Mid-Atlantic Urology Associates

Date of service 1/28/This is a response to the complaint a patient submitted regarding his recent procedure performed on January 28, The responses are somewhat cryptic at points (indicated by “[]”) due to HIPPA requirementsThe patient was referred to me by his primary care physician for an abblood testsaw him in the Office on 1/7/At that time we discussed his abblood testAfter counselling, exam and consultation I recommended the procedure that he has concerns aboutWe had a lengthy discussion regarding the technical aspects as well as the options for having the procedure under sedation or awakeWe did at that time discuss all risks and benefits of the procedureHe was given ample opportunity to ask any and all questions, and by the time he left, he appeared to understand the entire conversationThe order for the procedure was entered into my system and electronically forwarded to my scheduling staffHe was instructed that someone would be in touch with him to schedule the procedure and the Scheduling staff would mail him the specific instructionsHe appeared to understand this and again was given ample opportunity to ask any questionsThe scheduling staff called him on January 20, They fully explained the scheduling procedure and when a date and time was confirmed, they mailed the instruction packet that dayThis scheduling procedure has been performed for this specific procedure times specifically for my patients and by this Scheduling staff for this urology group's patients over the past yearsThere have been no other complaints over that time regarding the information packet, scheduling, or conveyance of informationThe day before the scheduled procedure the patient emailed through the EHR portal stating that he had not yet received the information packetThis message was passed on to the scheduling staff who called the patient directlyOn January 28, patient arrived at the surgery center for the procedureAt the time of signing the procedure consent form, he extensively complained that he had not received the information packetimmediately suggested to him that if he was uncomfortable having not received the written version of the information in advance that he should cancel the procedure and rescheduleHe decinedWe proceeded to perform the procedure per all of our discussions and his consentDuring the procedure he complained of moderate discomfort as explained in his complaintTwo separate times during the procedure after asking him the degree of discomfort, I asked him if he wanted to cancel and reschedule with IV sedationHe declinedDuring the procedure he was awake with no sedation as per his choiceThe entire procedure including technical aspects of the ultrasound portion and technical aspects of the procedure were explained to him as I proceededAt no point did I instruct him that I was injecting or applying injectable or topical anestheticThe day after the procedure (January 28,2016) he emailed me directly through the EHR portal stating: "I had a sprocedure] on me yesterday at Belle Point RdI was under the impression that was to receive a local anesthetic prior to the procedureWas that the case? Sitting down was painful on the way home and into the eveningIt is a little better nowPlease let me know if a local was applied, because I don't recall it being doneThank you.” I replied hours later: “the procedure is either sedation or awake, there is no reliable local anesthetic.” He replied hours later regarding his misunderstanding of the instructions: “t misunderstood you when we spoke at the first meetingthought the term local was used and mistakenly thought that meant local anesthetic." The term local was not usedThe procedure was described as performed with sedation or awake, On February 4, at 10:AM patient called my office and requested a call backThis was the first post procedure communication not done through the portal (email)I called the patient back approximately minutes later and documented in my chart the exchange: "called patient back....He yelled at me...he stated that in his last email he asked me to call him (he did not)I offered to give him his [procedure] results and send info to any other doctor...he refused and hung up on meI called back, he yelled againI again offered to give him his result and send to any other doctorHe hung up on me again." This was the last communication that I had with this patientI did call his primary care physician to pass on the results of the procedure immediately after that concerning conversationIn the patient's complaint to the Revdex.com he refers to a $“purchase price" and a $disputed amountThe total charge for this procedure was $including the procedure, and radiology portionsThe Contracted rate with the patient insurance company (including billed codes) is a total of $The remaining $is adjusted off per the insurance contract, do not, and I am contractually bound not to, Collect anything above the $from the patientThis patient carries high deductible insurancéI was paid a total of $for the radiology portionsA balance of $for the [procedure] was passed through to the patient as per his high deductible insurance contractAdditionally, he has a previous balance of $from the copay from his initial consultationThe patient has requested an apology for not getting him the printed pre-procedure informationThis was mailed to him of 1/20/more than a week before his scheduled procedureIt is regrettable that he did not receive this informationThe information was conveyed to him at his initial consultation, over the phone at the time of scheduling, and again when he called the day before the procedureThe patient has requested an apology for disparaging remarksI believe he is referring to the two times that I was being yelled at over the phone and attempted to give him his procedure laboratory results so that he could have the necessary medical informationHis repeatedly hanging up on me was frustrating, but repeated in an attempt to convey his medical information The patient has requested that I apologize for my nonexistent bedside mannerIt is regrettable that this was his experienceI have not heard this complaint previously or subsequent to this experienceThe patient has requested a billing adjustment in the amount of $The amount that he currently owes is $This is the amount that he is contractually required to pay for the services renderedIt is regrettable that the contract with his insurance carrier discounts these services to such a degree and equally regrettable that the predominance is passed through to himThis is frequently a problem when medical treatment is needed and patients carry high deductible insuranceWhen no treatment or intervention is required, high deductible insurance may be beneficialSincerely, Eric E [redacted] , MD

Date of service 1/28/2016This is a response to the complaint a patient submitted regarding his recent procedure performed on January 28, 2015. The responses are somewhat cryptic at points (indicated by “[]”) due to HIPPA requirements.The patient was referred to me by his primary care physician for...

an abnormal blood test. saw him in the Office on 1/7/2016. At that time we discussed his abnormal blood test. After counselling, exam and consultation I recommended the procedure that he has concerns about. We had a lengthy discussion regarding the technical aspects as well as the options for having the procedure under sedation or awake. We did at that time discuss all risks and benefits of the procedure. He was given ample opportunity to ask any and all questions, and by the time he left, he appeared to understand the entire conversation.The order for the procedure was entered into my system and electronically forwarded to my scheduling staff. He was instructed that someone would be in touch with him to schedule the procedure and the Scheduling staff would mail him the specific instructions. He appeared to understand this and again was given ample opportunity to ask any questions.The scheduling staff called him on January 20, 2015. They fully explained the scheduling procedure and when a date and time was confirmed, they mailed the instruction packet that day. This scheduling procedure has been performed for this specific procedure 116 times specifically for my patients and 996 by this Scheduling staff for this urology group's patients over the past 2 years. There have been no other complaints over that time regarding the information packet, scheduling, or conveyance of information.The day before the scheduled procedure the patient emailed through the EHR portal stating that he had not yet received the information packet. This message was passed on to the scheduling staff who called the patient directly. On January 28, 2016 patient arrived at the surgery center for the procedure. At the time of signing the procedure consent form, he extensively complained that he had not received the information packet. immediately suggested to him that if he was uncomfortable having not received the written version of the information in advance that he should cancel the procedure and reschedule. He decined.We proceeded to perform the procedure per all of our discussions and his consent. During the procedure he complained of moderate discomfort as explained in his complaint. Two separate times during the procedure after asking him the degree of discomfort, I asked him if he wanted to cancel and reschedule with IV sedation. He declined. During the procedure he was awake with no sedation as per his choice. The entire procedure including technical aspects of the ultrasound portion and technical  aspects of the procedure were explained to him as I proceeded. At no point did I instruct him that I was injecting or applying injectable or topical anesthetic.The day after the procedure (January 28,2016) he emailed me directly through the EHR portal stating: "I had a sprocedure] on me yesterday at 7759 Belle Point Rd. I was under the impression that was to receive a local anesthetic prior to the procedure. Was that the case? Sitting down was painful on the way home and into the evening. It is a little better now. Please let me know if a local was applied, because I don't recall it being done. Thank you.” I replied 2 hours later: “the procedure is either sedation or awake, there is no reliable local anesthetic.” He replied 3 hours later regarding his misunderstanding of the instructions: “t misunderstood you when we spoke at the first meeting. thought the term local was used and mistakenly thought that meant local anesthetic." The term local was not used. The procedure was described as performed with sedation or awake,On February 4, 2016 at 10:45 AM patient called my office and requested a call back. This was the first post procedure communication not done through the portal (email). I called the patient back approximately 20 minutes later and documented in my chart the exchange: "called patient back....He yelled at me...he stated that in his last email he asked me to call him (he did not). I offered to give him his [procedure] results and send info to any other doctor...he refused and hung up on me. I called back, he yelled again. I again offered to give him his result and send to any other doctor. He hung up on me again."This was the last communication that I had with this patient. I did call his primary care physician to pass on the results of the procedure immediately after that concerning conversation.In the patient's complaint to the Revdex.com he refers to a $2000 “purchase price" and a $200 disputed amount. The total charge for this procedure was $1375 including the procedure, and radiology portions. The Contracted rate with the patient insurance company (including 3 billed codes) is a total of $261.47. The remaining $1113.53 is adjusted off per the insurance contract, do not, and I am contractually bound not to, Collect anything above the $251.47 from the patient. This patient carries high deductible insurancé. I was paid a total of $80.67 for the radiology portions. A balance of $180.80 for the [procedure] was passed through to the patient as per his high deductible insurance contract. Additionally, he has a previous balance of $10 from the copay from his initial consultation.The patient has requested an apology for not getting him the printed pre-procedure information. This was mailed to him of 1/20/2015 more than a week before his scheduled procedure. It is regrettable that he did not receive this information. The information was conveyed to him at his initial consultation, over the phone at the time of scheduling, and again when he called the day before the procedure.The patient has requested an apology for disparaging remarks. I believe he is referring to the two times that I was being yelled at over the phone and attempted to give him his procedure laboratory results so that he could have the necessary medical information. His repeatedly hanging up on me was frustrating, but repeated in an attempt to convey his medical information.  The patient has requested that I apologize for my nonexistent bedside manner. It is regrettable that this was his experience. I have not heard this complaint previously or subsequent to this experience.The patient has requested a billing adjustment in the amount of $200. The amount that he currently owes is $190.80. This is the amount that he is contractually required to pay for the services rendered. It is regrettable that the contract with his insurance carrier discounts these services to such a degree and equally regrettable that the predominance is passed through to him. This is frequently a problem when medical treatment is needed and patients carry high deductible insurance. When no treatment or intervention is required, high deductible insurance may be beneficial.Sincerely,Eric E[redacted], MD

Date of service 1/28/2016
margin-bottom: 5pt;">This is a response to the complaint a patient submitted regarding his recent procedure performed on January 28, 2015. The responses are somewhat cryptic at points (indicated by “[]”) due to HIPPA requirements.
The patient was referred to me by his primary care physician for an abnormal blood test. saw him in the Office on 1/7/2016. At that time we discussed his abnormal blood test. After counselling, exam and consultation I recommended the procedure that he has concerns about. We had a lengthy discussion regarding the technical aspects as well as the options for having the procedure under sedation or awake. We did at that time discuss all risks and benefits of the procedure. He was given ample opportunity to ask any and all questions, and by the time he left, he appeared to understand the entire conversation.
The order for the procedure was entered into my system and electronically forwarded to my scheduling staff. He was instructed that someone would be in touch with him to schedule the procedure and the Scheduling staff would mail him the specific instructions. He appeared to understand this and again was given ample opportunity to ask any questions.
The scheduling staff called him on January 20, 2015. They fully explained the scheduling procedure and when a date and time was confirmed, they mailed the instruction packet that day. This scheduling procedure has been performed for this specific procedure 116 times specifically for my patients and 996 by this Scheduling staff for this urology group's patients over the past 2 years. There have been no other complaints over that time regarding the information packet, scheduling, or conveyance of information.
The day before the scheduled procedure the patient emailed through the EHR portal stating that he had not yet received the information packet. This message was passed on to the scheduling staff who called the patient directly. On January 28, 2016 patient arrived at the surgery center for the procedure. At the time of signing the procedure consent form, he extensively complained that he had not received the information packet. immediately suggested to him that if he was uncomfortable having not received the written version of the information in advance that he should cancel the procedure and reschedule. He decined.
We proceeded to perform the procedure per all of our discussions and his consent. During the procedure he complained of moderate discomfort as explained in his complaint. Two separate times during the procedure after asking him the degree of discomfort, I asked him if he wanted to cancel and reschedule with IV sedation. He declined. During the procedure he was awake with no sedation as per his choice. The entire procedure including technical aspects of the ultrasound portion and technical
 
aspects of the procedure were explained to him as I proceeded. At no point did I instruct him that I was injecting or applying injectable or topical anesthetic.
The day after the procedure (January 28,2016) he emailed me directly through the EHR portal stating: "I had a sprocedure] on me yesterday at 7759 Belle Point Rd. I was under the impression that was to receive a local anesthetic prior to the procedure. Was that the case? Sitting down was painful on the way home and into the evening. It is a little better now. Please let me know if a local was applied, because I don't recall it being done. Thank you.” I replied 2 hours later: “the procedure is either sedation or awake, there is no reliable local anesthetic.” He replied 3 hours later regarding his misunderstanding of the instructions: “t misunderstood you when we spoke at the first meeting. thought the term local was used and mistakenly thought that meant local anesthetic." The term local was not used. The procedure was described as performed with sedation or awake,
On February 4, 2016 at 10:45 AM patient called my office and requested a call back. This was the first post procedure communication not done through the portal (email). I called the patient back approximately 20 minutes later and documented in my chart the exchange: "called patient back....He yelled at me...he stated that in his last email he asked me to call him (he did not). I offered to give him his [procedure] results and send info to any other doctor...he refused and hung up on me. I called back, he yelled again. I again offered to give him his result and send to any other doctor. He hung up on me again."
This was the last communication that I had with this patient. I did call his primary care physician to pass on the results of the procedure immediately after that concerning conversation.
In the patient's complaint to the Revdex.com he refers to a $2000 “purchase price" and a $200 disputed amount. The total charge for this procedure was $1375 including the procedure, and radiology portions. The Contracted rate with the patient insurance company (including 3 billed codes) is a total of $261.47. The remaining $1113.53 is adjusted off per the insurance contract, do not, and I am contractually bound not to, Collect anything above the $251.47 from the patient. This patient carries high deductible insurancé. I was paid a total of $80.67 for the radiology portions. A balance of $180.80 for the [procedure] was passed through to the patient as per his high deductible insurance contract. Additionally, he has a previous balance of $10 from the copay from his initial consultation.
The patient has requested an apology for not getting him the printed pre-procedure information. This was mailed to him of 1/20/2015 more than a week before his scheduled procedure. It is regrettable that he did not receive this information. The information was conveyed to him at his initial consultation, over the phone at the time of scheduling, and again when he called the day before the procedure.
The patient has requested an apology for disparaging remarks. I believe he is referring to the two times that I was being yelled at over the phone and attempted to give him his procedure laboratory results so that he could have the necessary medical information. His repeatedly hanging up on me was frustrating, but repeated in an attempt to convey his medical information.
 
The patient has requested that I apologize for my nonexistent bedside manner. It is regrettable that this was his experience. I have not heard this complaint previously or subsequent to this experience.
The patient has requested a billing adjustment in the amount of $200. The amount that he currently owes is $190.80. This is the amount that he is contractually required to pay for the services rendered. It is regrettable that the contract with his insurance carrier discounts these services to such a degree and equally regrettable that the predominance is passed through to him. This is frequently a problem when medical treatment is needed and patients carry high deductible insurance. When no treatment or intervention is required, high deductible insurance may be beneficial.
Sincerely,
Eric E[redacted], MD