Mr. Mike Healy
Sheppard Pratt Collections
6501 North Charles Street
P.O. Box 6815
Baltimore, Maryland 21285-6815
Re: Patient Number: 30285-1
Date of Admission: September 30, 1996
Dear Mr. Healy:
It is well known that Sheppard and Enoch Pratt Hospital (SEPH) has undergone recent financial problems, some of which have led to SEPH's merger with the nearby Greater Baltimore Medical Center (GBMC). It is also known that the Chemical Dependency Unit as it existed at the time of the alleged charges has been dismantled, the remains merged with a GBMC entity and personnel transferred accordingly. It is also known that the billing supervisor on site at the Chemical Dependency Unit terminated abruptly and without warning during the period at issue.
Referring to the attachments, all charges relate to a voluntary, outpatient program where I paid by check or credit card at the time of service and in full. Contrary to SEP assertions, my checking records reveal Check No. 648 in the amount of $130 for "Initial Evaluation" dated September 30, 1997, clearing in the same amount on October 11, 1996. Many other people in the program relied on a variety of insurance policies and insurance carriers. To my direct knowledge at least five insurance carriers were also participants in the program. I am not aware of those records or record-keeping.
You have sent printouts of the same four (?) charges in three (3) different formats and five (5) different envelopes during the past month. The printouts are confusing, contradictory, lacking in specifics and, until the third series, do not set forth exactly what is in dispute.
As stated to you over the phone or on your answering machine on a number of occasions, all billings are unfair, misleading, fraudulent and/or in outright error. On their face they violate to a large degree the Price List in effect and distributed at the time of the alleged services (copy attached).
You have waited more than five months since the alleged services were rendered to forward these charges to me. This delay is unlike the pressures put on me while I was in the program to pay in full up front right away.
The program for which you are billing is one in which you have charged and received amounts in the neighborhood of $175 per half-day for group meetings led not by medical or psychological professionals, but by ordinary women whose sole credential is a history of chemical dependency. Two of my checks and several credit card receipts reveal that the payor for the program was "SPPA" and "SPPA" was prominently shown on-site at the billing window and intake office. Thus, apparently, "SPPA" was either the vendor or the agent of the vendor.
According to my records, SPPA has already been paid and received over $3000 in connection with this admission. There were also several hundred dollars in ancillary costs such as transportation and meals.
My entrance into the program on September 30, 1996 was predicated on the offering fee of $130 for an initial evaluation after several telephone inquiries and confirmations. I left my dwelling and travelled to Sheppard Pratt at some expense relying on this representation. You have now told me over the phone that the $130, listed as "Initial Evaluation" on the price list, did not include the 15-minute talk with a Dr. Barney, fully clothed and nary did he check my pulse or blood pressure or press a stethoscope to my chest much less touch me in any way. Had I known that an additional $155 or any other amount would be due, I would not have come to Sheppard Pratt, I would not have signed up for the program and incurred more than $3000 in expenses in connection therewith, I would have done without the service or gone elsewhere. My decision to terminate the program was also based on costs. Had I known about another $440 in charges, I would have terminated $440 earlier.
If you claim that the charge for Dr. Barney was not included in the "Initial Evaluation", you have and are perpetrating deceptive practices, unfair business dealings and, quite frankly, "bait and switch" tactics. The same can be extended to be said about all the charges alleged to total $440 coming as they have after a five-month delay.
For all these reasons, Sheppard Pratt, its agents, assigns, and business partners, at least in this instance, are apparently not acting in good faith, are openly engaging in deceptive practices, including but not limited to "bait and switch" on admissions, are maintaining faulty records, and adhere to different price lists when and if conditions suits it.
Although I am a "self pay" (Blue Cross Major Medical only) and no insurance policy is in effect or invoked, by copy of this letter I am alerting, in addition to the Maryland Attorney General, the Maryland Insurance Administration of this particular fact situation and the evidentiary materials I happened to have retained in my files regarding your business dealings and services. Given the nature of the program [Footnote 1: If you are so insistent on having an actual specimen of a cancelled check, I will contact my bank, have them issue an invoice for this service, and forward it to you for full payment before they issue it. You would thereby clear up $30 out of the $440 you are asking for.Footnote 1: During the month of October, 1996, the vast majority of patients in the program were seeking to overcome addiction to cocaine or heroin. Such persons would and did have concerns about possession, use, sale and ancillary matters, and would be less inclined to challenge a bill on factual grounds.], I am surmising that other patients were not so prescient.
enclosures
cc: Maryland Attorney General
Health Advocacy Unit
Maryland Insurance Administration
Insurance Fraud Division
Att'n: Mr. Larry Morse