Life as Crisis Management: The Dr. Steven Elfant Kiada

Complaint Against:
Dr. Steven Elfant
855 Central Ave, Suite Ll-112
Albany, NY 12206
518.437.1757
NPI: 1710069463
License: X004851-1 (NY)
Taxonomy: 11N00000X

Complainant:
Dr. Ronald Helfrich Jnr

Complaint:
Some essential backstory first: I saw Doctor Steven Elfant of 845 Central Avenue, Suite L112, Albany, NY 12206, for muscle and neck problems after an accident. State Farm (claim number 52-2B97-641), my automobile insurance company at the time, paid for my care with Elfant from 22 January 2013 and for several months afterwards.

Now back to the present: this case was never closed by Elfant. Given that New York State law requires the case to be closed by the attending physician, in this case Elfant, and Elfant did not close the case, the case remains open and it is now affecting my Medicare coverage in a negative way. Because the case was never closed Medicare has the State Farm coverage as my primary and Medicare as my secondary. Since State Farm isn't covering my doctor and medical bills, Medicare won't and can't pay them. Welcome to my bureaucratic nightmare. I was able to get Medicare changed to primary via the phone but this is, until the case is formally and officially closed, only a short-term solution to a long-term problem. I, of course, want a long-term solution so I don't have to call Medicare and to through the whole process again and again.

I contacted Elfant by phone and asked him to send a letter to State Farm closing the case. Elfant did not allow me to explain the issue talking over me whenever I tried to explain and repeatedly claiming that Medicare and State Farm were lying to me. He initially refused point blank to send a letter to State Farm and that the case could not be open because that is not the way insurance works and works in New York State. Assemblyman John McDonald, on the other hand, who I contacted about this issue, notified me that it is the law in NY State that a case like mine remains open in the state until it is closed by the attending physician. Later, Elfant called me back by phone and agreed to sign a letter if I wrote it. 

Needless to say, I find such behaviour unacceptable, problematic, and unprofessional hence my formal complaint herein. By initially refusing to listen to why I needed him to close the case and by dismissing the empirical facts, Elfant negatively impacted my health care, my health, and the doctors Medicare owes monies to that I saw.

In sum, Dr. Elfant violated his obligation to me and to NY State law when he refused to do anything about the open State Farm insurance that is keeping me from getting my Medicare properly and, as a consequence, is keeping Medicare from paying my doctors. He only reluctantly agreed to do this IF AND ONLY IF I wrote the letter for him and I assumed responsibility for everything relating to closing the State Farm insurance. I will be doing this as soon as I get the letter from State Farm. 

In closing, let me point up the arrogance (it is arrogance when you think you are right when you are actually wrong) of Elfant expressed in his rhetoric that he knows NY State law and insurance issues better than any other party including a representative of NY state, State Farm, and Medicare, regardless of any facts to the contrary. Let me also note his total lack of concern about the fact that his failure to close the State Farm case is negatively impacting my Medicare and Medicare's ability to pay my doctors. Finally, let me point out that his behaviour here is a clear violation of every responsibility of his profession, particularly his responsiblity to his patients. I need something to be done about this so I can get on with my life and so Medicare assumes responsibility for my medical care.

Thank you for your prompt attention.

Dr. Ronald Gail Helfrich Jnr.