Vein Clinics of Hawaii

In Response to complaint ID#***

To Whom It May Concern:

This is in reference to a complaint your office recently received against my medical practice locatedin Honolulu, Hawaii. The name of the practice is Vein Clinics of Hawaii. The complaint was from apatient that we initially saw on January 26, 2019. She came to us with a primary complaint of legvein problems.

During the patient's initial evaluation in our Honolulu office she was seen and evaluated by DennisG***, PA-C. I have two physician assistants working with me in our offices. Physician Assistantinvolvement in patient care is a very common practice these days throughout Hawaii as well as theentire country. It is very common for PA's and Nurse Practitioners to not only do initial evaluationsof patients but also to be in charge of ongoing treatment. I can assure you, neither of the two PA'sin our practice portrays themselves as doctors nor do they introduce themselves as "Doctor". Inpoint of fact, both introduce themselves using their first names and both have their name on eitherscrub uniforms or lab coats with the indicator "PA-C". This patient's insistence that she didn'trecognize she was being seen by a PA rather than an MD can only be attributed to her own lack ofawareness.

Our practice has a medical side and a cosmetic side. This patient made an initial appointment forconsultation on the cosmetic side of our practice. She inquired about superficial treatment ofspider veins (something called sclerotherapy, that is not covered by insurance) as well as a cosmeticlaser procedure that we do in our office. This is a procedure called SculpSure and is also not coveredby insurance. It is a laser that we use to bring about torso and extremity fat reduction. So these twoprocedures were explained in full to her as well as the cost for each. She was quoted a cost of $500for the sclerotherapy procedure for her spider veins and $3500 for the SculpSure procedure.Parenthetically, we were somewhat surprised that someone on Ohana Quest would have thisamount of expendable income

When a patient presents to us for evaluation of spider vein therapy it is not only customary but alsorecommended that diagnostic testing be undertaken to assure that the presence of spider veins isnot an indicator of deeper vein dysfunction. This is accomplished by doing an ultrasound to look atthe functional status of the veins in the legs. I'm sure that PA G did recommend to her that sheundergo ultrasound evaluation to look at her vein function. Again, that would have been uspracticing g*** medicine. For this patient to misconstrue this as us trying to coerce her into "usingher Medicaid to engage in EXTRA treatments" is a ridiculous, petty and an uninformed assertion.

With respect to us "double billing her", this was a simple billing mishap that could have beencorrected and resolved immediately over the telephone had she chosen to handle it in that fashion.She did ultimately call our billing department and it was taken care of immediately. What hadhappened was that an invoice had been generated automatically prior to her cash payment beingapplied to her account and unfortunately it was not caught in time prior to it going out in the mail.The additional $100 was part of that because our usual charge for the SculpSure procedure that sheneeded was $3600 however since she was purchasing two different procedures at the same timewe gave her a $100 discount. This also was removed from her balance as soon as we were notifiedof our mistake. So again, labeling this as us "double billing her'' is ridiculous and the disputedamount of $600 is bewildering to me. The $100 was removed from her balance and she continues tohave a $500 credit with us for spider vein therapy when she wishes to proceed with that procedure.As she states in her complaint, the SculpSure treatment is a 2 session treatment. She made it to onlythe first of those two visits. She was a "no-show" for the second without notice prior to the day oftreatment. This was after our practice had arranged to have Oahu personnel travel for the day tothe Kauai office to potentially treat her only to find that the trip and expense was for naught.

Intentional improper billing, impersonation of a physician and Medicaid fraud are extremely seriousaccusations that are is some cases punishable by spending time in jail. These accusations I of coursetake tremendous offense to. They are ludicrous and absurd and are completely unfounded. Thislady has paid exactly what was quoted to her for the services she requested. The only reason thatthey have not been fully rendered to date is because of the lack of scheduling on the patients part.

Please let me know if you need any further explanation.