Orange Coast Women's Medical Group Inc

Review: I found out I was pregnant and wanted to schedule my first appointment. The receptionist scheduled it for 12/11/13. I called the day before and tried to cancel the appointment because the insurance I had during 2013 had an extremely high deductible and my new insurance would kick in on 1/1/14. I explained this to the lady who worked there, [redacted], and she told me that I need to come in for my 8 week appointment because that's when they do certain genetic testing that can't be done after 10 weeks. I told her that I took a pregnancy test that said how far along I am and it said I'm about 7 weeks so I would still be at the 10 week period in the first week of January. [redacted] then said that I was 8 weeks. I asked her what sort of genetic testing is done at that time and she told me they test for Downs, which happened to be a test I definitely wanted to get done. The sole reason I went ahead with the appointment was because she said testing for Downs can only be done during that short time frame. When I went into the ultrasound appointment the doctor told me that they don't test for downs until 12 weeks which is in January. Not only that but I was correct in that I was only 7 weeks pregnant at the time and I could have waited until January to do the ultrasound had [redacted] not lied about it. Since realizing [redacted] lied about the time frame Downs is tested for (and attempted to fabricate how far along I was), I didn't do anything besides the ultrasound with that clinic. As expected, my new insurance covered my more recent ultrasound, same way it would have if [redacted] allowed me to reschedule for January like I tried.Desired Settlement: I would like a removal of the $109.43 charge from that clinic since it was the result of being tricked into coming in sooner unnecessarily.

Business

Response:

To Whom It May Concern,

In

early December [redacted] called in to our office to schedule her

first appointment for her pregnancy. [redacted] stated that her LMP was

10/12/13 making her approximately 6 ½ weeks pregnant when she spoke with our OB coordinator on 11/26/13 to schedule her initial appointments. Per our office

protocol we schedule patients for a viability ultrasound and initial pregnancy

office visit when the patient is 8 weeks pregnant. Based on [redacted]’s

stated LMP she would have been 8 weeks pregnant between 12/6 – 12/14. Our coordinator scheduled [redacted] for a dating viability ultrasound and visit with

Dr. [redacted] for 12/11/2013. On the same day that [redacted] called our

office to schedule, the OB coordinator verified [redacted]’s maternity coverage through her

Blue Cross/Shield insurance, and mailed a copy of the estimated cost to

[redacted]. On 12/10/13 [redacted] called in and spoke with [redacted] attempting

to cancel her appointments and to reschedule for after 1/1/14 stating that she

had a very large deductible and that she knew that she would be responsible for

the full amount of any visits and/or testing done. [redacted] explained to [redacted]

that based on her LMP waiting until after the first of the year would put her

at risk for possibly missing genetic screening tests. [redacted] asked what

the tests were for. Our associate did explained that the tests screens for

Downs Syndrome and other genetic defects. The OB coordinator did explaine that for her initial visit she had been

scheduled for a dating ultrasound so that we could determine exactly how far

along she is. The OB coordinator explained to [redacted] that we bring all of our patients in

at 8 weeks to confirm the location and health of the pregnancy and to determine

exactly how far along she is so that proper timing of certain tests can be

determined. Bringing a patient in for an ultrasound and visit at 8 weeks

is standard for our office. It is in no way too early. During their phone call [redacted] expressed concern regarding the cost of the appointments and the OB coordinator went over the estimates of the ultrasound and office visit. When

[redacted] came in on 12/11/13, her ultrasound showed that she was 7 weeks & 3

days pregnant. The ultrasound did show that she was early in pregnancy,

but again this is why OCWMG brings patients in for an initial ultrasound.

LMPs and home pregnancy tests have too many variables to be an accurate source

of dating. After the ultrasound, the patient spoke with our front office staff member and cancelled her visit with Dr. [redacted]. At that time, [redacted]

rescheduled the initial office visit for 1/17 and also scheduled to have her

state genetic screening testing for the same day. On 1/7/14 [redacted]

called in to the office scheduling department to cancel all of her upcoming

appointments, stating that she had transferred to a physician affiliated with

[redacted] Hospital. In summary, the patient was aware as to why we bring

patients in at 8 weeks and she was fully aware – through a letter and a phone

call – of the estimated cost of the ultrasound and visit.

We have sent a check to [redacted] in the amount of her request on 3/18/2014.

For any questions please contact our office at ###-###-####

Sincerely,

Administrative Assistant

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted] and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

I have received no check from OC Women's medical group. I also have no idea what the check is for specifically because their response was vague in regards to their stance. They sound like they're denying responsibility but then say at the end that they've sent me a check, which is confusing. I'd like to keep this open until this is resolved and I receive the check.

Regards,

Business

Response:

To Whom It May Concern,

After reviewing the patients complaint and speaking with our OB coordinator and physician Board it appears there is a difference in interpretation of what transpired. As stated before we have followed our office protocols. We are sorry that there was a miss-communication between our office and patient. There for we have elected to return the money that was collected and hope that this will conclude the matter. Check was issued on 3/19.

Sincerely,

OCWMG