Plasma Vision

In response to a complaint filed by ID # [redacted] This is a 40-year-old lady referred to the interventional pain management division that I personally direct Records were initially sent by the primary care physician for review to obtain an opinion as early as August 24, Upon my professional review of those records, which was done at no cost I determined that minor degenerative changes seen on scans did not warrant the services that I perform as an interventional spine physicianThat response was transmitted to the primary care doctor on August 24, 2017.The patient continued to request an appointment through the physician and the primary care physician again asked my division to see her so an initial intake appointment was made for September 20, I work side-by-side with a physician assistant who performed the initial intake along with a medical assistant, and organized the systems of involvement along with the records that were obtained, Thereafter a physical exam of the pertinent findings was performed to look for actual physical changes that one cannot see from the records aloneI then reviewed the case in detail and made the following determination.This patient had a number of diffuse spine pain patterns that were not consistent with the anatomy seen on diagnostic imaging that was performed over the past several years, having had this pain for years or so following a motor vehicle accidentNone of the findings seen on the scans appeared to be compatible with medical justification for interventioml/invasive spine procedures that I perform.It was therefore my opinion as relayed from my assistant to the patient that I had nothing to offer from my subspecialty beyond continuing medications that were given to her by her PCP.She had disagreed with that conclusion and was angry that she had to pay for the service of an evaluation when she would thereafter not be scheduled to have a procedure performed.She was in the office for 1-1/hours which is the amount of time that was necessary to register her, document intake of historical information, performed the physical examination, review the records that were obtained and correlate all of these findings to make a conclusionFrom her complaint, she seemed angry that she was brought into the office to make this conclusion when in fact, I made the conclusion to not see her month before but when she persisted and her family doctor continued to request that she be seen, I felt that it would be best for us to actually see the patient to correlate the records with the clinical findings.This is a very justified charge for which records are well documented in the chartIt was not reasonable to refund her co-pay that was required according to her particular insurance plan for service that was performedA very important role of the subspecialist is to determine who does and who does not need to undergo an invasive spine procedureA disservice would exist if an unnecessary procedure was offered and performed based on the findings and conclusions of this casePayment for this subspecialty opinion is reasonable and appropriate.Thank you