OC Sports and Wellness

This letter is in response to [redacted] complaint that he was not informed about the cost of prolotherapy injections gi'en at my office.A medical service was performed on [redacted] on 10/17/The service is not a covered benefit of the patient's health insurancePrior to the service being provided, my front office staff person informed the patient that the service is not covered by his insurance and that there would be a fee for the services provided.The patient had undergone thes metreatment in and received benefit from the procedureassume that the procedure was not covered at that time either and that he had to pay out of pocketIn addition, the patient was given a 27% discount on the cost of the procedures; each injection costs $and there is a $added fee for ultrasound guidance.I have been performing these no-covered services in my office for more than yearsThis is the first time that a patient has caimed that they have not been informed about the cost of a non-covered procedure, it is the patient's shared responsibility to know what his insurance covers and what his insurance does not cover.Common health insurance guide ines state, "considers prolotherapy (also known as proliferant therapy, proliferation therapy, jc nt sclerotherapy, or reconstructive ligament therapy) experimental and investigational for all indications, including the following (not an all-inclusive list), because there is inadequat evidence of its effectiveness." Nonetheless, there are textbooks, AMA approved medical conferences and a wealth of medical articles on the benefits of prolotherapyThe practice of prolotherapy dates back to the 1950's and been a beneficial therapy since its discovery, In addition, the patient signed a "statement of Insurance Eligibility" which states that he agrees to be financially responsible for al costs incurred during the delivery of health care services and agree to pay charges to OCSports and Wellness for any ineligible services his health plan does nOt COVel.It seems unreasonable to request a full-refund for in-office procedures that were performed at the patient's requestIn fact, a variety of treatment options were offered to the patient and he specifically elected to proceed with this particular form of therapy.We have offered to provide the patient a superbill to submit to his insurance for reimbursement.Although perform quite a few n n-covered procedures, this is the first time that a patient has claimed that he has the victim of "a deceptive practice." Nonetheless, we have since instituted an office form to be signed by all patients prior to these procedures being performedThis office form will explain the cost of the non-covered procedures and require a patient's signature prior to the commencement of these non-covered procedures

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint The office has refused to provide any amount of reimbursement and only offered to provide a superbill for insurance reimbursement requestIt was only after my written complaint and upon my suggestion that the office implemented written disclosure detailing the costs for future patients Regards, [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  
The office has refused to provide any amount of reimbursement and only offered to provide a superbill for insurance reimbursement request. It was only after my written  complaint and upon my suggestion that the office implemented written disclosure detailing the costs for future patients.
Regards,
[redacted]

This letter is in response to [redacted] complaint that he was not informed about the cost of prolotherapy injections gi'en at my office.A medical service was performed on [redacted] on 10/17/2017. The service is not a covered benefit of the patient's health insurance. Prior to the...

service being provided, my front office staff person informed the patient that the service is not covered by his insurance and that there would be a fee for the services provided.The patient had undergone thes metreatment in 2011 and received benefit from the procedure. assume that the procedure was not covered at that time either and that he had to pay out of pocket. In addition, the patient was given a 27% discount on the cost of the procedures; each injection costs $295.00 and there is a $50.00 added fee for ultrasound guidance.I have been performing these no-covered services in my office for more than 10 years. This is the first time that a patient has caimed that they have not been informed about the cost of a non-covered procedure, it is the patient's shared responsibility to know what his insurance covers and what his insurance does not cover.Common health insurance guide ines state, "considers prolotherapy (also known as proliferant therapy, proliferation therapy, jc nt sclerotherapy, or reconstructive ligament therapy) experimental and investigational for all indications, including the following (not an all-inclusive list), because there is inadequat evidence of its effectiveness." Nonetheless, there are textbooks, AMA approved medical conferences and a wealth of medical articles on the benefits of prolotherapy. The practice of prolotherapy dates back to the 1950's and been a beneficial therapy since its discovery,  In addition, the patient signed a "statement of Insurance Eligibility" which states that he agrees to be financially responsible for al costs incurred during the delivery of health care services and agree to pay charges to OCSports and Wellness for any ineligible services his health plan does nOt COVel.It seems unreasonable to request a full-refund for 2 in-office procedures that were performed at the patient's request. In fact, a variety of treatment options were offered to the patient and he specifically elected to proceed with this particular form of therapy.We have offered to provide the patient a superbill to submit to his insurance for reimbursement.Although perform quite a few n n-covered procedures, this is the first time that a patient has claimed that he has the victim of "a deceptive practice." Nonetheless, we have since instituted an office form to be signed by all patients prior to these procedures being performed. This office form will explain the cost of the non-covered procedures and require a patient's signature prior to the commencement of these non-covered procedures.

Review: inaccurate diagnosis.excruciating and unnecessary rehab.unrelenting collection harassmentDesired Settlement: stop collection efforts.refund for time and pain