Complaints

• Initial Complaint

  04/10/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  This doctor keeps charging us for a "depression screening" test that my son has never received. On their website, these exams are given to 12-17-year-olds and my son is 11. He never had a screening nor where we told that there would be one with more out-of-pocket costs. They send us bills consistently for this service that has not been provided. We refuse to pay this bill as we don't pay for services that are just made up. I would like to see the test screening results. I was at the doctor's with him the whole time and had never seen this service done. Payment will not be released unless documentation of this screening is provided. Doctor's can't make up charges willy-nilly while most of us struggle to get by with inflation, low wages, and a terrible economy while the 1% such as Doctors make out just billing us for nothing.

  Business response

  05/03/2023

  Patient’s dad called into the billing department on 4/12/23 and we have that documented conversation with our billing staff.  Dad was very upset stating that we were billing for services not performed and states he is refusing the pay the balance.  He stated that we “just make things up”. Our billing staff attempted to explain and reassure him that the Depression screen form in question (PHQ-9) was completed and we have a scanned copy in the chart (electronic health record), and help dad understand that services were provided, but dad continued to exclaim complaints that we are always billing for things that are not done, saying he is changing pediatric practices, and eventually hung up on our staff. He then proceeded to send a hand-written note stating that “if you want my money, you can take me to small claims court”.  This note is also scanned into the patient’s record.
  
  Upon review of chart by our Clinical Committee (Senior Physician Leaders in the Practice) it was noted that the PHQ-9 Depression Screen was both completed by child/parent and reviewed by the provider who saw the family on 8/3/22.  This screen is a billable service – some insurances cover it and unfortunately, others do not, and deem it patient responsibility. The Depression screen is suggested for use by all insurance companies and recommended by the American Academy of Pediatrics to attempt to identify any significant signs of depression in pre-adolescent and adolescent patients.  We do this routinely for all well-visits for patients in that age range, as well as any additional visits that indicate problems with a child’s mental health status.  Additionally, the parent signed a Consent-to-Treat form and a Behavioral Health form that same day, as well as our Screenings and Services form that informs families that there may be additional charges for screenings and procedures that may or may not be covered by individual insurances.  Since we have hundreds of insurance plans, we ask all families to read, understand and sign this form, and it was signed by the dad on 8/3/22.  This form makes families aware that if their insurances do not cover the additional screenings and procedures, they are responsible for the balance.  This signed form is also scanned into the patient’s electronic health record.  Following review, our Clinical Committee agrees that we had billed appropriately.
  
  Joyce W******
  Director, Clinical Services
  ************

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