Kingdom Purposes, Inc.

In response to your letter on 3/14/16 regarding Ms. [redacted] complaints regarding her we and billing at Greenwood Pain Management, we offer the following:Patient states she was referred to Greenwood Pain Management for a "consult" on 8124/15 by her family physician and felt like x-rays and a urine...

sample was "a lot".Clinic: Her PCP, John [redacted] MD, stated on his referral form; "External referral to evaluate. develop & implement Tx plan of care for "chronic pain". Dr. [redacted] referral was reviewed then Dr. Doraswamy performed an exam, ordered x-rays to assess a diagnosis and then recommended a plan of treatment. It is our clinic protocol to examine the patient, order necessary x-rays and a urine screen on their initial visit.2. Patient: discusses a bill from Quicktox lab that was out of her network.Clinic: The patient signed the Quicktox test requisition form and received a copy of said form. As a courtesy to patients we check insurance for eligibility and benefits. Ultimately the patient is responsible for their own insurance. We do not perform eligibility and benefits for the confirmation lab, The patient could have checked with Quicktox or declined the urine screen until she verified if the lab was in her network.Our charges for the drug screen were $180. Her Insurance allowed $84.27 which wasapplied to her deductible, so the insurance did not pay our clinic. The remainder of the $180 was written off. The patient received $84.27 credit toward her deductible and she is responsible for paying that amount to our clinic. It will not be written oft.The treatment plan for the patient included injections. While patients are in treatment they may receive narcotic pain medications which require initial and periodic urine drug screen. The patient signed a "Controlled Substance (narcotic) Agreement" and specifically initialed the line agreeing to urine screening.Furthermore, The Indiana Medical Licensing Board adopted Senate Enrolled Act 246 which states in part:"At any time the physician determines that it is medically necessary, whether at the outset of the treatment plan, or any time thereafter, a prescribing physician shall perform or order a drug monitoring test that must include a confirmatory test using a method selective enough to differentiate individual drugs within a drug class."It is our position that we acted in accordance with her primary care physician's referral/request. In addition, we followed our clinic protocol which is consistent with DEA guidelines and the Indiana Medical Licensing Board. Finally, we followed the decision tendered by Cigna in regard to the patient's charges.If there are further questions, we would be happy to respond.Sincerely, Mark [redacted]Greenwood Pain Management