South Texas Colorectal Center

The following is a response to complaint ID [redacted] . Ms. ***’s complaint stems from a claim that her refund from her insurance company was not fully reimbursed to her by Tenet Healthcare (Dr. [redacted] ’s management and employment agency). Ms. [redacted] has been in direct contact with [redacted] , my... practice manager, regarding her claim. Ms. ***’s refund was not completely refunded to her, due to a prior unpaid balance. Tenet/Guardien records did not show evidence of prior payment for a $221.92 balance in 2013. Ms. [redacted] could also not provide proof of prior payment of outstanding balance in 2013. Refund of $706.93 was therefore reduced to $485.01, reflecting deduction/payment of outstanding balance from 2013. Ms. [redacted] is under contractual obligation to pay outstanding balances for services provided. Ms. ***’s rates and terms for payment of healthcare services are contractually set between Ms. ***, her health insurer, and my employment agency (Tenet Healthcare). Ms. ***’s financial situation has been discussed between [redacted] , Tenet Healthcare administration, and me. This response is being sent personally by the surgeon providing care, in order to provide expeditious response to the complaint described. Ms. ***’s care has been provided at and generally above standard of care. All medical issues have been addressed to the patient’s satisfaction. Our practice prides itself in providing among the best medical care in the City of San Antonio. We take patient grievances extremely seriously, and strive to resolve all issues appropriately. Unfortunately, Ms. ***’s complaints at this time do not have appropriate documentation to merit further refund by my employment agency. Regardless, Ms. [redacted] is welcome to continue her medical care with my practice. Furthermore, we will continue to provide excellent medical care for her. Sincerely, [redacted] , MD, FACS, FASCRS

Tell us why hereIn response to complaint ***…..On 3/11/the 43-year-old male patient initially came in for a hemorrhoid versus perianal lesionIt was discussed that he would be set him up for rectal exam under anesthesia with excisionDr*** explained to him that with his history
of HIV status it could be a premalignant lesion, however, the doctor would wait for the final pathology report and the patient would need a colonoscopy also. On 3/15/Patient was given information regarding the cost of his responsible portion, which was $and per SPC (procedure center) his portion was going to cost $997, which was explained as the estimated costA payment plan was offered for the procedure but the patient had to put a down payment of $700, of which he would be billed $Patient got really upset after hearing this information, and stated that "what am I suppose to do, die with it" which at this point the patient was told he could also go to a hospital to have this procedure donePatient was told that the hospital might even be able to accept his grantHe then said that this was a waste of time, and that he would be contacting the Drthat referred him over to us to explain the situationThe patient then was scheduled on 3/16/for a hemorrhoidectomy, of which he signed all consent forms and acknowledged that all charges are estimatesOn 5/05/the patient called the office and was upset because he now owed more money due to the fact that while the doctor was in the procedure for hemorrhoidectomy a large mass was found, of which the doctor removed for biopsy, given the history of HIV the patient hadThe reasoning for the extra charges was explained to the patient from the staff and also the managerThe patient got upset and did not agree with the charges, even though there was a signed consent which mentions the fact that if extra issues are found during the procedure, extra fees may apply

The following is a response to complaint ID ***Ms***’s complaint stems from a claim that her refund from her insurance company was not fully reimbursed to her by Tenet Healthcare (Dr***’s management and employment agency)Ms*** has been in direct contact with ***
***, my practice manager, regarding her claimMs***’s refund was not completely refunded to her, due to a prior unpaid balanceTenet/Guardien records did not show evidence of prior payment for a $balance in Ms*** could also not provide proof of prior payment of outstanding balance in Refund of $was therefore reduced to $485.01, reflecting deduction/payment of outstanding balance from Ms*** is under contractual obligation to pay outstanding balances for services providedMs***’s rates and terms for payment of healthcare services are contractually set between Ms***, her health insurer, and my employment agency (Tenet Healthcare)Ms***’s financial situation has been discussed between *** ***, Tenet Healthcare administration, and meThis response is being sent personally by the surgeon providing care, in order to provide expeditious response to the complaint describedMs***’s care has been provided at and generally above standard of careAll medical issues have been addressed to the patient’s satisfactionOur practice prides itself in providing among the best medical care in the City of San AntonioWe take patient grievances extremely seriously, and strive to resolve all issues appropriatelyUnfortunately, Ms***’s complaints at this time do not have appropriate documentation to merit further refund by my employment agencyRegardless, Ms*** is welcome to continue her medical care with my practiceFurthermore, we will continue to provide excellent medical care for herSincerely, *** ***, MD, FACS, FASCRS

Complaint: ***
I am rejecting this response because:
Regards,
*** ***
The business is lying regarding what was discussed with the doctorThe person responding to this email is a new employee was not in the examination room when my situation was discussed with the DoctorThe day of the initial visit the doctor examined me and told me what I had was NOT A HEMORRHOIDThe doctor explained that a hemorrhoid is purple in colorThe doctor showed me with a display what a hemorrhoid looked like versus what I had which was a polyp that was inflamedA doctor that specializing in Colons doesn't know that difference from a hemorrhoid to a poly? I don't understand what was the doctor's motivation for writing all over my chart that it was a hemorrhoidThe doctor even when to explain that day that it could be colon cancerIf I knew what the procedure was actually called that I was signing for then I would be in the medical fieldThis office just has a patient sign away without explaining anythingWhat's really alarming is that we had a discussion as to what it was yet the doctor writes in the chart something differentTHE PERSON RESPONDING WAS NOT THEREEven if this was the case, which it was not, I would think that the doctor would have a discussion with me after the surgery as to what was done, if it was not a hemorrhoidectomyThe discussion did not happen after the surgery, BECAUSE IT HAPPENED THE DAY OF THE INTIAL APPOINTMENTThis argument is not valid especially with a doctor that specializing in colonsThis is a very SHADY facilityUNETHICAL!!

Complaint: ***
I am rejecting this response because: the practices were not followedThe amount of was not stated to meI was quoted further I was never told that there would be a balance of over This doctors office is completely lieing about the facts that transpiredAs a matter of fact the billing department must have spoken to my insurance or something else happened because the stated amount was paid through a discount programThe person responding to this complaint is completely lieing about this caseThe quote that I said was because this office only told me about the not 700.00, because I called the day before the surgeryI had to scramble and ask family members for the money because the doctor specifically said to me it could be cancerThis office is UNETHICAL and a bunch of liarsWhen I spoke with the Manager she tried to deflect from the issue and I had to reel her back in to speak about the issue
Regards,
*** ***

The Practice has verified the information previously provided. We strive for each patient to be informed of the situation and care to be provided, and potential charges, prior to receiving the care. Such steps were followed with this patient.

Tell us why here... In response to complaint [redacted]…..On 3/11/16 the 43-year-old male patient initially came in for a hemorrhoid versus perianal lesion. It was discussed...

that he would be set him up for rectal exam under anesthesia with excision. Dr. [redacted] explained to him that with his history of HIV status it could be a premalignant lesion, however, the doctor would wait for the final pathology report and the patient would need a colonoscopy also.  On 3/15/16 Patient was given information regarding the cost of his responsible portion, which was $466.41 and per SPC (procedure center) his portion was going to cost $997, which was explained as the estimated cost. A payment plan was offered for the procedure but the patient had to put a down payment of $700, of which he would be billed $297. Patient got really upset after hearing this information, and stated that "what am I suppose to do, die with it" which at this point the patient was told he could also go to a hospital to have this procedure done. Patient was told that the hospital might even be able to accept his grant. He then said that this was a waste of time, and that he would be contacting the Dr. that referred him over to us to explain the situation. The patient then was scheduled on 3/16/16 for a hemorrhoidectomy, of which he signed all consent forms and acknowledged that all charges are estimates. On 5/05/16 the patient called the office and was upset because he now owed more money due to the fact that while the doctor was in the procedure for hemorrhoidectomy a large mass was found, of which the doctor removed for biopsy, given the history of HIV the patient had. The reasoning for the extra charges was explained to the patient from the staff and also the manager. The patient got upset and did not agree with the charges, even though there was a signed consent which mentions the fact that if extra issues are found during the procedure, extra fees may apply.

The following is a response to complaint ID [redacted]. Ms. [redacted]’s complaint stems from a claim that her refund from her insurance company was not fully reimbursed to her by Tenet Healthcare (Dr. [redacted]’s management and employment agency). Ms. [redacted] has been in direct contact with [redacted], my...

practice manager, regarding her claim. Ms. [redacted]’s refund was not completely refunded to her, due to a prior unpaid balance. Tenet/Guardien records did not show evidence of prior payment for a $221.92 balance in 2013. Ms. [redacted] could also not provide proof of prior payment of outstanding balance in 2013. Refund of $706.93 was therefore reduced to $485.01, reflecting deduction/payment of outstanding balance from 2013. Ms. [redacted] is under contractual obligation to pay outstanding balances for services provided. Ms. [redacted]’s rates and terms for payment of healthcare services are contractually set between Ms. [redacted], her health insurer, and my employment agency (Tenet Healthcare). Ms. [redacted]’s financial situation has been discussed between [redacted], Tenet Healthcare administration, and me. This response is being sent personally by the surgeon providing care, in order to provide expeditious response to the complaint described. Ms. [redacted]’s care has been provided at and generally above standard of care. All medical issues have been addressed to the patient’s satisfaction. Our practice prides itself in providing among the best medical care in the City of San Antonio. We take patient grievances extremely seriously, and strive to resolve all issues appropriately. Unfortunately, Ms. [redacted]’s complaints at this time do not have appropriate documentation to merit further refund by my employment agency. Regardless, Ms. [redacted] is welcome to continue her medical care with my practice. Furthermore, we will continue to provide excellent medical care for her. Sincerely, [redacted], MD, FACS, FASCRS