Spring Hill Primary Care

To Whom It May Concern;We are in receipt of the customer concerns filed by [redacted] *** and do wish to respondConcern number (patient being overcharged and was not a first time patient) is completely falseOur fees are reasonable and standard for each patient regardless of insurance carrier Please find attached the explanation of each CPT code, copied from our CPT reference book, which was used for this patient[redacted] (New Patient Preventive Medicine Service age 40-60)A patient is considered new to the practice if they have not been seen within a year time frameThis patient had not been seen since April which classified her as a new patientThis code also allows for an additional code if an abnormality is encountered (at this visit, an abnormality is documented and addressed) [redacted] (New patient-Level II) This code was used with the appropriate modifier to identify it was in addition to the preventive medicine services rendered due to a documented abnormality[redacted] (collection of venous blood) This code was used for the collection of the blood work drawn at our facility.During her visit in December of 2016, [redacted] ***s provided our facility a copy of an insurance card and signed our financial policy (which I will also attach)She did not indicate that she was in fact a self-pay patientWe were given instruction to bill her insurance for her office visit.I am attaching a correspondence which was received from her insurance, that was also sent to [redacted] , which instructed the patient to contact her insurance company to supply additional informationI will also attach the explanation of benefits received from the patient's insurance company which shows they made the patient completely responsible for her charges[redacted] did supply you with a copy of her statement which also indicated her claim was pending claimants statement and authorization form [redacted] received a total of five statements from our facility and I do not show any documentation of a phone call where she called to inquire about the charges or set up any sort of payment arrangementThe patient finally paid for her December visit in July of Her payment was sent with a letter, in which I will attach, without giving us an opportunity to discussShe states in her letter that she spoke with a manager; however, I have never spoken with [redacted] Concern number (No Show) During her December visit, [redacted] was instructed to follow up in one month due to the abnormalities that were encounteredShe was given her next appointment at the check-out window along with a visit summary that indicated her next visit [redacted] was also aware that our facility does charge a $no-show fee (please see the patient information page signed by [redacted] Concern number (not returning calls) Please find attached two correspondence logs where the patient contacted us to get refills, Once in June and once in JulyIn June, she was given a refill and instructed to follow up for her health conditionsThis was completed within hoursPatient did not schedule appointmentDuring the July call, we left [redacted] multiple messages to call us back regarding her requestThe fact that she did not return our calls does not indicate we did not contact her within a timely mannerAt this call, our facility exercised its right to terminate the patient-physician relationship but also gave the patient her refills for days.It is not standard of care, to supply patients with medication without appropriate monitoringIt is our stance to never deviate from standard of care and we are proud to be a medical facility that focuses on quality healthcare in our areaWe regret that [redacted] was not satisfied with the level of care she was provided; however, she never discussed this with a manager or the physicianIn fact, she ignored physician direction, account statements and correspondence directly from her insurance carrier.We are confident that the Revdex.com will see there was no wrongdoing by Spring Hill Primary Care or is employees

We are in receipt of the response filed by MsSinesAt this time, it has become unclear to us as to what MsSince complaint/request is, I will attach a copy of the Appointment screen from our system that shows MsSines was in our facility on December 15, It also shows the appointment that was scheduled for January 19, (that was created on December 15, 2016)I will also attach a copy of the Visit Summary that was provided to the patient on that day that also shows she was scheduled a follow up visit for the conditions that were discussed (We have blocked out sensitive information)I have spoken with DrCriniti who denies this patient spoke to her about being a new patientI have also reviewed her appointment history and medical record and she had NOT been seen by any other providers in this facility within the three year time frame.MsSines had months to dispute any charges that were assessed to her at her December visit and she must have been satisfied with the care she received since she did contact us in June for refillsI didn't have any contact with MsSines nor was I aware she had a complaint until I received her letter addressed to our office to notify us she was filing complaints.I am unable to identify a prescription that was allegedly sent in to the wrong pharmacyTypically refills are given by the physician at the visits they request to avoid any issues that could ariseIf in fact a prescription was sent in to the wrong pharmacy, we sincerely apologize; however, she was not assessed any charges for that request.I have reviewed the call log provided by MsSinesI wouldn't be able to verify that we are "dr office" without seeing the phone numberI am also unable to see if these calls are outgoing or incomingWith that being said, MsSines was not charged for telephone calls placed to our facility or from our facilityThe charges in question are from her December visitWe have reviewed our billing record along with the documented medical care from this dateThey are true and accurateDrCriniti does not agree with providing any refund for her services that she was compensated for almost seven months after the service was providedMsSines never attempted to resolve this by speaking with DrCriniti or myself.In her response MsSines contradicts her first filing letterShe stated in her first letter that her office visits are not covered by her insuranceIn her second letter, she states she wanted the charges submitted so the insurance company would be aware of her meeting her deductibleBeing an uncovered service or being applied to a deductible is two separate possibilities.In summary, we stand behind our charges and billing practicesWe hope this alleviates any further concerns

Revdex.com:I have reviewed the response made by the business in reference to complaint I* ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.My internet has been down since 8/23/from *** I was unable to respond to the complaint because I did not have access to my email, I have taken new screen shots of my phone log and I will send them to you as soon as they come through in my email account, sometimes it takes several hours with the cellular carrierThe bottom line is no Dr office in this valley charges the amount I was charged for services at Springhill Primary care, my insurance was new and I did not know exactly how much they would cover, they told me they never recieved anything from the physicians office I had to submit to the insurance company twice the billing from the Dr office, the amount they charged me is ridiculous, and my phone logs show how many times I called the office over times and I did speak with someone in the office about the charges, they are lying about how many times I called the office and left messages, and I tried several times to remedy the issue of the charges, I want reimbursed the over charged amount of $ because it is excessive for a office visit, I never got anything detailing any appointment The paper they sent in to Revdex.com is the first time I have seen itThere was no problem for me to go back for the second appointmentI understand I have to go back for a prescription renewal, but I am not going to pay a Dr per office visit, that is not and the charges are excessive
[Provide details of why you are not satisfied with this resolution.]
Regards,
*** ***

To Whom It May Concern;We are in receipt of the customer concerns filed by [redacted] and do wish to respond. Concern number 1 (patient being overcharged and was not a first time patient) is completely false. Our fees are reasonable and standard for each patient regardless of insurance carrier....

Please find attached the explanation of each CPT code, copied from our CPT 2017 reference book, which was used for this patient.[redacted] (New Patient Preventive Medicine Service age 40-60). A patient is considered new to the practice if they have not been seen within a 3 year time frame. This patient had not been seen since April 2013 which classified her as a new patient. This code also allows for an additional code if an abnormality is encountered (at this visit, an abnormality is documented and addressed)[redacted] (New patient-Level II) This code was used with the appropriate 25 modifier to identify it was in addition to the preventive medicine services rendered due to a documented abnormality.[redacted] (collection of venous blood) This code was used for the collection of the blood work drawn at our facility.During her visit in December of 2016, [redacted]s provided our facility a copy of an insurance card and signed our financial policy (which I will also attach). She did not indicate that she was in fact a self-pay patient. We were given instruction to bill her insurance for her office visit.I am attaching a correspondence which was received from her insurance, that was also sent to [redacted] , which instructed the patient to contact her insurance company to supply additional information. I will also attach the explanation of benefits received from the patient's insurance company which shows they made the patient completely responsible for her charges.[redacted] did supply you with a copy of her statement which also indicated her claim was pending claimants statement and authorization form. [redacted] received a total of five statements from our facility and I do not show any documentation of a phone call where she called to inquire about the charges or set up any sort of payment arrangement. The patient finally paid for her December 2016 visit in July of 2017. Her payment was sent with a letter, in which I will attach, without giving us an opportunity to discuss. She states in her letter that she spoke with a manager; however, I have never spoken with [redacted] Concern number 3 (No Show) During her December visit, [redacted] was instructed to follow up in one month due to the abnormalities that were encountered. She was given her next appointment at the check-out window along with a visit summary that indicated her next visit. [redacted] was also aware that our facility does charge a $25.00 no-show fee (please see the patient information page signed by [redacted]Concern number 4 (not returning calls) Please find attached two correspondence logs where the patient contacted us to get refills, Once in June and once in July. In June, she was given a refill and instructed to follow up for her health conditions. This was completed within 24 hours. Patient did not schedule appointment. During the July call, we left [redacted] multiple messages to call us back regarding her request. The fact that she did not return our calls does not indicate we did not contact her within a timely manner. At this call, our facility exercised its right to terminate the patient-physician relationship but also gave the patient her refills for 30 days.It is not standard of care, to supply patients with medication without appropriate monitoring. It is our stance to never deviate from standard of care and we are proud to be a medical facility that focuses on quality healthcare in our area. We regret that [redacted] was not satisfied with the level of care she was provided; however, she never discussed this with a manager or the physician. In fact, she ignored physician direction, account statements and correspondence directly from her insurance carrier.We are confident that the Revdex.com will see there was no wrongdoing by Spring Hill Primary Care or is employees.

We are in receipt of the response filed by Ms. Sines. At this time, it has become unclear to us as to what Ms. Since complaint/request is, I will attach a copy of the Appointment screen from our system that shows Ms. Sines was in our facility on December 15, 2016. It also shows the appointment that was scheduled for January 19, 2017 (that was created on December 15, 2016). I will also attach a copy of the Visit Summary that was provided to the patient on that day that also shows she was scheduled a follow up visit for the conditions that were discussed (We have blocked out sensitive information). I have spoken with Dr. Criniti who denies this patient spoke to her about being a new patient. I have also reviewed her appointment history and medical record and she had NOT been seen by any other providers in this facility within the three year time frame.Ms. Sines had months to dispute any charges that were assessed to her at her December visit and she must have been satisfied with the care she received since she did contact us in June for refills. I didn't have any contact with Ms. Sines nor was I aware she had a complaint until I received her letter addressed to our office to notify us she was filing complaints.I am unable to identify a prescription that was allegedly sent in to the wrong pharmacy. Typically refills are given by the physician at the visits they request to avoid any issues that could arise. If in fact a prescription was sent in to the wrong pharmacy, we sincerely apologize; however, she was not assessed any charges for that request.I have reviewed the call log provided by Ms. Sines. I wouldn't be able to verify that we are "dr office" without seeing the phone number. I am also unable to see if these calls are outgoing or incoming. With that being said, Ms. Sines was not charged for telephone calls placed to our facility or from our facility. The charges in question are from her December 2016 visit. We have reviewed our billing record along with the documented medical care from this date. They are true and accurate. Dr. Criniti does not agree with providing any refund for her services that she was compensated for almost seven months after the service was provided. Ms. Sines never attempted to resolve this by speaking with Dr. Criniti or myself.In her response Ms. Sines contradicts her first filing letter. She stated in her first letter that her office visits are not covered by her insurance. In her second letter, she states she wanted the charges submitted so the insurance company would be aware of her meeting her deductible. Being an uncovered service or being applied to a deductible is two separate possibilities.In summary, we stand behind our charges and billing practices. We hope this alleviates any further concerns.