Nova Surgical Arts

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed as Answered] Complaint: [redacted] I am rejecting this response because: again the business provided inaccurate statements and factsI did not ask for any free serviceNor did I assert that evaluation was billed twiceAs I said earlier, any valid charges must be presented on the bill at the time of service to be given to the customerThe ledger provided by the business was prepared recently in which an evaluation charge item was addedThis is not the same bill I was given at the time of service on Dec 31, The original bill did not include the evaluation charge of $They told me that the reason they did not include the evaluation charge on the first bill because it will be billed to the insurance company and insurance company would pay for itThis is not a valid reason because any charges must be presented to customer regardless whether or not they may be paid for by the insurance companyThis is because there is always a chance that the insurance company won't pay for any particular item in full amount or won't pay at allThis is exactly what happenedThe business hid some charges from the bill on the day of serviceThe hidden charge was billed to the insurance separatelyThen when the insurance company did not pay all charges in fullThe business sent me a final bill with all charges including charge that I was not aware earlier such as evaluation charge.I again ask the business to drop evaluation charge that was not properly presented to me at the time service was completed Regards, [redacted] **

Patient was evaluated on 12/23/15. At the time of evaluation, guarantor was advised that there is a fee of $for the evaluation but that we would submit the claim to the insurance company which is our procedure. On 12/31/15, the procedure was performed. From *** **'s
note, he is contesting that the evaluation fee should have been included in the statement on the date of the procedure. This is against insurance policy. Since the evaluation was previously done and had been submitted to the insurance company, the evaluation fee could not be included in the charges on 12/31/15. The patient's insurance was maxed out, therefore, there is a balance on the account. We have tried to explain this to *** ** on 9/via telephone and again on 9/when he came in person to our office. He may call me directly at ###-###-#### should he want to discuss this further

Attached is a ledger for the complainant's daughter.  This ledger clearly shows that he was not billed twice for the evaluation charge which was billed on 12/23/15 and was sent to his insurance for payment.  We do not ask for patients to pay for the evaluation at that time as we try to submit to insurance first which he was advised we would do.  I do not understand why he would think that this is free as none of our patients have ever thought so.  When patients call, they are told that there is a fee for evaluation but that we would submit to insurance.  The evaluation involves the doctor reviewing the x-ray prior to spending time with the patient, the assistants reviewing the patient's medical history with the patient which is then reviewed again by the doctor, and the doctor advising the patient what the treatment plan will be.  As explained in my previous response, we do not include the evaluation fee in the cost estimate as this is a separate charge and not part of the procedure itself.  We cannot combine service dates when we submit claims to insurance.  They must be done separately.  We are not in the business of misleading patients.  We are in the business of providing the best medical care for our patients and assisting them with insurance needs and the best estimate we can provide at the time of treatment.  We can write off the service charges but the evaluation fee stands.  Again, if [redacted] wants to discuss this further, I will be happy to talk to him at ###-###-####.

[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 as Answered]
 Complaint: [redacted]
I am rejecting this response because:
again the business provided inaccurate statements and facts. I did not ask for any free service. Nor did I assert that evaluation was billed twice. As I said earlier, any valid charges must be presented on the bill at the time of service to be given to the customer. The ledger provided by the business was prepared recently in which an evaluation charge item was added. This is not the same bill I was given at the time of service on Dec  31, 2015. The original bill did not include the evaluation charge of $109. They told me that the reason they did not include the evaluation charge on the first bill because it will be billed to the insurance company and insurance company would pay for it. This is not a valid reason because any charges must be presented to customer regardless whether or not they may be paid for by the insurance company. This is because there is always a chance that the insurance company won't pay for any particular item in full amount or won't pay at all. This is exactly what happened. The business hid some charges from the bill on the day of service. The hidden charge was billed to the insurance separately. Then when the insurance company did not pay all charges in full. The business sent me a final bill with all charges including charge that I was not aware earlier such as evaluation charge.I again ask the business to drop evaluation charge that was not properly presented to me at the time service was completed.
Regards,
[redacted]