Regional Gastroenterology Associates of Lancaster, Ltd.

Review: November 5, 2013

To Whom It May Concern:

Complaint — I had an appointment with the above mentioned group of physicians on May 30,2013. My scheduled appointment was due to having proble** with an internal hemorrhoid. My family physician had referred me to them because of them specializing in this type of problem. I had gone to my scheduled appointment and was called into a room. I then met with the doctor who asked me what seemed to be the problem. I began to explain. He then asked me how I heard of his office. I explained my family doctor had referred me to his office. He then stated I would need to come back for another appointment in order for him to do x-rays order to determine if my problem is truly an internal hemorrhoid or if there is something else going on. I said fine. He then ended the conversation by stating that was all he needed for today, I can check out and make another appointment,

I later received a bill in the mail for $197. This was the portion of the bill that was my responsibility to pay after my insurance was billed. I became extremely frustrated and called to speak to someone in their billing department. I was instructed to speak to [redacted]. I left a message for him. After a week had gone by and I had not yet received a return call, I called again with still the same result. I called, let another message, and no one returned the phone calk I then decided to go into their office in order to speak to someone directly concerning my bill. I spoke to a man by the name of [redacted] who I found out later Was another individual who also oversees billing, I explained to him I was not happy with getting a bill when I was at their office for no more than 10 minutes just for the doctor to ask me how I was referred to him and to schedule another appointment. I further explained I thought it was wrong to charge that amount when the doctor did nothing at all. [redacted] said we would look into the situation and get back to me after he spoke directly to the doctor and asked that I schedule a follow-up appointment. I told him I did not have a comfort level scheduling another appointment until this was resolved. [redacted] insisted I still make the appointment. I decided not to. I was then told my bill would be placed on hold until this was resoived.

Several weeks later I still had no response. Still continuing to receive billing statements, I then followed up with additional messages for both [redacted] and Andre. Finally on November 4,2013 after leaving the last message on October 30, 2013 [redacted] returned the phone call, He told me he thought this situation was previously resolved and questioned me as to why I hadn’t made another appointment. He said it sounds to him as though I just didn’t want to pay my bill and that I don’t want to come back. Then he said you want me to reimburse you the money and you still are not intending to come back because I had yet to schedule another appointment. I explained to him why would I reschedule if no one can get back to me and resolve the current problem. I also stated if I was in your business I would help the customer to resolve their issue in order to keep the business. He then told me I was stupid for not resolving it by scheduling another appointment. I then hung up with him after stating I am not going to argue with you about this.

This whole situation upsets me because after 5 months nothing has been resolved from either a medical or billing standpoint.Desired Settlement: Resolution - What I would like to see occur is not to be charged the $197. I state this because nothing was resolved because nothing was done. For what the doctor had stated, the ladies at the front desk could have said without charging me $197. I feel as though it is wrong to charge this amount especially when no examination had taken place and I was not even there for 10 minutes. If they are billing me this way, the same thing has got to be occurring with other patients as well

I have been trying to work through this situation for 5 months now and do not know where else to turn. If you would like to further discuss this with me, please feel free to call me directly at ###-###-####. Please feel free to leave a message if I am unavailable and I will return your call.

Sincerely,

Business

Response:

November 12, 2013

Dear **. [redacted]:

I will address this complaint with the appropriate level of detail so as not to violate HIPAA. **. [redacted]’s version of the events, including what occurred at the original visit, does not reflect the facts.

First, his implication that he had only a few minutes with the physician and nothing wras resolved is inaccurate. A healthcare visit is not only the face-to-face time with the physician, but it is a cumulative number of activities that include the physician reviewing the medical chart and information prior to the exam room time with the patient. There is also time spent after the visit entering information into the medical record. Our records indicate that **. [redacted] did receive the appropriate standard of care.

**. [redacted] implied that the physician just told him to come back and on the follow-up visit he would assess his care, when, in fact, the physician recommended that **. [redacted] be scheduled for a necessary procedure in order to appropriately diagnose his condition.

When **. [redacted] was done with his initial visit, he was visibly upset and created an uncomfortable situation at our checkout area. At this point, I was called from my office to speak with **. [redacted]. (I am the Executive Director of the practice). I met with **. [redacted], who was definitely upset, and we discussed the events. He felt, even at that time, that he should not have to pay for his visit. What we agreed to is that RGAL would hold on his billing and sending him to collections and he would schedule a second visit, find out what his situation was, and then we could discuss the first and second visit. He agreed with this plan and we shook hands and parted. Under no circu**tances did anyone at RGAL insist that he make a second appointment.

Apparently, at some point **. [redacted] decided to change the course of action that we agreed upon. This was never relayed to me until I spoke with him recently.

I am aware that I returned his call within 48 hours of receiving his message.

He had only left me that one message. Whether he left **. [redacted] numerous calls is not consistent with what **. [redacted] has relayed to me.

He does recall speaking with **. [redacted] on one occasion, and also speaking with me about **. [redacted]’s concern. Believing that **. [redacted] was following the course of action as discussed, I assumed everything was proceeding well.

Regarding the telephone conversation I recently had with **. [redacted], it was not as he stated. We discussed our original meeting and what we both said we would do; he was to follow up with scheduling a second visit, and I would review his records and refrain from sending any balance to collections. I, in fact, did follow through with my commitment. **. [redacted] decided to take another course. When I reminded him about our understanding, he became hostile and loud. In fact, he said “he would have to be stupid to come back.”

I, at no time, called or inferred his actions or position was stupid, but did say that if he had a health issue, he needs to address it and let’s deal with that first. Again, he became indignant and said I must be crazy if I think he will come back.

When I said that he did receive the appropriate standard of care, the billing was correct, and he changed the understanding of the next steps, he yelled, stating something about “this is not over” and slammed down the telephone.

It is unfortunate how this situation unfolded, but we have tried to address **. [redacted]’s medical needs. His position, as he states in the closing of his letter, is “not to be charged.” This is not the position of RGAL.

If you would like to discuss further, without violating HIPAA, please call me at ###-###-####.

Thank you for your time and consideration in this matter.

Sincerely

Consumer

Response:

Review: [redacted]

I am rejecting this response because:

Please see attached handwritten rebuttal.

Regards,

Business

Response:

November 25, 2013

Dear **. [redacted]:

I contacted your office today upon receiving your letter dated November 20. As I mentioned to **. [redacted], RGAL has made repeated efforts to address the situation, particularly the issue of care, which appears to be the central complaint. As **. [redacted] notes in his handwritten letter to Revdex.com dated November 19, “the money isn’t the issue, it is that they (the doctor) didn’t discuss or look at anything with me.” I submit that this is not a billing issue, but a question of care. And, as stated in my letter dated November 12, RGAL did comply with the appropriate standard of care and prescribed a course of action to further address **. [redacted]’s healthcare needs.

He elected to deviate from the recommended plan. That is his prerogative, but it does not imply an inappropriate billing situation.

We continue to want to meet with **. [redacted] to address his healthcare needs.

Thank you for your consideration, but this will be our final letter response to this matter.

Consumer

Response:

Review: [redacted]

I am rejecting this response because:

Please see attached rebuttal.

Regards,

December 8, 2013

Dear [redacted],

I received your letter dated 12/02/13 along with a copy of the response the Revdex.com received from RGAL dated 11/25/13. I wanted to provide a response.

My dispute has to do specifically with the amount of the charge the physician is billing. I do not understand how the physician can bill the amount he has when he did not spend much time with me nor did he exam me. Instead, as mentioned previously he suggested I make another appointment for an examination.

As RGAL5s response indicated, I did not follow through with making another appointment. Reason being, if their office is charging over $300 for not doing an examination, what would they charge for actually examining me? I do not want to continue any type of treatment with their office if we cannot even agree on the first bill I received.

I mentioned in my previous letter of the complaint that it has nothing to do with money. To be more specific when I stated this, I was referring to the fact I am perfectly capable of paying the bill. The point is the amount being charged seems outrageous for the time spent with me when nothing other than the physician stating I need to schedule another appointment was accomplished. This is where my complaint lies. Thus RGAL’s response from Andrew Renna stating ‘the issue of care, which appears to be the central complaint' is not totally accurate.

Bottom line, the amount charged for my initial first office visit to the RGAL practice seems ridiculous.

Sincerely,