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Report: #368813

Complaint Review: Tjerk F. Bury, M.D. - Thousand Oaks California

  • Submitted:
  • Updated:
  • Reported By: oak park California
  • Author Confirmed What's this?
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  • Tjerk F. Bury, M.D. 351 Rolling Oaks Drive #203 Thousand Oaks, California U.S.A.
  • Phone: 805-777 7333
  • Web:
  • Category: Doctors

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To whom it may concern.

On Sunday June 15th, my 3 years old son Ilan broke his arm and was rushed to urgent care in West lake California . The doctor at urgent care took 2 x rays and advise me to see an Orthopedic doctor the next day as my son needed a cast on his arm. The doctor at urgent care also provide me with a list of doctors in my neighborhood to contact for that. I picked the first name on the list, Dr. Tjerk F. Bury, called the office and asked the person who answered the phone, Jill, if they do treat kids, she said yes and asked for my insurance information over the phone. She also said they do take Blue Cross and they are Blue Cross providers. She also said that she has to check my insurance information and will call me back in few minutes to let me know if there is any problem. She called me back and booked my little boy for the same day to apply the cast on his arm.

When I walked into Dr. Bury's office I realized that I am in a plastic surgeon's office. I was a little worried and asked Jill if she is sure that they treat kids and if I am in the right office for my child. . She said Dr. Burry is also hand specialist, I was concern that it will may cost me more, my child needed only cast application that was not necessary for him to be seen by hand specialist. Jill smiled and said don't you worry, we do treat kids and we will charge your insurance .

She charged me $25 co pay before we walked in to see the doctor.

Dr. Bury looked at the x rays that I had from urgent care and said yes its broken, lets put the cast on 15 minutes later he walked me to his receptionist, Jill, and asked me to come back in 4 weeks. I booked my boy a 4th week appointment and was ready to leave the office when Jill said it is $500 for the service. I was shocked and asked her what? $500 to apply the cast on? Is this is the allowed amount by the insurance?
And she said yes, Dr. Bury is a plastic surgeon so we have to charge you for surgery. You have to pay it now. She also said different surgeon office may charge me $2000 for that!!!!

I was shocked, I told her that she did not indicate that when I was not sure if this is a right office for my child for that purpose, she kept asking for the money right now and she said I can't leave without paying now! I had my 3 years old screaming in my arms and rather than arguing just handed her my credit card so I can leave and deal with them later, she also said this amount include follow up visits and cast removal. I asked her why I have to pay her for all that now? Why she can not charge me just for the cast application? She said that some patients do not come back , and they go to different office to follow up so they want their money now! I told her that I am definitely not coming back and will not pay twice to remove this cast in 4 weeks. She said this is your choice but we have to charge you anyway. She also said that they charge the whole amount in advance before they submit that to the insurance because people usually don't pay their bills!!!
I find that very humiliating and after checking with my insurance company, I am now aware that only allow $88.22 for cast application.

To add insult to injury, on July 19th I received the claim from my insurance company -- Dr. Bury charged my insurance company $1,505.00, the bill included $995 for surgery -- he NEVER performed surgery on my son!!! My payment responsibility according to the claim is $620.07 when I was told at his office by him and by his receptionist Jill that the $525.00 that I have paid include also the follow up visits. Dr. Burry was also paid by my insurance $137.24 . Jill said that any payment they will receive by my insurance will be send back to me, since I paid $525.00 in advanced. I did not receive a phone call or a check from them.

I feel totally mislead by Dr. Bury's office. Why didn't his receptionist/assistant Jill tell me that it will cost me that and why she didn't tell me that I will have to pay it the same day of the service, she checked my insurance information before she booked me, so she knew I did not meet my $2500 deductible, why she didn't indicate that too? In addition, I don't understand why I have to pay Dr. Bury for service he didn't provide my son with.

Also, in mid June, my son was going to water camp and I don't understand why he didn't offer water proof cast for a 3 year old in the beginning of the summer. When I called Dr. Bury's office the day after he put the cast on my son's arm, Jill said that they don't have waterproof cast.

On July 14th I visited pediatric orthopedic doctor for my little boy to remove the cast and of course had to pay again.

I feel mislead, ripped off and humiliated and requesting a refund of $525.00 back on my credit card, and have Dr. Bury re-submit the claim to my insurance for the correct service he performed on my child using the correct code for cast application (code # 29105, using 1 roll for child arm) plus $35 office visit (my co-pay). Of course I will put the correct fair amount back on my credit card.

I would appreciate you looking into this situation.

Ronit
oak park, California
U.S.A.

This report was posted on Ripoff Report on 09/01/2008 04:21 PM and is a permanent record located here: https://www.ripoffreport.com/reports/tjerk-f-bury-md/thousand-oaks-california-91361/tjerk-f-burry-md-akas-dr-bury-tjerk-is-a-ripoff-please-read-my-report-thousand-oa-368813. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content

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REBUTTALS & REPLIES:
0Author
16Consumer
2Employee/Owner

#18 Consumer Comment

Who Cares?

AUTHOR: Shreddi - (USA)

POSTED: Friday, April 22, 2016

Who cares how nice a Dr. is?  How do they perform is all I care about.  Can anyone say they had hand surgery, Carpel Tunnel and/or Trigger finger surgery done and how did it work over time?  I do agree its the insurance companys deal to go over charges but imagine the people behind that desk rubber stamping everything to get to lunch on time.  Anyway,  Someone with first hand experience relating to the Dr. work?   My sister had Carpal tunnel done there and no problems ever since, years ago.  I was just getting another opinion and find everyone more concerned witrh how nice a Dr. is.  Who cares?

 

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#17 REBUTTAL Owner of company

Health Care in U.S.

AUTHOR: nay - (USA)

POSTED: Wednesday, October 07, 2015

I just wanted to say that it seems unfair to blame one doctor for a broken system.  As long as we have a for-profit health system, we will continually pay high fees so that executives of companies such as Anthem Blue Cross can make salaries in the millions, not to mention other kinds of hospital administrators (remember the Congressional testimony?).  No one in health care should make millions, and until we change this, people in the U.S. will continue to pay horrifically high prices for what people in other countries take for granted.  nay

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#16 Consumer Comment

In defense of Dr. Bury

AUTHOR: Teri R - (United States of America)

POSTED: Sunday, August 26, 2012

I was googling Dr. Bury to try and email a post-surgical question and was SHOCKED to find this pathetic diatribe on page one of a google search for him. Dr. Bury practices in Thousand Oaks, where my husband has had a family physician practice for 30+ years. We know the medical community extremely well. We know who the good and not-so-good physicians are. So I was shocked to see this vicious and ridiculous diatribe against this fine physician!

I wonder if the angry attacker in this post has any idea how much personal money and time Dr. Bury and his wife have spent to make numerous medical missions trips to third world countries? Shame on this accuser for trying to malign the name of this fine doctor and shame on whatever mechanism allows this ancient SINGLE complaint to show up on the first page of a google search! For the record, Dr. Bury is a first-rate surgeon and a man of integrity. 

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#15 Consumer Comment

Reply to Oakpark

AUTHOR: tdog - (United States of America)

POSTED: Thursday, December 31, 2009

How horrible of you to post this on a website. Dr. Bury is one of the finest physicians that I have ever known. He will always go out of his way to help a patient and will do so with the utmost professionalism.

If you want to be angry with anyone, contact your insurance carrier. The word "surgery" is a very common phrase used for billing purposes and does not indicate that any cutting or removing of body parts was done. I see my dermatologist and the code submitted to my insurance company indicates "surgery". I know that I did not have surgery but the codes are sometimes limited and encompass many areas of treatment.

You obviously are not looking at the big picture, which is that you had not met your deductible and therefore the money owed is yours to pay. You should pay the doctor immediately and be very thankful that a fantastic surgeon set your son's arm and he will never have a problem with that particular break in his lifetime.

As for bashing the doctor's staff, how rude of you to "shoot the messenger". Do you really think that the staff has any control over what your insurance carrier deems to be your responsibility?

In the future, you should stick with urgent care and allow the specialists to treat patients that are amazed and grateful of their talents. The talent of Dr. Bury should not be wasted on having to defend himself on-line. You must feel pretty powerful sitting behind the keyboard.

 

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#14 Consumer Suggestion

Surgery charged to insurance co.

AUTHOR: Sono Pro - (U.S.A.)

POSTED: Friday, September 19, 2008

If the doctor did not perform any surgery on you and filed the procedure with your insutance complany, this may constitute fraud. I am not an expert on this and by no means am I suggesting that this took place. It is just an avenue you may wish to explore. The actual cast application my be considered "surgical" in the MD's office/billing. There are many ways to find "loopholes". I always thought surgery was cutting and removing or fixing something. Like I said, this is only an opinion and in no way am I accusing anyone of any wrong doing, illegal, or unethical activity. I just don't like people taking advantage of others. Good Luck EP

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#13 Author of original report

Doctor Burry

AUTHOR: Ronit - (U.S.A.)

POSTED: Thursday, September 18, 2008

The allegations made by this doctor of Ronit "impersonating" another person, being abusive to his staff, not wanting to pay the insurance co-pay are just absolutely outrageous and pathetic. These lies were invented to distract from the fact that Dr. Bury overcharged for putting a cast on the arm of a three year old. It definitely DOES NOT COST $757.



Response to doctor's response:

Doctor Burry's note omits the fact that aside from charging me the co pay, he also charged me $500 for the cast application and that he also billed my insurance (for surgery he didn't perform) $620.07 and got a check from them in the amount of $137.24 and on top of it had the nerve to bill me for an additional $95.

The calls to his office were not "harrassing." The initial call was to ask for an itemized bill as the charge for the cast application seemed extremely excessive. The second call was to let the office know that I may have to recast my son's arm as he had gotten his cast wet and to ask them why they didn't offer a waterproof cast when the doctor who re checked his wet cast offered that to me. Dr. Burrry's office had responded to me that they don't have waterproof casts.

I investigated the fee for cast applications at other doctor offices and they don't even come close to being $757. Even though I run a successful and thriving business, being ripped off is unpleasant. Applying a cast to a child's arm does not cost $757. The standard fee for that is $88. Dr. Burry used did not use code number 29105 in the insurance application which is the code for cast application but rather used a different code which should be applied for a surgery procedure. Dr. Burry did not perform surgery on my son and to ask me to pay an additional $95 which the insurance didn't cover for the "surgery" is simply outrageous. Dr. Burry should refund the amount he overcharged me.

I must add that I've been living in this country for over twenty years, and this is the first time that I have ever had to dispute any doctor charges. It is absolutely wrong and immoral, not to mention unethical, for any doctor to overcharge patients and on top of that, to ask them to pay for services they had not rendered.

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#12 Author of original report

Doctor Burry

AUTHOR: Ronit - (U.S.A.)

POSTED: Thursday, September 18, 2008

The allegations made by this doctor of Ronit "impersonating" another person, being abusive to his staff, not wanting to pay the insurance co-pay are just absolutely outrageous and pathetic. These lies were invented to distract from the fact that Dr. Bury overcharged for putting a cast on the arm of a three year old. It definitely DOES NOT COST $757.



Response to doctor's response:

Doctor Burry's note omits the fact that aside from charging me the co pay, he also charged me $500 for the cast application and that he also billed my insurance (for surgery he didn't perform) $620.07 and got a check from them in the amount of $137.24 and on top of it had the nerve to bill me for an additional $95.

The calls to his office were not "harrassing." The initial call was to ask for an itemized bill as the charge for the cast application seemed extremely excessive. The second call was to let the office know that I may have to recast my son's arm as he had gotten his cast wet and to ask them why they didn't offer a waterproof cast when the doctor who re checked his wet cast offered that to me. Dr. Burrry's office had responded to me that they don't have waterproof casts.

I investigated the fee for cast applications at other doctor offices and they don't even come close to being $757. Even though I run a successful and thriving business, being ripped off is unpleasant. Applying a cast to a child's arm does not cost $757. The standard fee for that is $88. Dr. Burry used did not use code number 29105 in the insurance application which is the code for cast application but rather used a different code which should be applied for a surgery procedure. Dr. Burry did not perform surgery on my son and to ask me to pay an additional $95 which the insurance didn't cover for the "surgery" is simply outrageous. Dr. Burry should refund the amount he overcharged me.

I must add that I've been living in this country for over twenty years, and this is the first time that I have ever had to dispute any doctor charges. It is absolutely wrong and immoral, not to mention unethical, for any doctor to overcharge patients and on top of that, to ask them to pay for services they had not rendered.

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#11 Author of original report

Doctor Burry

AUTHOR: Ronit - (U.S.A.)

POSTED: Thursday, September 18, 2008

The allegations made by this doctor of Ronit "impersonating" another person, being abusive to his staff, not wanting to pay the insurance co-pay are just absolutely outrageous and pathetic. These lies were invented to distract from the fact that Dr. Bury overcharged for putting a cast on the arm of a three year old. It definitely DOES NOT COST $757.



Response to doctor's response:

Doctor Burry's note omits the fact that aside from charging me the co pay, he also charged me $500 for the cast application and that he also billed my insurance (for surgery he didn't perform) $620.07 and got a check from them in the amount of $137.24 and on top of it had the nerve to bill me for an additional $95.

The calls to his office were not "harrassing." The initial call was to ask for an itemized bill as the charge for the cast application seemed extremely excessive. The second call was to let the office know that I may have to recast my son's arm as he had gotten his cast wet and to ask them why they didn't offer a waterproof cast when the doctor who re checked his wet cast offered that to me. Dr. Burrry's office had responded to me that they don't have waterproof casts.

I investigated the fee for cast applications at other doctor offices and they don't even come close to being $757. Even though I run a successful and thriving business, being ripped off is unpleasant. Applying a cast to a child's arm does not cost $757. The standard fee for that is $88. Dr. Burry used did not use code number 29105 in the insurance application which is the code for cast application but rather used a different code which should be applied for a surgery procedure. Dr. Burry did not perform surgery on my son and to ask me to pay an additional $95 which the insurance didn't cover for the "surgery" is simply outrageous. Dr. Burry should refund the amount he overcharged me.

I must add that I've been living in this country for over twenty years, and this is the first time that I have ever had to dispute any doctor charges. It is absolutely wrong and immoral, not to mention unethical, for any doctor to overcharge patients and on top of that, to ask them to pay for services they had not rendered.

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#10 Author of original report

Doctor Burry

AUTHOR: Ronit - (U.S.A.)

POSTED: Thursday, September 18, 2008

The allegations made by this doctor of Ronit "impersonating" another person, being abusive to his staff, not wanting to pay the insurance co-pay are just absolutely outrageous and pathetic. These lies were invented to distract from the fact that Dr. Bury overcharged for putting a cast on the arm of a three year old. It definitely DOES NOT COST $757.



Response to doctor's response:

Doctor Burry's note omits the fact that aside from charging me the co pay, he also charged me $500 for the cast application and that he also billed my insurance (for surgery he didn't perform) $620.07 and got a check from them in the amount of $137.24 and on top of it had the nerve to bill me for an additional $95.

The calls to his office were not "harrassing." The initial call was to ask for an itemized bill as the charge for the cast application seemed extremely excessive. The second call was to let the office know that I may have to recast my son's arm as he had gotten his cast wet and to ask them why they didn't offer a waterproof cast when the doctor who re checked his wet cast offered that to me. Dr. Burrry's office had responded to me that they don't have waterproof casts.

I investigated the fee for cast applications at other doctor offices and they don't even come close to being $757. Even though I run a successful and thriving business, being ripped off is unpleasant. Applying a cast to a child's arm does not cost $757. The standard fee for that is $88. Dr. Burry used did not use code number 29105 in the insurance application which is the code for cast application but rather used a different code which should be applied for a surgery procedure. Dr. Burry did not perform surgery on my son and to ask me to pay an additional $95 which the insurance didn't cover for the "surgery" is simply outrageous. Dr. Burry should refund the amount he overcharged me.

I must add that I've been living in this country for over twenty years, and this is the first time that I have ever had to dispute any doctor charges. It is absolutely wrong and immoral, not to mention unethical, for any doctor to overcharge patients and on top of that, to ask them to pay for services they had not rendered.

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#9 Author of original report

Doctor Burry

AUTHOR: Ronit - (U.S.A.)

POSTED: Thursday, September 18, 2008

The allegations made by this doctor of Ronit "impersonating" another person, being abusive to his staff, not wanting to pay the insurance co-pay are just absolutely outrageous and pathetic. These lies were invented to distract from the fact that Dr. Bury overcharged for putting a cast on the arm of a three year old. It definitely DOES NOT COST $757.



Response to doctor's response:

Doctor Burry's note omits the fact that aside from charging me the co pay, he also charged me $500 for the cast application and that he also billed my insurance (for surgery he didn't perform) $620.07 and got a check from them in the amount of $137.24 and on top of it had the nerve to bill me for an additional $95.

The calls to his office were not "harrassing." The initial call was to ask for an itemized bill as the charge for the cast application seemed extremely excessive. The second call was to let the office know that I may have to recast my son's arm as he had gotten his cast wet and to ask them why they didn't offer a waterproof cast when the doctor who re checked his wet cast offered that to me. Dr. Burrry's office had responded to me that they don't have waterproof casts.

I investigated the fee for cast applications at other doctor offices and they don't even come close to being $757. Even though I run a successful and thriving business, being ripped off is unpleasant. Applying a cast to a child's arm does not cost $757. The standard fee for that is $88. Dr. Burry used did not use code number 29105 in the insurance application which is the code for cast application but rather used a different code which should be applied for a surgery procedure. Dr. Burry did not perform surgery on my son and to ask me to pay an additional $95 which the insurance didn't cover for the "surgery" is simply outrageous. Dr. Burry should refund the amount he overcharged me.

I must add that I've been living in this country for over twenty years, and this is the first time that I have ever had to dispute any doctor charges. It is absolutely wrong and immoral, not to mention unethical, for any doctor to overcharge patients and on top of that, to ask them to pay for services they had not rendered.

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#8 Author of original report

UPDATE

AUTHOR: Ronit - (U.S.A.)

POSTED: Thursday, September 18, 2008

The allegations made by this doctor of Mrs. F "impersonating" another person, being abusive to his staff, not wanting to pay the insurance co-pay are just absolutely outrageous and pathetic. These lies were invented to distract from the fact that Dr. Bury grossly overcharged for putting a cast on the arm of a three year old. It definitely DOES NOT COST $757.

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#7 Author of original report

UPDATE

AUTHOR: Ronit - (U.S.A.)

POSTED: Thursday, September 18, 2008

I also have family plan Blue Cross PPO health insurance

for the last 16 years and never had to use "Medil-Cal" health insurance.

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#6 Author of original report

UPDATE

AUTHOR: Ronit - (U.S.A.)

POSTED: Wednesday, September 17, 2008

Response to doctor Burry response:

Doctor Burry's note omits the fact that aside from charging me the co pay, he also charged me $500 for the cast application and that he also billed my insurance (for surgery he didn't perform) $620.07 and got a check from them in the amount of $137.24 and on top of it had the nerve to bill me for an additional $95.

The calls to his office were not "harrassing." The initial call was to ask for an itemized bill as the charge for the cast application seemed extremely excessive. The second call was to let the office know that I may have to recast my son's arm as he had gotten his cast wet and to ask them why they didn't offer a waterproof cast when the doctor who re checked his wet cast offered that to me. Dr. Burrry's office had responded to me that they don't have waterproof casts.

I investigated the fee for cast applications at other doctor offices and they don't even come close to being $757. Even though I run a successful and thriving business, being ripped off is unpleasant. Applying a cast to a child's arm does not cost $757. The standard fee for that is $88. Dr. Burry used did not use code number 29105 in the insurance application which is the code for cast application but rather used a different code which should be applied for a surgery procedure. Dr. Burry did not perform surgery on my son and to ask me to pay an additional $95 which the insurance didn't cover for the "surgery" is simply outrageous. Dr. Burry should refund the amount he overcharged me.

I must add that I've been living in this country for over twenty years, and this is the first time that I have ever had to dispute any doctor charges. It is absolutely wrong and immoral, not to mention unethical, for any doctor to overcharge patients and on top of that, to ask them to pay for services they had not rendered.

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#5 Author of original report

UPDATE

AUTHOR: Ronit - (U.S.A.)

POSTED: Wednesday, September 17, 2008

Response to doctor Burry response:

Doctor Burry's note omits the fact that aside from charging me the co pay, he also charged me $500 for the cast application and that he also billed my insurance (for surgery he didn't perform) $620.07 and got a check from them in the amount of $137.24 and on top of it had the nerve to bill me for an additional $95.

The calls to his office were not "harrassing." The initial call was to ask for an itemized bill as the charge for the cast application seemed extremely excessive. The second call was to let the office know that I may have to recast my son's arm as he had gotten his cast wet and to ask them why they didn't offer a waterproof cast when the doctor who re checked his wet cast offered that to me. Dr. Burrry's office had responded to me that they don't have waterproof casts.

I investigated the fee for cast applications at other doctor offices and they don't even come close to being $757. Even though I run a successful and thriving business, being ripped off is unpleasant. Applying a cast to a child's arm does not cost $757. The standard fee for that is $88. Dr. Burry used did not use code number 29105 in the insurance application which is the code for cast application but rather used a different code which should be applied for a surgery procedure. Dr. Burry did not perform surgery on my son and to ask me to pay an additional $95 which the insurance didn't cover for the "surgery" is simply outrageous. Dr. Burry should refund the amount he overcharged me.

I must add that I've been living in this country for over twenty years, and this is the first time that I have ever had to dispute any doctor charges. It is absolutely wrong and immoral, not to mention unethical, for any doctor to overcharge patients and on top of that, to ask them to pay for services they had not rendered.

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#4 Author of original report

UPDATE

AUTHOR: Ronit - (U.S.A.)

POSTED: Wednesday, September 17, 2008

Response to doctor Burry response:

Doctor Burry's note omits the fact that aside from charging me the co pay, he also charged me $500 for the cast application and that he also billed my insurance (for surgery he didn't perform) $620.07 and got a check from them in the amount of $137.24 and on top of it had the nerve to bill me for an additional $95.

The calls to his office were not "harrassing." The initial call was to ask for an itemized bill as the charge for the cast application seemed extremely excessive. The second call was to let the office know that I may have to recast my son's arm as he had gotten his cast wet and to ask them why they didn't offer a waterproof cast when the doctor who re checked his wet cast offered that to me. Dr. Burrry's office had responded to me that they don't have waterproof casts.

I investigated the fee for cast applications at other doctor offices and they don't even come close to being $757. Even though I run a successful and thriving business, being ripped off is unpleasant. Applying a cast to a child's arm does not cost $757. The standard fee for that is $88. Dr. Burry used did not use code number 29105 in the insurance application which is the code for cast application but rather used a different code which should be applied for a surgery procedure. Dr. Burry did not perform surgery on my son and to ask me to pay an additional $95 which the insurance didn't cover for the "surgery" is simply outrageous. Dr. Burry should refund the amount he overcharged me.

I must add that I've been living in this country for over twenty years, and this is the first time that I have ever had to dispute any doctor charges. It is absolutely wrong and immoral, not to mention unethical, for any doctor to overcharge patients and on top of that, to ask them to pay for services they had not rendered.

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#3 Author of original report

UPDATE

AUTHOR: Ronit - (U.S.A.)

POSTED: Wednesday, September 17, 2008

Response to doctor Burry response:

Doctor Burry's note omits the fact that aside from charging me the co pay, he also charged me $500 for the cast application and that he also billed my insurance (for surgery he didn't perform) $620.07 and got a check from them in the amount of $137.24 and on top of it had the nerve to bill me for an additional $95.

The calls to his office were not "harrassing." The initial call was to ask for an itemized bill as the charge for the cast application seemed extremely excessive. The second call was to let the office know that I may have to recast my son's arm as he had gotten his cast wet and to ask them why they didn't offer a waterproof cast when the doctor who re checked his wet cast offered that to me. Dr. Burrry's office had responded to me that they don't have waterproof casts.

I investigated the fee for cast applications at other doctor offices and they don't even come close to being $757. Even though I run a successful and thriving business, being ripped off is unpleasant. Applying a cast to a child's arm does not cost $757. The standard fee for that is $88. Dr. Burry used did not use code number 29105 in the insurance application which is the code for cast application but rather used a different code which should be applied for a surgery procedure. Dr. Burry did not perform surgery on my son and to ask me to pay an additional $95 which the insurance didn't cover for the "surgery" is simply outrageous. Dr. Burry should refund the amount he overcharged me.

I must add that I've been living in this country for over twenty years, and this is the first time that I have ever had to dispute any doctor charges. It is absolutely wrong and immoral, not to mention unethical, for any doctor to overcharge patients and on top of that, to ask them to pay for services they had not rendered.

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#2 REBUTTAL Owner of company

Appropriate care and billing provided on an emergent basis as requested by patients mother

AUTHOR: T. Bury Md - (U.S.A.)

POSTED: Friday, September 12, 2008

This is in response to a Complaint from Ronit ((REDACTED NAME, WAS WRONG FOR A DR. TO REVEAL THEIR PATIENTS NAME!))(ID# 16019704). Ms. ((REDACTED NAME)), called my office Monday morning June 16th, requesting an emergency appointment for her son on the same day. She had been told be the local urgent care that her son needed a consultation with a specialist for his arm injury. As a courtesy to her and her son she was give the emergency appointment that same afternoon, with the understanding that she may have to wait as she was fitted into the regular schedule at the last minute. As a courtesy to her we verified her insurance coverage and informed her that she would be charged her co-pay for the consultation. Any further treatment or surgery would be extra and subject to her deductible. Her son Ilan ((REDACTED NAME)), was seen in consultation that afternoon and the usual history and physical were taken and the X-rays were reviewed with her. Treatment options including risks, benefits, complications and alternatives were discussed with the mother. She agreed to proceed with the appropriate treatment and a fiberglass cast was applied. The mother was given extensive cast care instructions and a follow up appointment in my office. She was charged the visit co-pay as required by her insurance prior to the consultation and was charged a deposit for the fracture treatment on the way out. She was informed that her insurance uses a global fee schedule for fracture treatment, which includes the first cast application and follow-up visits for 90 days. As she had a $2,500.00 deductible, she was charged a deposit. She was also given the CPT codes for the treatment and called her insurance herself. Her insurance informed her that this was a valid code and the insurance allowable cost was $530.00, after which she agreed to pay the deposit.



6/20/08 Patients mother called asking if her son could participate in gymnastics class, she was told no, as he could further injure his arm.



6/22/08 Ms. ((REDACTED NAME)), called and asked for an itemized bill for the treatment to submit for taxes and also informed us that she has Medi-Cal coverage and wants to get a refund from them.



6/23/08 Ms. ((REDACTED NAME)), called to say that her sons cast got wet over the weekend and that he needs a new cast. She was told to come in for a cast change and that there would be an additional cost involved as per her insurance benefits. She then became angry and abusive on the phone and said:Dr Bury is a cheater, and he charged for surgery he did not perform. She started to yell on the phone and threaten to sue the doctor. She was informed to call her insurance to verify her benefits and to make sure the cast was changed if she decided not to return to our office.



7/1/08 Ms ((REDACTED NAME)), called the office and identified herself as the sister of one of our front office staff. Once she spoke to that staff member she admitted to be Ms. ((REDACTED NAME)), . She requested a refund of the treatment deposit. She was again explained the billing codes as used by her insurance. She was also told she would get a complete statement as soon as her insurance processes the claim.



7/14/08 Ms. ((REDACTED NAME)), called again asking for a statement to give to her husband, so he doesn't think she is having Botox done.



Ms. ((REDACTED NAME)), has continued to call our office on multiple occasions with increasingly abusive language, threats and demands. Attached are the documentation sheets of her phone calls.



The following are responses to her allegations:



1. Ms. ((REDACTED NAME)), called our office requesting an emergency consultation for her son. We did not solicit her business.

2. Dr. Bury is a board certified plastic surgeon and board certified hand surgeon. He does treat hand injuries in children all the time. The fee schedule is set by Ms. ((REDACTED NAME)), 's insurance, not by us. The fee schedule (by CPT code) does not depend on the qualifications of the doctor. No matter how highly trained and experienced the doctor, the fee is the same. Ms. ((REDACTED NAME)), 's allegation that it would cost more because Dr. Bury is a Plastic Surgeon has no basis.

3. Ms. ((REDACTED NAME)), was asked for her insurance coverage and never told us that she may have Medi-Cal coverage. This office does not accept Medi-Cal coverage and she would have been told so. Her later claim that she may have Medi-Cal coverage shows that the was withholding insurance information when she was asked for it.

4. Waterproof casts are not a covered benefit under this patients coverage and would have cost the mother even more.

5. The patient was seen on an emergent basis as a courtesy to the mother. Although this is an additional charge to her (CPT 99058), it was waived.

6. Impersonating someone on the phone to get access to one of my staff members is absolutely unacceptable and so is abusive language and lawsuit threats.

7. All medical billing and charges are governed by CPT coding. The correct coding for this patients services is CPT99244 (consult, history and physical, decision making process), CPT25605 (fracture treatment, including first cast application and 90 days follow up), CPT99058 (emergency services during regular office visit hours). The patients insurance carrier authorized these codes and has processed the claim accordingly.

8. Unfortunately the patients Blue Cross carrier bundles all non office visit codes under one general heading of surgery even though many of these codes do not involve surgery, such as injections, casting, fracture treatment etc. This thoroughly confuses the patients. Endless requests to Blue Cross to change this very bad habit have gone unanswered.

9. Not collecting a visit co-pay or a procedure deductible is against the law and carries a $25,000.00 federal final and possible jail time (see attached article). Even giving the patient a discount is a violation unless the insurance carrier is given the same discount.



10. The patient still has a remaining balance with this office. If Ms. ((REDACTED NAME)), can show proof of financial hardship and stops harassing our front office, this office will consider writing off some or all of the remaining balance.



11. All coding of the services provided and all co-pay and deductible collections were made exactly according to the patients benefits. Ms. ((REDACTED NAME)), didn't decide not to come back to this office until 07/14/08, a full month after her initial visit. She also did not follow instructions about cast care and having the cast replaced as advised. Requesting a refund after being abusive to the staff and impersonating someone else on the phone is far from reasonable. The patient was never denied standard of care treatment. The mother was non compliant and never came back to our office.



Sincerely



Tjerk F. Bury, MD

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#1 Author of original report

Dr. Burry Tjerk

AUTHOR: Ronit - (U.S.A.)

POSTED: Monday, September 08, 2008

Dr. Burry contact me this afternoon (after 3 month that he was avoiding my phone calls). He is trying to solve this dispute. I will update the results of this dispute when it will be resolved.

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