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Ask HN: Should I sue drchrono (YC W11) for violating their contract w/ me?
211 points by drdal on Feb 4, 2014 | hide | past | web | favorite | 31 comments
[1 of 2]: My name is Dr. Dal Bedi. I'm owner of a medical practice in Va. I took a chance on a start-up drchrono as my EHR & billing service provider; both services being a vital part of my business. It's a decision I wish I never made. In the past 5 mo, I've had massive issues w/ the drchrono service. The setup of their billing & collections services has taken 4 months due to repeated, inept errors by outsourced-to-India drchrono billing staff. Other drchrono users have been complaining about similar issues & have asked for refunds: http://bit.ly/1doMER9 & http://bit.ly/1fL8dzH. I've forwarded pages of errors to the drchrono staff http://cl.ly/image/200i2D2y1s2R , http://cl.ly/image/1z0g230x0N1I , http://cl.ly/image/3H072F0f3k43 , http://cl.ly/image/0k3G1t2h3h3w , http://cl.ly/image/0V1x2h3E2m43 , escalated w/ their support team for months, and finally escalated to the CEO, Michael Nusimow. When that proved ineffective, I asked for a refund for the months when the service wasn't functional, all while being a committed customer w/o a single outstanding balance. This past Xmas Eve, drchrono sent me an email raising my monthly fee 3x from $1.5k/mo to $4.5k/mo starting Jan 1st, 2014 w/o any reason given -- even tho. we have a signed contract which sets the price for their services and can't be changed.



drchrono cofounder here.

I spoke with Dr. Dal on the phone and we worked out his issues. We try to make all of our users happy, but from time to time things don't work out. The drchrono team and I are working to change healthcare doctor by doctor and healthcare is a hard space to fix.

Dr. Dal was using our RCM (Revenue Cycle Management) service where we do all of the staff work for billing for the Doctor in exchange for a percentage of all of the insurance collections done in a month. There is a monthly minimum fee for the first few months the service ramps up, but for all of these contracts the percentage of billing fees is designed to exceed the monthly minimum in a steady state. In all the months Dr. Dal was using our RCM service he was paid on all of his medical claims in our system, but his account still never exceeded the minimum fee.

We raised rates for all of our RCM customers whose contracts weren't exceeding the minimums across the board. We gave customers several months notice about these rate changes and helped any customer that wanted to do their own billing or port to another service do so.

All of our users have access to download all of their data at any time. Users can also synch all of their data on an ongoing basis to Box's Enterprise HIPAA compliant storage. We put up a blog post to highlight these features and give instructions for users with links to our knowledge base: https://drchrono.com/blog/backup-records-outside-drchrono/

I think it's important that users always have access to their own data to use with other services at their convenience and to have for their own safety and peace of mind.


Yes, file the suit.

Lawsuits serve more purposes than just taking an issue to trial - they are also a mechanism to force the resolution of an issue when more reasonable conflict resolution methods have failed.

Nobody really wants to go to trial over stuff like this - but it will force them to stop ignoring the situation. (Or, if their story differs from yours, it will force their side to come forward as well.)

It is almost always less painful to settle outside of court once a suit is filed, and odds are that is exactly what they will do if you file the suit.


Speaking as a physician, and with the caveat that I assume Dr. Bedi wouldn't waste his time if this story wasn't mostly accurate, I want to express my frustration - this is why we can't have nice things!

Medical bureaucracies are very reticent to chose software from companies that don't have a long track record. Examples like this are why we have to suffer through 1980s era software to get our work done.


Yes, this family member of mine who's in the start-up world really encouraged me to go with drchrono originally because he wanted me to be able to take advantage of the newest technology in my field. This whole process has been extremely stressful and frustrating.


Having worked in the medical billing industry (supported a "competitor" to DrChrono), I've seen many complaints like this come through our e-mail system. It's not always 100% as cut and dry as it should be. The medical billing industry is a huge disaster. One lady threatened to sue us because we weren't doing her billing, but when pointed toward to multiple requests for the government mandated information (CMNs) she must provide, she said "she didn't know what that meant" (and that's with support staff more than willing to answer those questions, instead she apparently just trashed the emails).

Other times medicare would just pull the rug out from under us and enforce some new requirement that would takes weeks to implement.

And other times it surely was our billing company's fault. Something was billed with the wrong diagnosis code, then the insurance company takes too long to get back (or doesn't at all, or the system has a bug and doesn't process it), then it falls off the biller's radar and gets forgotten.

Either way, you should get a reply from them letting you know WHY your billing isn't being done, when it's going to be fixed, and what steps will be taken to avoid it happening again. I think there are really two separate issues here, the quality of service (which is debatable whether you should pursue legal action) and the price increase (which you probably should get some legal council about).

Regardless, the medical billing industry is a pain in the ass and I'm so glad to be out of that line of work.

*If a 1990s moped can be seen as a competitor to a ferrari


I think you've made the correct move posting here (since it's on the front page). If you don't get rectification this week I would most certainly sue. You shouldn't "feel bad" that they're a start up. They're screwing you over and practicing bad business.

Pretty crappy stuff from a YC company but this doesn't surprise me anymore.


I understand you posted this here. If this business (yes, a startup is a business) doens't feel it should respond to client's questions and even a freaking legal letter (even though there are clear contracts in place) well, then "getting the word out" could just push them in your direction. No sane developer/designer would want to work for this specific business. I don't even know them, but based upon your post my mind is thinking they'll probably go out of business soon. I bet we'll see a statement from them at this very spot soon. It'd better not be a bs statement.


If what you say is accurate, the only other thing I would try is reaching out to one or more of their investors / board members. It might not help, but as a paying customer, I'm sure they'd want to know (and can make a call and get your grievance bumped to the top of the line).

Since your representing that your business is in jeopardy, do what you need to do. It's great that you are sensitive to the plight of startups and don't want to do anything that might hurt their chances of success. However, they also have to live up to their end of the deal. If they aren't communicating with you, that's a huge problem.


| the only other thing I would try is reaching out to one or more of their investors / board members

I think that's what he is doing right now :)


I don't know the valley very well so it's hard for me to navigate it. I did ask a family member who's in the startup world for advice (he suggested I post here) and he tried reaching out to a few of his contacts but I don't believe it went anywhere. The most frustrating thing for me has been the CEO's attitude. From my very first interaction with him he seemed uninterested in helping resolve this. If I were the CEO of a startup, I would be paying super close attention to my userbase and their concerns. I just can't understand why he hasn't jumped at the chance to make things right with me and the other doctors who have had similar problems.


You should be getting a reaction in about 5, 4, 3, ...


As we say in the guidelines,

http://ycombinator.com/newsguidelines.html

HN is a news site, not a forum for people with issues with companies we've funded (even when concealed as Ask HNs). So I'm killing this. If you have an issue with Dr Chrono, please contact them directly.


This is actually pretty fascinating that you posted this here. Really highlights how companies can't hide from a bad customer experience anywhere. People are going to find out if your treating your customers badly.

I wonder if this thread is going to get deleted soon?



If a company doesn't treat you properly and refuses to help, cut your losses and move on.

Switch to athenahealth. By far the best company in the space (my wife works there so I'm biased), but you can dig in to their financials (NSDQ: ATHN) and see for yourself.

http://www.athenahealth.com/

Medical billing is an incredibly broken process, so I applaud anyone trying to fix the problem. There is never an excuse for treating customers poorly, however. If you do, you will no longer have a business.


If everything you said is true, then I feel terrible because I've recommended DrChrono to at least 10 different independent physicians in the last couple of years, two of whom I know use it. I regret that I recommended it without actually trying it out for myself and judged it based on their marketing material and association with the YC brand.

I hope there is more to the story here and maybe they haven't been able to explain their side well due to reasons beyond their control (legal, contracts etc.) I come across a lot of physicians who run their own practice here in Florida and DrChrono has been my goto answer to their EMR/EHR maladies. I really don't want to recommend AllScripts or EPIC.


Sue

This is business impacting, and while emotionally, I can understand your desire to help out a new entrant in the field... they are violating your trust, endangering your livelihood, and extorting money out of you against written contracts. The off contract fee increase may be the saving grace that lets you legally out of the contract early, depending on how the contract is worded.

There is likely a set amount of time to wait for compliance, but after it is over, I would not hesitate to seek redress of grievances. You're talking about your patients data and your income, which should be your first and second priorities.

Note that I am not a lawyer.


HN accounts of drchrono co-founders, although both last commented over a year ago:

http://news.ycombinator.com/user?id=d8niel

http://news.ycombinator.com/user?id=Skeletor


Yes sue. Stop messing around and sue, today...now. Stop reading this, pick up the phone, call your lawyer and tell him to file the papers today.


This. Startups are not an excuse for crap services, and this should never become something acceptable.


Don't let the fact that drchrono is a startup stop you from suing. Drchrono is a business. They've breached their contract. Tear them apart. If possible, put them out of business.


I work for a similar company. When our clients encounter issues like these (esp when money is involved) we will be sure enough to respond quickly and if it escalates to the CEO, I believe, we always pay the price in terms of compensation or apologizing for our mistakes and some clients just leave us. But even after escalating your problem to the CEO and you get such response, I think you should leave drchrono and if you don't get compensation back I think it's appropriate to sue them.

BTW the company that I work for is called CareCloud (we are established in revenue cycle management)


This sounds like growing-pains for a growing business that has perhaps bitten more than it can chew. I would suggest you wait, now that you are surely going to get their attention :)

If they don't respond to this, then by all means take them to small claims court.


[2 of 2]: I finally sent them a demand letter 2+ weeks ago stating that I wanted to leave the service & asking for my patient & billing data back. They haven't responded to it despite requests from me and from my attorney. My attorney says the next step is to file a lawsuit against them. I don't want to do that to a startup, but they are holding my patient data hostage in their system and refusing to respond to the demand letter. Without that data, my ability to do business is in jeopardy. Any suggestions on what I should do? I badly need my data back.


If what you've said is all true, and you've thoroughly gone over with your attorney all of the grievances and have enough data to back it up, and they have yet to respond within a reasonable timeframe through a legal channel, then go for their jugular and take them out. Don't relent on these types of offenses, doubly so if they are a start-up. Without knowing too much about the founders, say this kind of activity goes unchecked, and continues rampant within their business despite still being successful. That could potentially send signals to departing entrepreneurs that this kind of behavior is OK and that they could very well get away with it as well.

Go for the kill.


1. Ask nicely.

2. Ask via lawyer.

3. Ask via judge.

It sounds like you've already tried the first two options.


Does the contract give you the right to get your patient & billing data back?


The same way that health issues are better discussed with a doctor, legal issues are better discussed with a lawyer.


I don't think he is asking for legal advice. I think it actually shows a lot of courtesy to post here. It seems to me that he understands lawsuits can destroy a young company and simply wants to find out if anyone in the startup community has any ideas on how to better resolve the issue or if anyone might be able to offer non-legal assistance. He clearly has a lawyer to advise him on his legal remedies.


Yes, exactly. I really didn't not want to go that route and reached out to drchrono several times but to no avail.


Yeah, he noted in the comments that he has consulted his lawyer, they have taken steps, written letters. The last option is a formal suit, which would have impact on the community's view of him and DrChrono, hence the community outreach. PLUS public shaming is a kinder ultimatum than a fomral suit, as I see it.




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