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Post by mlleelise on Jan 19, 2012 17:21:45 GMT -5
Okay. Is this normal business practice?? Today I received a bill from Dr. Michel Gagner for 'consulting' with me through email. Charge? $100, with 2% monthly charge if late. I was very surprised, since he had never mentioned there was a charge for communicating with him by email. I had given him my address and asked him to send information on the hospital, his office, the aftercare - which he never did. Instead, he used my address to send me a BILL. We wrote back & forth in September; However, I decided to check out other options, because he said he may have to do a revision from lapband to DS in 2 stages - wouldn't know til he was 'in there.' Also, I couldn't get a direct answer about what sort of follow-up care he offered. Maybe it would have been just fine, but I couldn't get a direct answer. AND I certainly couldn't afford TWO self-pay surgeries. Maybe it is usual & normal to send a bill like this - but it kind of ticked me off. Has this happened to anyone else?  |
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Post by ricky136 on Jan 19, 2012 17:32:46 GMT -5
I would say it is bad form to bill you without disclosure. I would understand the bill if you went to his office and had a appointment, but just emails...and no talk of a consult fee, I doubt i would pay that.
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Post by Deleted on Jan 19, 2012 17:45:43 GMT -5
Their time is money. I have fully expected to be charged when I have a phone consult or lengthy e-mail correspondence. However, I work in health care and am somewhat familiar with billing practices. I can imagine it could come as an unpleasant surprise if it was not mentioned previously.
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Post by lisalou79 on Jan 19, 2012 17:55:06 GMT -5
I just spoke with Dr Stewart's office today and was told I would have to start with a consult with the Dr. and I could do it via phone BUT it would cost me $200 just to talk with him.
I don't know why it surprised me at first. Of course he get's paid for doling out advice to potential clients but I just never would have thought about being charged any money to talk to him. So yeah, I definitely can see you being a little heated at getting a bill without knowing it would be coming. Gotta love medical expenses, they never seem to end.
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Post by mlleelise on Jan 19, 2012 18:02:13 GMT -5
Thanks for your thoughts! Dr. Gagner is in Canada. It really didn't even cross my mind that I would be billed - 4 months later. If he had told me, I might have thought twice about it. He doesn't apparently have an office manager, or someone to ask general questions of...at least I never found a number for an office.
I have corresponded with 4 other doctors here in the States; none of them said anything about a charge for emails either. Egad! I hope I won't get 4 more such bills in the mail!!
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Post by beth28 on Jan 19, 2012 18:07:06 GMT -5
A lot of surgeons consider any e-mail or call directly with them, a consult. And are very likely to charge for the "consult."
You may be able to dispute it, if there was no disclosure. Maybe Diana Cox knows?
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Post by Deleted on Jan 19, 2012 18:56:54 GMT -5
FYI: Just thought some of you might find this interesting...
CPT-4 Code Category CPT-4 Descriptions
99371 Evaluation & Management Telephone call by a physician to patient or for consultation or medical management or for coordinating medical management with other health care professionals (eg, nurses, therapists, social workers, nutritionists, physicians, pharmacists); simple or brief.
99372 Evaluation & Management Telephone call by a physician to patient or for consultation or medical management or for coordinating medical management with other health care professionals (eg, nurses, therapists, social workers, nutritionists, physicians, pharmacists); intermediate.
99373 Evaluation & Management Telephone call by a physician to patient or for consultation or medical management or for coordinating medical management with other health care professionals (eg, nurses, therapists, social workers, nutritionists, physicians, pharmacists); complex or lengthy.
CPT codes were designed for physician billing purposes. When I was first exposed to them, these surprised me. Yet, after thinking about them, it did make sense that there would be ways to fill in a billing form for everything from a tonsillectomy, chest x-ray interpretation , or phone call in order for the physician to account for his time to justify to insurance companies or patients when insurance doesn't pay.
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Post by Deleted on Jan 19, 2012 19:43:50 GMT -5
THE FOLLOWING IS NOT LEGAL ADVICE - I AM NOT A CONTRACT ATTORNEY, NOT QUALIFIED TO GIVE YOU ADVICE ABOUT CONTRACT LAW IN YOUR STATE (AND I DON'T EVEN KNOW WHAT STATE YOU LIVE IN) AND CERTAINLY NOT THE LAW OF CANADA, BUT I MIGHT WRITE A LETTER SOMETHING LIKE THIS TO MAKE HIM REALIZE IT WOULD NOT BE PRODUCTIVE TO PURSUE THIS FURTHER:
Dear Dr. Gagner,
I may not be familiar with standard medical business practice in Canada, nor any other form of business in which a POTENTIAL CUSTOMER makes a telephonic or email inquiry about the professional services offered by the practitioner or business, but certainly in the United States those are business communications, i.e., sales pitches, which are EXPECTED by both the POTENTIAL CUSTOMER and the business to be offered free of charge. They are, in essence, the SELLING part of the establishment of the relationship between the POTENTIAL CUSTOMER and the business.
I was beyond astonished, therefore, to receive in January 2012 a bill from you for our brief email exchange in September 2011. The topic of those emails was a request for information about the medical services you, your office and the hospital you are affliated with provide, your qualifications to provide those services, and the cost of those services. The time you took to correspond with me is appreciated, but it was part of YOUR cost of doing business to provide such information to your POTENTIAL CUSTOMERS.
I never agreed to pay for the time you took to answer my inquiry about your business practices and medical services. We do not and did not have a doctor-patient relationship. There was no contract for services, and in fact your provided me no billable services, and certainly no billable medical services. You quite correctly deferred any specific answers to my questions that called for medical opinion to a time when you could examine me in person. You merely provided general answers to my inquiry about the POTENTIAL for hiring you to perform these services. In fact, after hearing what you had to say, in particular when you would not answer direct questions about follow up care, or under what circumstances you might decide to do my surgery in two parts, which is an almost unheard of occurrance in the US when surgery is performed by competent DS revision surgeons, I decided to go in a different direction.
Under US law, founded in UK common law which I understand also forms the foundation of Canadian law, a contract is established by offer and acceptance. A contractual obligation does not exist until both steps have taken place, and there is a meeting of the minds with respect to the nature of the services to be rendered and the amount and nature of the consideration therefor. Your email communications with me were an OFFER of services; I did not accept. I certainly never agreed to pay for you to make an offer of your medical services, and a claim that my inquiry amounted to a medical consultation is farfetched indeed.
If you believe under Canadian law that you have a right to send me an invoice for a sales pitch about your services, for which I never agreed to pay, either in advance or afterwards, and to pursue collection of those charges via legal channels, please feel free to do so. You certainly are welcome to argue in a US court that I owe you money for your sales pitch, but I feel quite confident that under US law, you will not find satisfaction for your claim.
Sending out invoices for medical or other services which have not been rendered, nor agreed to, would likely violate various state and federal laws in the United States. I suspect the same would be true in Canada.
I therefore respectfully request that you withdraw and void your invoice immediately.
Sincerely,
Elise
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Post by ricky136 on Jan 19, 2012 19:51:21 GMT -5
Yeah thats what i meant to say ;D Very nice letter!! *exalt*
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Post by Jolly Rancher on Jan 19, 2012 20:01:14 GMT -5
What Diana said. Tacky, tacky.
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Post by karenflorida on Jan 19, 2012 20:58:07 GMT -5
If I were you, I wouldn't pay it. I think speaking or emailing with potential patients, some of whom will eventually go elsewhere, is part of having a practice with many self-pay patients who live at a great distance. The exception, to me, would be if he spent HOURS dealing with one patient who then went elsewhere for surgery.
Karen
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Post by patxyz on Jan 20, 2012 16:12:13 GMT -5
Okay. Is this normal business practice?? Today I received a bill from Dr. Michel Gagner for 'consulting' with me through email. Charge? $100, with 2% monthly charge if late. I was very surprised, since he had never mentioned there was a charge for communicating with him by email. I had given him my address and asked him to send information on the hospital, his office, the aftercare - which he never did. Instead, he used my address to send me a BILL. We wrote back & forth in September; However, I decided to check out other options, because he said he may have to do a revision from lapband to DS in 2 stages - wouldn't know til he was 'in there.' Also, I couldn't get a direct answer about what sort of follow-up care he offered. Maybe it would have been just fine, but I couldn't get a direct answer. AND I certainly couldn't afford TWO self-pay surgeries. Maybe it is usual & normal to send a bill like this - but it kind of ticked me off. Has this happened to anyone else? I've now received a bill from Gagner as well, for $150 for digital consultation. Have you responded yet? What happened? |
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Post by patxyz on Jan 20, 2012 16:42:37 GMT -5
PS - I've gotten some differing opinions from law school friends about the legality of the billing, so I've sent an email to the College of Physicians in Quebec asking for clarification. I'll let you know what I find out.
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Post by Deleted on Jan 20, 2012 17:17:13 GMT -5
PS - I've gotten some differing opinions from law school friends about the legality of the billing, so I've sent an email to the College of Physicians in Quebec asking for clarification. I'll let you know what I find out. Please review your emails with him to see if there was ANY mention of billing for electronic consultation. I do not see how he can justify billing you for an electronic inquiry about his practice without adequate notice and acceptance that you would be charged for his "sales pitch." As for this having been a "digital consultation" - I would agree - he "stuck his thumb up your cloaca" to paraphrase the late Steve Irwin. |
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Post by momx4 on Jan 20, 2012 18:01:05 GMT -5
You rock Diana!!!!
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Post by kyal on Jan 20, 2012 19:50:26 GMT -5
This just backs up what I have known all along.
Bariatric surgeons are just like the rest of the diet industry and out to take our money.
I have always wondered why I could get my gall bladder or appendix removed or a gastrectomy if I had cancer for no out of pocket costs, yet it costs $3000-$5000 for a sleeve gastrectomy for weight loss.
Pay him nothing and tell him where to go. Dianna is dead right. I just wonder if this means his keeping medical records in accordance with law on you or if he just bills email consults to line his fat pockets.
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Post by Deleted on Jan 20, 2012 21:23:17 GMT -5
Time is money, but any generated bills should come with full disclosure. There should be a blanket e-mail response from his office detailing fees with the option of proceeding for a fee or backing out without incurring any expenses.
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Post by newyorkbitch on Jan 20, 2012 21:28:08 GMT -5
Okay. Is this normal business practice?? Today I received a bill from Dr. Michel Gagner for 'consulting' with me through email. Charge? $100, with 2% monthly charge if late. I was very surprised, since he had never mentioned there was a charge for communicating with him by email. I had given him my address and asked him to send information on the hospital, his office, the aftercare - which he never did. Instead, he used my address to send me a BILL. We wrote back & forth in September; However, I decided to check out other options, because he said he may have to do a revision from lapband to DS in 2 stages - wouldn't know til he was 'in there.' Also, I couldn't get a direct answer about what sort of follow-up care he offered. Maybe it would have been just fine, but I couldn't get a direct answer. AND I certainly couldn't afford TWO self-pay surgeries. Maybe it is usual & normal to send a bill like this - but it kind of ticked me off. Has this happened to anyone else? I assume you emailed about your obesity, your medical condition, the advisability of surgery, etc? That's not a "sales pitch" that's a consult. And he has no obligation to work for free, ever. I have carpa tunnel syndrome. I have been to 2 surgeons to discuss my options and whether they are the right surgeon for me. Of course those consults cost money. This is no different. The fact that it was email doesn't change that. Doctors charge for phone consults all the time. Just because email consults are relatively new, doesn't make them different. However, I fully agree that he should have told you what his consult fee was. Without mutual understanding of the fee, you have no obligation. |
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Post by patxyz on Jan 20, 2012 21:31:49 GMT -5
Time is money, but any generated bills should come with full disclosure. There should be a blanket e-mail response from his office detailing fees with the option of proceeding for a fee or backing out without incurring any expenses. And this I would have absolutely accepted and understood, but there was nothing. I've exchanged 3 emails with him and the only mention of any fees was the surgical fee ($18,500) and that it would have to be paid in full at least 30 days ahead of surgery. That's it. I've looked over everything. It doesn't seem right that after a phone call and a couple of short emails that he can bill me without first telling me there was a fee for 'consulting' with him. There is one reason I'm thinking of paying it though. If there is any problem with my DS that my surgeon can't handle, he is the guy my surgeon would refer me to. So I'm a little worried about torching that bridge over $150 that really isn't a big deal for me. But it's the friggin' principle! Maybe I should just enclose a snarky note with the cheque about how the College of Physicians and Surgeons didn't think it was a good practice (presuming I hear back from them about this next week). I think first I will email his office assistant asking her to explain the bill since I was never advised of any fees and see what I get back. |
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Post by newyorkbitch on Jan 20, 2012 21:33:59 GMT -5
THE FOLLOWING IS NOT LEGAL ADVICE - I AM NOT A CONTRACT ATTORNEY, NOT QUALIFIED TO GIVE YOU ADVICE ABOUT CONTRACT LAW IN YOUR STATE (AND I DON'T EVEN KNOW WHAT STATE YOU LIVE IN) AND CERTAINLY NOT THE LAW OF CANADA, BUT I MIGHT WRITE A LETTER SOMETHING LIKE THIS TO MAKE HIM REALIZE IT WOULD NOT BE PRODUCTIVE TO PURSUE THIS FURTHER:
Dear Dr. Gagner, I may not be familiar with standard medical business practice in Canada, nor any other form of business in which a POTENTIAL CUSTOMER makes a telephonic or email inquiry about the professional services offered by the practitioner or business, but certainly in the United States those are business communications, i.e., sales pitches, which are EXPECTED by both the POTENTIAL CUSTOMER and the business to be offered free of charge. They are, in essence, the SELLING part of the establishment of the relationship between the POTENTIAL CUSTOMER and the business. I was beyond astonished, therefore, to receive in January 2012 a bill from you for our brief email exchange in September 2011. The topic of those emails was a request for information about the medical services you, your office and the hospital you are affliated with provide, your qualifications to provide those services, and the cost of those services. The time you took to correspond with me is appreciated, but it was part of YOUR cost of doing business to provide such information to your POTENTIAL CUSTOMERS. I never agreed to pay for the time you took to answer my inquiry about your business practices and medical services. We do not and did not have a doctor-patient relationship. There was no contract for services, and in fact your provided me no billable services, and certainly no billable medical services. You quite correctly deferred any specific answers to my questions that called for medical opinion to a time when you could examine me in person. You merely provided general answers to my inquiry about the POTENTIAL for hiring you to perform these services. In fact, after hearing what you had to say, in particular when you would not answer direct questions about follow up care, or under what circumstances you might decide to do my surgery in two parts, which is an almost unheard of occurrance in the US when surgery is performed by competent DS revision surgeons, I decided to go in a different direction. Under US law, founded in UK common law which I understand also forms the foundation of Canadian law, a contract is established by offer and acceptance. A contractual obligation does not exist until both steps have taken place, and there is a meeting of the minds with respect to the nature of the services to be rendered and the amount and nature of the consideration therefor. Your email communications with me were an OFFER of services; I did not accept. I certainly never agreed to pay for you to make an offer of your medical services, and a claim that my inquiry amounted to a medical consultation is farfetched indeed. If you believe under Canadian law that you have a right to send me an invoice for a sales pitch about your services, for which I never agreed to pay, either in advance or afterwards, and to pursue collection of those charges via legal channels, please feel free to do so. You certainly are welcome to argue in a US court that I owe you money for your sales pitch, but I feel quite confident that under US law, you will not find satisfaction for your claim. Sending out invoices for medical or other services which have not been rendered, nor agreed to, would likely violate various state and federal laws in the United States. I suspect the same would be true in Canada. I therefore respectfully request that you withdraw and void your invoice immediately. Sincerely, Elise Or you could just say: Dear Dr Gagner, You did not inform me that there is a fee associated with your email consultation, nor did you inform me what that fee was. Therefore I do not intend to pay it. Sincerely, XXX However, if you want him to be your surgeon, pay the fee and move forward with him. Doesn't get better than Gagner for a DS. He was my surgeon. I think he's an asshole, but he's a good surgeon. Or, if you decide to move forward with him, you could tell him that and tell him you expect him to apply your consult fee toward the surgical fee. |
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Post by patxyz on Jan 20, 2012 21:35:18 GMT -5
Okay. Is this normal business practice?? Today I received a bill from Dr. Michel Gagner for 'consulting' with me through email. Charge? $100, with 2% monthly charge if late. I was very surprised, since he had never mentioned there was a charge for communicating with him by email. I had given him my address and asked him to send information on the hospital, his office, the aftercare - which he never did. Instead, he used my address to send me a BILL. We wrote back & forth in September; However, I decided to check out other options, because he said he may have to do a revision from lapband to DS in 2 stages - wouldn't know til he was 'in there.' Also, I couldn't get a direct answer about what sort of follow-up care he offered. Maybe it would have been just fine, but I couldn't get a direct answer. AND I certainly couldn't afford TWO self-pay surgeries. Maybe it is usual & normal to send a bill like this - but it kind of ticked me off. Has this happened to anyone else? I assume you emailed about your obesity, your medical condition, the advisability of surgery, etc? That's not a "sales pitch" that's a consult. And he has no obligation to work for free, ever. I have carpa tunnel syndrome. I have been to 2 surgeons to discuss my options and whether they are the right surgeon for me. Of course those consults cost money. This is no different. The fact that it was email doesn't change that. Doctors charge for phone consults all the time. Just because email consults are relatively new, doesn't make them different. However, I fully agree that he should have told you what his consult fee was. Without mutual understanding of the fee, you have no obligation. It's true that time is money, but the initial conversations are very general. Dr. Gagner sends you info and asks you to go get a bunch of test done and you discuss when you'll meet for an in-person consultation ahead of surgery and a potential surgery date, that's it. If he expects to get paid for telling you what you need to do in order to be evaluated for surgery, he needs to tell people that before he engages with them any further. |
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Post by patxyz on Jan 20, 2012 21:37:24 GMT -5
THE FOLLOWING IS NOT LEGAL ADVICE - I AM NOT A CONTRACT ATTORNEY, NOT QUALIFIED TO GIVE YOU ADVICE ABOUT CONTRACT LAW IN YOUR STATE (AND I DON'T EVEN KNOW WHAT STATE YOU LIVE IN) AND CERTAINLY NOT THE LAW OF CANADA, BUT I MIGHT WRITE A LETTER SOMETHING LIKE THIS TO MAKE HIM REALIZE IT WOULD NOT BE PRODUCTIVE TO PURSUE THIS FURTHER:
Dear Dr. Gagner, I may not be familiar with standard medical business practice in Canada, nor any other form of business in which a POTENTIAL CUSTOMER makes a telephonic or email inquiry about the professional services offered by the practitioner or business, but certainly in the United States those are business communications, i.e., sales pitches, which are EXPECTED by both the POTENTIAL CUSTOMER and the business to be offered free of charge. They are, in essence, the SELLING part of the establishment of the relationship between the POTENTIAL CUSTOMER and the business. I was beyond astonished, therefore, to receive in January 2012 a bill from you for our brief email exchange in September 2011. The topic of those emails was a request for information about the medical services you, your office and the hospital you are affliated with provide, your qualifications to provide those services, and the cost of those services. The time you took to correspond with me is appreciated, but it was part of YOUR cost of doing business to provide such information to your POTENTIAL CUSTOMERS. I never agreed to pay for the time you took to answer my inquiry about your business practices and medical services. We do not and did not have a doctor-patient relationship. There was no contract for services, and in fact your provided me no billable services, and certainly no billable medical services. You quite correctly deferred any specific answers to my questions that called for medical opinion to a time when you could examine me in person. You merely provided general answers to my inquiry about the POTENTIAL for hiring you to perform these services. In fact, after hearing what you had to say, in particular when you would not answer direct questions about follow up care, or under what circumstances you might decide to do my surgery in two parts, which is an almost unheard of occurrance in the US when surgery is performed by competent DS revision surgeons, I decided to go in a different direction. Under US law, founded in UK common law which I understand also forms the foundation of Canadian law, a contract is established by offer and acceptance. A contractual obligation does not exist until both steps have taken place, and there is a meeting of the minds with respect to the nature of the services to be rendered and the amount and nature of the consideration therefor. Your email communications with me were an OFFER of services; I did not accept. I certainly never agreed to pay for you to make an offer of your medical services, and a claim that my inquiry amounted to a medical consultation is farfetched indeed. If you believe under Canadian law that you have a right to send me an invoice for a sales pitch about your services, for which I never agreed to pay, either in advance or afterwards, and to pursue collection of those charges via legal channels, please feel free to do so. You certainly are welcome to argue in a US court that I owe you money for your sales pitch, but I feel quite confident that under US law, you will not find satisfaction for your claim. Sending out invoices for medical or other services which have not been rendered, nor agreed to, would likely violate various state and federal laws in the United States. I suspect the same would be true in Canada. I therefore respectfully request that you withdraw and void your invoice immediately. Sincerely, Elise Or you could just say: Dear Dr Gagner, You did not inform me that there is a fee associated with your email consultation, nor did you inform me what that fee was. Therefore I do not intend to pay it. Sincerely, XXX However, if you want him to be your surgeon, pay the fee and move forward with him. Doesn't get better than Gagner for a DS. He was my surgeon. I think he's an asshole, but he's a good surgeon. Or, if you decide to move forward with him, you could tell him that and tell him you expect him to apply your consult fee toward the surgical fee. It appears as though he's only charging the fee to people who spoke with him or emailed him but who decided not to have surgery with him. |
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Post by karenflorida on Jan 21, 2012 21:50:32 GMT -5
It appears as though he's only charging the fee to people who spoke with him or emailed him but who decided not to have surgery with him. I think you're right. I had surgery with him and was not billed for the phone / email consultations. Karen |
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Post by scoob on Jan 22, 2012 8:14:01 GMT -5
THE FOLLOWING IS NOT LEGAL ADVICE - I AM NOT A CONTRACT ATTORNEY, NOT QUALIFIED TO GIVE YOU ADVICE ABOUT CONTRACT LAW IN YOUR STATE (AND I DON'T EVEN KNOW WHAT STATE YOU LIVE IN) AND CERTAINLY NOT THE LAW OF CANADA, BUT I MIGHT WRITE A LETTER SOMETHING LIKE THIS TO MAKE HIM REALIZE IT WOULD NOT BE PRODUCTIVE TO PURSUE THIS FURTHER:
Dear Dr. Gagner, I may not be familiar with standard medical business practice in Canada, nor any other form of business in which a POTENTIAL CUSTOMER makes a telephonic or email inquiry about the professional services offered by the practitioner or business, but certainly in the United States those are business communications, i.e., sales pitches, which are EXPECTED by both the POTENTIAL CUSTOMER and the business to be offered free of charge. They are, in essence, the SELLING part of the establishment of the relationship between the POTENTIAL CUSTOMER and the business. I was beyond astonished, therefore, to receive in January 2012 a bill from you for our brief email exchange in September 2011. The topic of those emails was a request for information about the medical services you, your office and the hospital you are affliated with provide, your qualifications to provide those services, and the cost of those services. The time you took to correspond with me is appreciated, but it was part of YOUR cost of doing business to provide such information to your POTENTIAL CUSTOMERS. I never agreed to pay for the time you took to answer my inquiry about your business practices and medical services. We do not and did not have a doctor-patient relationship. There was no contract for services, and in fact your provided me no billable services, and certainly no billable medical services. You quite correctly deferred any specific answers to my questions that called for medical opinion to a time when you could examine me in person. You merely provided general answers to my inquiry about the POTENTIAL for hiring you to perform these services. In fact, after hearing what you had to say, in particular when you would not answer direct questions about follow up care, or under what circumstances you might decide to do my surgery in two parts, which is an almost unheard of occurrance in the US when surgery is performed by competent DS revision surgeons, I decided to go in a different direction. Under US law, founded in UK common law which I understand also forms the foundation of Canadian law, a contract is established by offer and acceptance. A contractual obligation does not exist until both steps have taken place, and there is a meeting of the minds with respect to the nature of the services to be rendered and the amount and nature of the consideration therefor. Your email communications with me were an OFFER of services; I did not accept. I certainly never agreed to pay for you to make an offer of your medical services, and a claim that my inquiry amounted to a medical consultation is farfetched indeed. If you believe under Canadian law that you have a right to send me an invoice for a sales pitch about your services, for which I never agreed to pay, either in advance or afterwards, and to pursue collection of those charges via legal channels, please feel free to do so. You certainly are welcome to argue in a US court that I owe you money for your sales pitch, but I feel quite confident that under US law, you will not find satisfaction for your claim. Sending out invoices for medical or other services which have not been rendered, nor agreed to, would likely violate various state and federal laws in the United States. I suspect the same would be true in Canada. I therefore respectfully request that you withdraw and void your invoice immediately. Sincerely, Elise EXALT!!! Cause you're awesome!! Ruby |
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Post by omeaga7 on Jan 22, 2012 9:55:15 GMT -5
Wow that bites. Thanks for the info. I would not be hacky if I was not informed that I would be billed for an email. On that note, I would not pay it either.
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Post by omeaga7 on Jan 22, 2012 9:56:22 GMT -5
THE FOLLOWING IS NOT LEGAL ADVICE - I AM NOT A CONTRACT ATTORNEY, NOT QUALIFIED TO GIVE YOU ADVICE ABOUT CONTRACT LAW IN YOUR STATE (AND I DON'T EVEN KNOW WHAT STATE YOU LIVE IN) AND CERTAINLY NOT THE LAW OF CANADA, BUT I MIGHT WRITE A LETTER SOMETHING LIKE THIS TO MAKE HIM REALIZE IT WOULD NOT BE PRODUCTIVE TO PURSUE THIS FURTHER:
Dear Dr. Gagner, I may not be familiar with standard medical business practice in Canada, nor any other form of business in which a POTENTIAL CUSTOMER makes a telephonic or email inquiry about the professional services offered by the practitioner or business, but certainly in the United States those are business communications, i.e., sales pitches, which are EXPECTED by both the POTENTIAL CUSTOMER and the business to be offered free of charge. They are, in essence, the SELLING part of the establishment of the relationship between the POTENTIAL CUSTOMER and the business. I was beyond astonished, therefore, to receive in January 2012 a bill from you for our brief email exchange in September 2011. The topic of those emails was a request for information about the medical services you, your office and the hospital you are affliated with provide, your qualifications to provide those services, and the cost of those services. The time you took to correspond with me is appreciated, but it was part of YOUR cost of doing business to provide such information to your POTENTIAL CUSTOMERS. I never agreed to pay for the time you took to answer my inquiry about your business practices and medical services. We do not and did not have a doctor-patient relationship. There was no contract for services, and in fact your provided me no billable services, and certainly no billable medical services. You quite correctly deferred any specific answers to my questions that called for medical opinion to a time when you could examine me in person. You merely provided general answers to my inquiry about the POTENTIAL for hiring you to perform these services. In fact, after hearing what you had to say, in particular when you would not answer direct questions about follow up care, or under what circumstances you might decide to do my surgery in two parts, which is an almost unheard of occurrance in the US when surgery is performed by competent DS revision surgeons, I decided to go in a different direction. Under US law, founded in UK common law which I understand also forms the foundation of Canadian law, a contract is established by offer and acceptance. A contractual obligation does not exist until both steps have taken place, and there is a meeting of the minds with respect to the nature of the services to be rendered and the amount and nature of the consideration therefor. Your email communications with me were an OFFER of services; I did not accept. I certainly never agreed to pay for you to make an offer of your medical services, and a claim that my inquiry amounted to a medical consultation is farfetched indeed. If you believe under Canadian law that you have a right to send me an invoice for a sales pitch about your services, for which I never agreed to pay, either in advance or afterwards, and to pursue collection of those charges via legal channels, please feel free to do so. You certainly are welcome to argue in a US court that I owe you money for your sales pitch, but I feel quite confident that under US law, you will not find satisfaction for your claim. Sending out invoices for medical or other services which have not been rendered, nor agreed to, would likely violate various state and federal laws in the United States. I suspect the same would be true in Canada. I therefore respectfully request that you withdraw and void your invoice immediately. Sincerely, Elise A.W.E.S.O.M.E. |
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Post by rhiannon on Jan 24, 2012 13:03:47 GMT -5
I emailed back and forth with Dr Gagner in early winter of 2010. Ended up going with Dr Ungson. Have not received a bill from Dr Gagner. Probably had 5 or 6 communications. I could see why he may have begun charging people who may have decided not to go with him, however that should be disclosed up front, or all communications should be handled by office staff. At the time I was conferring with him he still was not completely set up in his office I believe, and it seems like he's very hands on, contacting potential patients and setting up surgery dates himself. I e-mailed him expecting to get an answer from an office, not from him, and it appeared to me that he was the only source to contact at that time. I would have been very unhappy to have received a bill I was not forewarned about.
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Post by mlleelise on Jan 24, 2012 17:12:31 GMT -5
HE FOLLOWING IS NOT LEGAL ADVICE - I AM NOT A CONTRACT ATTORNEY, NOT QUALIFIED TO GIVE YOU ADVICE ABOUT CONTRACT LAW IN YOUR STATE (AND I DON'T EVEN KNOW WHAT STATE YOU LIVE IN) AND CERTAINLY NOT THE LAW OF CANADA, BUT I MIGHT WRITE A LETTER SOMETHING LIKE THIS TO MAKE HIM REALIZE IT WOULD NOT BE PRODUCTIVE TO PURSUE THIS FURTHER: Dear Dr. Gagner, I may not be familiar with standard medical business practice in Canada, nor any other form of business in which a POTENTIAL CUSTOMER makes a telephonic or email inquiry about the professional services offered by the practitioner or business, but certainly in the United States those are business communications, i.e., sales pitches, which are EXPECTED by both the POTENTIAL CUSTOMER and the business to be offered free of charge. They are, in essence, the SELLING part of the establishment of the relationship between the POTENTIAL CUSTOMER and the business. I was beyond astonished, therefore, to receive in January 2012 a bill from you for our brief email exchange in September 2011. The topic of those emails was a request for information about the medical services you, your office and the hospital you are affliated with provide, your qualifications to provide those services, and the cost of those services. The time you took to correspond with me is appreciated, but it was part of YOUR cost of doing business to provide such information to your POTENTIAL CUSTOMERS. I never agreed to pay for the time you took to answer my inquiry about your business practices and medical services. We do not and did not have a doctor-patient relationship. There was no contract for services, and in fact your provided me no billable services, and certainly no billable medical services. You quite correctly deferred any specific answers to my questions that called for medical opinion to a time when you could examine me in person. You merely provided general answers to my inquiry about the POTENTIAL for hiring you to perform these services. In fact, after hearing what you had to say, in particular when you would not answer direct questions about follow up care, or under what circumstances you might decide to do my surgery in two parts, which is an almost unheard of occurrance in the US when surgery is performed by competent DS revision surgeons, I decided to go in a different direction. Under US law, founded in UK common law which I understand also forms the foundation of Canadian law, a contract is established by offer and acceptance. A contractual obligation does not exist until both steps have taken place, and there is a meeting of the minds with respect to the nature of the services to be rendered and the amount and nature of the consideration therefor. Your email communications with me were an OFFER of services; I did not accept. I certainly never agreed to pay for you to make an offer of your medical services, and a claim that my inquiry amounted to a medical consultation is farfetched indeed. If you believe under Canadian law that you have a right to send me an invoice for a sales pitch about your services, for which I never agreed to pay, either in advance or afterwards, and to pursue collection of those charges via legal channels, please feel free to do so. You certainly are welcome to argue in a US court that I owe you money for your sales pitch, but I feel quite confident that under US law, you will not find satisfaction for your claim. Sending out invoices for medical or other services which have not been rendered, nor agreed to, would likely violate various state and federal laws in the United States. I suspect the same would be true in Canada. I therefore respectfully request that you withdraw and void your invoice immediately. Sincerely, Elise Read more: www.weightlosssurgery.proboards.com/index.cgi?action=display&board=talk&thread=1342&page=1#18654#ixzz1kPlTRNTnWow! I was gone for a few days - (thought the discussion had ended) - came back and found SO many more comments. Thanks for your input. Patxyz, please let me know what you find out about the legality of the bill, okay? Diana, once again, you are MOST AWESOME!! Thank you for the letter. I WILL send it to him, with a few tweaks. I am ticked also because I gave my address to him in an email, asking him to send info on the hospital, after-care, etc - and instead I got a bill! He never provided any info which I specifically asked for. At our last correspondence, he knew I was waiting to hear from my insurance. If denied (which I was), I was considering traveling to Montreal because it isn't that far. I DID decide to go in another direction, because I couldn't get an answer about aftercare - and he still didn't apparently have an office staff to work with. So, he didn't know that I was going with another doctor - still doesn't. (I may be repeating things I already posted - sorry!) I do understand that this might be beginning to be a routine practice- but it's not right. When you get estimates at an autobody shop for your car, you're not charged for the estimate. When you have a bunch of different contractors come & look at your home to build an addition, they don't charge for that time - nor for the paper estimate. I know doctors are different - but they shouldn't be...or at least they should tell you when you are going to be charged for the 'privilege' of digital communication. |
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Post by stillhopefull on Jan 24, 2012 20:24:04 GMT -5
I also received a bill toady from him for $250. At no time did he state there would be a charge. I work for a medical oncologist and she calls patients all the time and does not charge along with numerous doctors in the practice. This is unethical and should be against the law.
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Post by Happy DSr on Jan 24, 2012 20:40:20 GMT -5
THE FOLLOWING IS NOT LEGAL ADVICE - I AM NOT A CONTRACT ATTORNEY, NOT QUALIFIED TO GIVE YOU ADVICE ABOUT CONTRACT LAW IN YOUR STATE (AND I DON'T EVEN KNOW WHAT STATE YOU LIVE IN) AND CERTAINLY NOT THE LAW OF CANADA, BUT I MIGHT WRITE A LETTER SOMETHING LIKE THIS TO MAKE HIM REALIZE IT WOULD NOT BE PRODUCTIVE TO PURSUE THIS FURTHER:Under US law, founded in UK common law which I understand also forms the foundation of Canadian law, a contract is established by offer and acceptance. A contractual obligation does not exist until both steps have taken place, and there is a meeting of the minds with respect to the nature of the services to be rendered and the amount and nature of the consideration therefor. Elise also not a lawyer, but wanted to let you know that Quebec law is not based on Common Law for civil litigation. Similar to the state of Louisiana, it is based on French legal tenets, or "Code Civil" (common law does guide the criminal law) |
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