There is an option to give the medication for three daysbut this could potentially result In more gastrointestinal upset. Please refer to the following insert fromdrugs.(om for additional information. http://www.drugs.com/dosage/zithromax.htmlResponse to #2:Unfortunately, this is more a reflection of the patient's insurance policy and the amount of his/herdeductible and not the result of any policy KidsDoc Urgent Care may have. It is customary to offer acash discount if the patient does not have insurance or prefers not to utilize his insurance at the time ofthe office visit. However, if the patient presents an insurance policy for us to bill, we ·are obliged to billthe insurance company accordingly. Whether the insurance policy has a nominal copay versus a largedeductible, this is a function of the individual insurance policy and ultimately his or her premium.As per the case(s) in question, Mr. [redacted] has a high deductible plan, for which he is responsible for thefirst 5000$ in medical services rendered per calendar year before the insurance starts to reimburse anymonies for the services billed. Since the deductible for the year 2015 had not been met, his insurancecompany did not reimburse any monies for the services in question. He did however receive anegotiated discount that was applied towards his deductible. No monies were reimburse to our officeand since the patient had not reached his deductible and did not pay a copay, he was billed the amountof 104.11$.To clarify, the bill was for 200$ per occurrence and after an Insurance adjustment or discount, 104.11$was applied towards his deductible. The 95.89 was not reimbursed to our office but rather a negotiateddiscount by his insurance. AS such, Mr. [redacted] is responsible for the full 104.11 $ per occurrence.As per the overall charge, Kidsdoc is an after-hours urgent care and as such, bills accordingly and is at afair market level. Mr. [redacted]'s insurance negotiated a substantial discount from our traditional rate and asthe result, his bill is a reflection of this preferred status. If his children had been seen at the Emergencyroom, the charges would likely have been substantially more.Insofar as a cash discount, this would have been offered to the patient if he had not presented hisinsurance policy for billing at the time services were rendered. If he had paid cash, none of the moniesapplied towards his deductible would have been realized and Mr. [redacted] would still need to satisfy thisportion of his deductible before any monies would be paid towards any future medical services. As itturns out, his contracted rate was lower than our cash rate. He has already received a 95.89$ discountfrom our usual rate and a 45.89$ discount from our cash rate. Simply put, the office visit was $104.11(and not the stated 200$) and any further discount at this time would not be possible.This is an unfortunate situation and often, patients are not aware of the extent of their deductible, norare they aware that they are financially responsible for all payments until the deductible has been met.So, as you can see, this is truly not a reflection of KidDoc policies but more a function of the insurancecompanies and the insurance policies patrons select.Yours Truly,[redacted] MD FAAP