MedVet Medical & Cancer Centers for Pets

I reviewed the response made by the business in reference to complaint ID [redacted], and find the resolution is satisfactory to me.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
I do not accept MedVets’ response.  They did not address all of the concerns, including but not limited to concerns regarding medical necessity, backdating charges, and the fact that we almost unnecessary put our dog down.  In addition, the response does not comport with reason or fact, as it is replete with inaccuracies.  
 
 
1.       I asked for an estimate of the ENTIRE treatment, several times.  I was informed I would be given an estimate of the ENTIRE treatment.  The ER Doctor, Dr. [redacted], documented in the medical record: “I advised the owner that the state that their dog is in, that many days of hospitalization are needed.  I talked about the cost of treatment and the owner decided to hospitalize their pet...” (p. 48).  To now claim that it's estimate was only for a 1/4 day is disingenuous and contradicts Medvet's own statements.  For a business to present a written document that is contradictory to prior and contemporaneous verbal statements to a customer is at a minimum, a questionable practice—even more so considering the emotional state of customers (including myself) during this time. 
 
Moreover, this new ¼ day estimate claim is not supported by a plain reading of the document and simply does not make sense.  Within the written estimate is language about a ¼ day with an internal specialist, in addition to other items, including time and expenses in the ICU and “continued care".   Indeed, I was informed that [redacted] would not even see the above-referenced internal specialist until the following morning (over 1/4 day later).  I was also informed that the bulk of [redacted]’s time would be spent resting, hooked up to IVs, which would not seem to necessitate either department (especially since our veterinarian had provided those services for several days prior).  Based on the conversation I had with Dr. [redacted], I believed that after a ¼ day of treatment with the internal medicine department, Medvets would continue my dog's care until he was well enough to be discharged and the estimate would correspond accordingly.  
 
Also, at that time, we were required to pay a deposit for ½ of the amount of the high end of the estimate.  Is it Medvet’s contention now that its practice and process is to require a deposit of ½ of the amount of a ¼ day of treatment?  Is it also Medvets' contention that it requires a signed written estimate for only ¼ day of treatment but seeks verbal consents for the subsequent (and much-larger) charges?  Again, not only does this not make sense from a practical standpoint, it raises questions about its communicative and billing practices.  
 
 
2.       Instead of addressing this concern, Medvets appears to provide a definition of the word “common.”  This response does not obviate or even address the fact that we were informed by Medvets (and others) that [redacted]’s condition was common.  I’m not a medical professional and I was relying on the statements of medical professionals in making decisions regarding my dog’s care.  This is why I repeatedly asked Dr. [redacted] for an accurate estimate and told her numerous times that I needed a good estimate as to how much it would cost to treat his condition.  If that is not a determination that they can make in their professional judgment and/or experience, then they should not make those statements.  
 
 
3.       These statements are great illustrations of the vagueness and confusion of Medvet’s communications.   This appears to be a form statement that is not specifically related to or was drafted in response to my concern and as such, I am unable to respond.     
 
 
4.       My wife made several calls to the Practice Manager to discuss the status of the bill.  She did not receive a return call from the Practice Manager.  Conveniently, messages, incoming calls and in-person communications are apparently not recorded by this practice.   I am not surprised to learn that Medvet’s planned, orchestrated phones calls are the only conversations recorded.  
 
Yes, we met with the Practice Manager and Dr. [redacted]—over a month after [redacted]’s discharge and my wife’s initial calls to the Practice Manager.  
 
 
 
5.       We did meet with Dr. [redacted].  During that conversation, we discussed [redacted]’s care as well as billing concerns.  During that conversation, Dr. [redacted]:
 
•         admitted that she could see how the estimate was misleading;
•         apologized for the communication issues;
•         advised us that [redacted] was getting the best care and that she was “the best”;
•         advised us that if she were in our position, she would choose to keep [redacted] at Medvets; and
•         told us that [redacted] needs to be at 24-hour care facility and not a veterinarian’s office.
 
 
The Medical Director did offer to transport [redacted] to his veterinarian; however, conveniently omitted are the facts that the offer was contradictory to Dr. [redacted] advice, was made when our veterinarian’s office was closed, and that the transport would have been at our expense.  
 
 
 
6.       My concern was based on Medvets statement that its billing cycle is from 9AM-9AM (the “PM” was an error and does not substantively affect the concern).  My concern about charges beyond 9:00AM on Tuesday November 25th when my dog was in my care, remain unaddressed.  
 
 
7.       I do not know any details about the “glitch” other than what was represented to me by Medvets.  Again, we were informed the “glitch” only happened to our statement.  We were informed of this error and provided a chronological bill only after we questioned the statement AND over a month after we received the statement.  
 
We did attend a meeting; however, all the questions were not answered.  At the onset of the meeting, we were informed that medical decision-making and medical care questions would not/could not be answered.  In addition, they were unable to provide answers to several billing questions until a week later—including the questions about charges after [redacted] was in my care.  This is when we were told that Medvets’ response was to “backdate” several of the charges to the prior day and to claim that one of the fees is an exception to the 9am-9am billing schedule. 
 
 
In sum, I am disappointed in Medvet’s continuing lack of accountability which is only further illustrated by its untimely, incomplete response.  From the onset, in my opinion, Medvets has been selective in its documentation and misleading in its communication.  
Regards,
[redacted]

[redacted] bought [redacted] to Cincinnati MedVet Medical and Cancer Centers for Pets on 1/29/15. [redacted] was taken to the ER immediately while the owner completed the rush back forms giving consent for immediate care including resuscitation. Attempts to resuscitate [redacted] were initiated but not...

successful. First let me express my sincere sympathy and condolences for the loss of [redacted]. We clearly empathize with you and regret your loss of [redacted].
While we may differ with your perspective of some of the facts you outline in your letter, we can't help but understand where those feelings and views come from. Please let me reassure you that while our staff did not exhibit empathetic, compassionate behaviors based on your feedback, we acknowledge that it is clearly unacceptable and not congruent with the best MedVet Experience. However, I can assure you that [redacted] care was not compromised. We appreciate the feedback and can guarantee you that we have addressed directly the staff's interface with you and their behaviors. We take an aggressive, but practical approach to patient care in our Emergency Room that it tailored to an individual patient's needs. [redacted] received this individualized care and resuscitation, but it was not adequate and can never be fully adequate to handle all acute events in our patients. This is why we had you sign the rush back form upon arrival as [redacted] was already agonal. We regret his loss, but remain steadfast that our team did their best to deal with his presenting condition.
Since our careful review of the circumstances did not find fault in our level of care, we find it difficult to rationalize your request to refund all your money. That said, we do not wish to profit from your loss and would be willing to provide a good will gesture and should not be construed as anything but that. We will waive the Emergency visit charge of $101.00 and half of the charges for CPR package (cost @ $99.91). The charges for the cremation with ashes returned is $163.00 and you have stated you are in agreement to pay these charges. The balance of the charges due of the $492.82 is therefore $319.82; $178.82 will be credited back to your Mastercard if you are in agreement. 
We wish you the very best during the worst of circumstances and hope you will understand our position and accept our goodwill offer.
 
[redacted]
Senior VP of Development
MedVet Medical & Cancer Center for Pets

Ms. [redacted] brought her dog [redacted] to the MedVet
Emergency Department for a second opinion on 5/25/2015, after having been
evaluated elsewhere for his illness.  Diagnostic
testing was performed, revealing anemia and very low protein in Fritz’s
blood.  Admission to the hospital...

for
further care and treatment was offered, but was declined.  Ms. [redacted] returned with [redacted] on May 28th,
and [redacted] was seen by the Internal Medicine service.  Dr. [redacted], DVM, Dipl. ACVIM
evaluated Fritz, and [redacted] was hospitalized until 5/29/15 for his illness.  After evaluating all previous diagnostic
testing, Dr. [redacted] advised Ms. [redacted] that [redacted] most likely had the low
blood protein (albumin) due to an intestinal problem called protein losing
enteropathy.  This is a very serious
condition, and is most commonly caused by an immune-mediated disease called
inflammatory bowel disease (IBD).  Other less
common causes were also discussed.  Dr.
[redacted] and Ms. [redacted] decided that [redacted] should be treated empirically for
the most likely diagnosis of inflammatory bowel disease (IBD).
For the presumptive diagnosis of IBD, Dr. [redacted] prescribed
prednisone and cyclosporine.  Prednisone
is an immunosuppressive and anti-inflammatory steroid.  It is relatively inexpensive, but can have
significant side effects such as increased drinking, urinating and panting.  Cyclosporine is a more specific kind of
immunosuppressive, with less side effects. 
While prednisone alone can be used, veterinary internists often use a
drug such as cyclosporine in order to be able to reduce the dose of prednisone
more rapidly over time, reducing undesirable side effects, and still achieve a good
response of the inflammatory bowel disease. 
Therefore, this was a medically appropriate choice.  Unfortunately, cyclosporine is a more
expensive drug than prednisone.  While
cyclosporine can be used for cancer treatment in conjunction with more
chemotherapy drugs, it is also widely used for immune-mediated and inflammatory
conditions.  In addition, Dr. [redacted]
prescribed 3 other drugs for the treatment of Fritz’s condition.   
The owner of every dog that is seen at MedVet receives
written client discharge instructions at the time they take their pet home from
the hospital.  These instructions inform
the owner about the doctor’s assessment of the patient as well as what drugs
are being prescribed, in detail.  The
description of each drug states what the drug is, what it is for, what the most
common side effects may be, and the dosing schedule that should be
followed.  For example, the discharge
instructions for [redacted] stated that cyclosporine is an immunosuppressant, and
included a list of side effects to watch for.  Because Dr. [redacted] had already discussed her
pet’s condition and treatment recommendations with her, the discharge
instructions were reviewed with Ms. [redacted] by a veterinary technician.  Veterinary technicians, like nurses, are well
equipped to be able to have these discussions with the pet owner.  Most of our clients value and appreciate the
training and client communication skills of our veterinary technicians.  The discharge instructions are discussed with
clients in either an examination room or a consultation room.  The consultation rooms, although also used
for euthanasia, are often used for client education and client discharge
discussions. 
Once a prescription medication leaves the hospital with a
client, by pharmacy law it cannot be returned and re-dispensed to another
patient.  Prescription medications are therefore
not returnable, and this is stated on the bottom of our invoices.
Our finance department reached out to Ms. [redacted] on
September 29th to request payment for a balance on her account of
$967.01. During this conversation, Ms. [redacted] expressed that she would like
to talk with someone about getting a refund for the cyclosporine.  Anastacia Internal Medicine
manager called and left her voicemail on September 29th, but never
received a call back from Ms. [redacted].  On
10/22/15, Ms. [redacted] brought the medication back in and left it at the reception
desk.  [redacted] reached out to her again
by phone to discuss the situation and answer any questions the client had, again
with no return phone call.  On 11/4/2015
the owner spoke with our finance department and asked again to receive a phone
call to discuss the medications.  During
this conversation Kristi (finance employee) reminded the owner that once
medications leave the building they cannot be returned, as is stated on the
bottom of our invoices.  [redacted]
reached out to Ms. [redacted] again, but did not hear back from the owner.  There was no additional contact from Ms.
[redacted] until March 10th of 2016. 
Amanda D[redacted], the ER manager was put in contact with Ms. [redacted] and
she discussed her concerns for the first time with someone from the clinical management
team.  Amanda D[redacted] told her that MedVet
needed some additional time to look into her concerns and that Amanda would
contact her the following the week.  Amanda
phoned Ms. [redacted] with follow-up, but was unsuccessful in reaching her.
Ms. [redacted] still has an outstanding balance of $570.80
with our company.  Even though our clear
expectation is that pet health care services should be paid for at the time of
discharge from the hospital, Ms. [redacted] still has not paid her balance in
full more than 10 months after the services were provided. Her last payment to
us was made on 10/22/15, and the bill was sent out to collections on
1/29/15.  Several attempts over a 6 month
period were made to reach her to discuss her concerns about the cyclosporine, with
no success.  As a good faith gesture, we
are willing to discount her balance by the amount of the cyclosporine, which is
$127.70.  We will, however, expect Ms. [redacted]
to pay the remainder of her balance for the services that were provided by Dr.
[redacted] and our animal health care team for her dog Fritz.

I reviewed the response made by the business in reference to complaint ID [redacted], and find the resolution is satisfactory to me provided they also remove the report from my credit record.In response to the statement by Melissa S. W[redacted], DVM I will note the following facts that were omitted or overlooked:I did bring my dog to MedVet on 5/25/2015 and received wonderful care under Warren M[redacted], DVM.   Dr. M[redacted] did a comprehensive workup and did offer further care  but we agreed [redacted] would be more comfortable being cared for at home.   [redacted] did required some additional fluids and workup and had a short stay from 5/28 to 5/29/2015.   During that stay I called MedVet on 5/28 at 11:49 am, 5/28 at 12:44pm, 5/29 7:42 am, 5/29 1:06 pm, and 5/29 4:55 pm.  There were significant wait/hold times each time I called.  In my last call I stated I would come into see how [redacted] was doing and discuss his needs.  Arriving at MedVet there was over a 20 minute wait before I could get any information.  Then I was asked to wait in the euthanasia room and after another 15 minutes a vet tech came to hand me a bag of medication.  I disagree with Melissa S. W[redacted] DVM in her comparison of Med Tech to "like nurses."  I too am a medical professional and their is no comparison of level of training for a Vet Tech and nurse.  While I value the training of a Vet Tech - when dogs are having significant medical issues one would expect to have a discussion and full explanation by the Veterinarian - that did not happen.   Exhausted from waiting lengthy times in the MedVet waiting room and euthanasia room I left with no clear explanation of why my dog would have been placed on cyclosporine and a large bottle of steroids even though I wad advised Dr. [redacted] that I was advised from my vet that he should NOT have steroids due to previous liver failure.   When dog owners are being pressured by the front desk to take out a loan to cover the cost of MedVet care, while still struggling with a sick animal, it is sad that the front desk was more willing to spend time discussing loan options than the Vet time spent in explanation of care received.   MedVet is a huge facility that can certainly afford to have more reasonable accommodations than escorting people into euthanasia rooms as a means of education. As for the phone calls, there were numerous calls to MedVet to discuss the bill that were never returned (thank goodness for call tracking).   I originally called 10/22/15.   When no return call was received I called again on 10/28 and spoke with Lisa expressing my concern that no one had called me.  On 10/29/15 I spoke with [redacted] and she stated she would look into the matter of obtaining credit for sealed medication that was never opened and has an expiration date of late 2017.   I heard nothing and again called on 11/4/15.   While the finance staff again tried to convince me to take out a loan to cover the costs, there was NO discussion regarding medication with the finance staff (That would not be an appropriate discussion with a staff person who has nothing to do with the care of the animals).   I called again on 11/6/15 and did not receive a call back from [redacted].   I reached out to MedVet on 1/24/16 and could not be given an answer about the medication (3 months after it was accepted back and is in their possession).  I do have an outstanding balance and will pay the $443.10.   I will also note that I have since had to accompany a friend to OSU Emergency Vet Hospital and we received a much higher level of care at that facility - with full explanations from the Vet.  I will also note that [redacted] is doing very well thanks to our regular Vet who advised me how to treat the "presumed Inflammatory Bowel disease."  [redacted] never took the Prednisone, Amoxicillin or other drugs thrown at him in presumptive care.    I cannot say enough about the level of quality care received from Dr. M[redacted], but I also know staff who have left MedVet in frustration over their practices.    I hope they take a look at staff response time, waiting room times and the inappropriate use of techs to counsel families on medication when animals are in crisis.

This client came to our facility on Saturday, October 14, 2017. Due to the diagnosis, they made thedifficult decision to euthanasia their pet. They elected to have him buried through [redacted] PetCemetery.In an effort to limit the amount of time that our clients pet would remain at our facility...

waiting for pickup by [redacted], we recently added an additional Sunday pick up to our weekly schedule.The pet was picked up on Sunday October 15, 2017 for burial services through [redacted]. Theclient contacted our office and [redacted] on Monday, October 16, 2016 and asked if it werepossible for her to bring in toys to be buried with him and was advised that it would not be a problem.Unfortunately when the client called us on Monday, we did not factor in the additional Sunday pick upand told her it was fine to bring the toys in that evening.When the owner arrived that evening with the toys, we advised her that her pet was picked up onSunday and apologized for the misinformation and confusion.We make every attempt to handle these difficult situations in a timely and respectful manner andunderstand the disappointment that she experienced. We have contacted her and offered to reduceher invoice which she agreed to.Please feel free to contact us with any further questions or concerns.Thank you,Nancy T[redacted]Hospital Director

Revdex.com:
There wasn't an option stating I will accept if that is the best I'm going to get, I'm not satisfied but I don't want to relive losing My Beloved 1st and only Dog at that time or their coldness and their unwillingness to bend at all in customer relations. 
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.
Regards,
[redacted]