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Saturday, September 5, 2015

I letter I just wrote to a doctor in response to an incorrect medical bill

Dear Dr. _______,

I am returning this bill to you unpaid, as it clearly is for services not provided to my daughter based on the accompanying diagnosis code: 364.81 “Floppy Iris Syndrome”.  IFIS was first described by Chang and Campbell in the Journal of Cataract & Refractive Surgery in 2005 (see http://www-ncbi-nlm-nih-gov.liboff.ohsu.edu/pubmed/15899440 ).  Based on their description, this is clearly not a syndrome my daughter suffers from. This disease is diagnosed intraoperatively, typically during cataract surgery.  Since you are not treating my daughter for cataracts, nor did she receive any eye surgery, I am presuming that this bill and related charges are incorrect. 

As a result of sending this bill to my insurance company, my daughter will now have an incorrect diagnosis in her insurance record, which could result in denial of services later in life due to a pre-existing condition.

Thus, I am requesting that you correct the diagnosis, and send a new claim to my insurer.  Upon receiving a corrected bill with an accurate diagnosis, I believe appropriate adjustments will be made to your bill, and I will, upon receipt of an accurate description of services being billed for, pay them based on my insurers agreement.

Sincerely,


/s/

Keith W. Boone

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