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Vein Clinic Inc

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Review: I went in for a routine consultation for spider vein treatment. I was quoted a consultation fee of $120, if Insurance did not cover the process. This consultation with the nurse turned into a $750 bill for the initial consultation.Desired Settlement: Stop taking advantage of people.

Business

Response:

Dear [redacted],

This letter is in response to the patient complaint submitted to you on 9/9/13.

ID # [redacted]

Patient: [redacted] initially contacted our office and spoke with our clinic supervisor, Nadia to discuss her physical complaints and concerns and whether our clinic could diagnose and treat her. She was told that she had two options for consultation in our clinic. If she had symptomatic varicose vein disease, then she should be evaluated with duplex evaluation and consultation and this would be considered a medical visit and would be billed to her insurance. If she had cosmetic concerns, she should be evaluated as a cosmetic evaluation and she would pay cash for her evaluation as cosmetic evaluations are not covered by insurance. She was told at this time that a cosmetic evaluation would be $120 and that if she opted for medical evaluation, the charges would be billed to her insurance and she would be responsible for any co-pay and deductible from her insurance. She was not told that "if insurance did not cover the process", fee would be $120 as her complaint indicates. She was told she would have to decide which type of consultation she wanted and the appropriate fees would apply. She told Nadia she was not sure what she had but that she had symptoms so Nadia advised her to have a full medical evaluation and not a cosmetic evaluation.

On 6/28/13, [redacted] was seen in our clinic for a medical evaluation. She had symptoms and she wanted to know whether she had underlying disease and whether it would be considered medically necessary so her insurance would cover the treatment. She asked us what the cost was for medical evaluation. We told her that medical evaluation included history, physical and duplex evaluation and cost $850 which would be billed to her insurance and her insurance would determine how much we would actually get paid and that she would be responsible for any deductible or share of cost that her insurance assigned to her. She also signed a consent form agreeing to be treated and agreeing that she would be financially responsible for what her insurance assigned as her share of cost for the visit. She made the decision to have full medical evaluation and not cosmetic evaluation on the day of her visit after everything was explained to her.

[redacted] was seen on 6/28/13 by me and I am a physician and a board certified general surgeon. Her complaint that she was only seen by a nurse is incorrect. Although a nurse was present throughout her evaluation, her evaluation was provided by me and I introduced myself to her as "Dr. [redacted]".

After [redacted]'s evaluation was completed, her insurance was billed. The entire amount allowed by the insurance was $750 and was applied to her deductible because she had not met her deductible for the year. Her husband called our office to inquire about the bill and we told him of our conversations with [redacted] on her visit. Mr. [redacted] wanted us to adjust this amount off of their account and only pay the $120 for a cosmetic evaluation. We informed him that she made the decision for medical evaluation and we provided the services and they could not change their mind after our services had been provided and their insurance has been billed. [redacted] was symptomatic and she chose to have medical evaluation rather than cosmetic evaluation after both were discussed with her.

It is every patient's responsibility to know what type of contract they have with their insurance company, what is their deductible and how much is their share of cost for medical visits and treatments. We have discovered that [redacted] has an $8000 deductible from her insurance. She knew that she was responsible for $8000 of her medical costs for the 2013 calendar year. Although she may be unhappy with the contractual obligations she had with her insurance company, she was not taken advantage of by our clinic. She was informed of all her options, made an informed decision, provided services and then was unsatisfied when it came time to pay her bill.

Please feel free to contact me if you have any questions, 760-352-3366.

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Description: Clinics

Address: 1699 W Main St #E, El Centro, California, United States, 92243

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