Whitaker Eye Works

Review: I have previously had my eye exam at this location with no issues. This year however, was a different story. I was asked upon arrival for my appointment to verify my patient and insurance information was the same from the last visit. I confirmed there were no changes. After my eye exam and picking out my glasses I was presented a hefty bill. It was a bit shocking and was told that they changed their practice to now patients pay the FULL bill then they submit the paperwork to the insurance company. The insurance company will then reimburse the patient. I wasn't prepared to pay that much money but did so knowing I'd be reimbursed. Little did I know that Whitaker Eye Works is no longer an In-Network provider and the insurance company doesn't reimburse out-of-network providers for eye exa**. I called to complain and was told they'd make it up to me next time... Sorry but no. I find this practice to be very deceptive. When I first arrived for my appointment they should have informed me then that they were no longer an in-network provider and the eye exam would not be covered by the insurance.Desired Settlement: Recover the out of pocket expenses incurred to their deception.

Business

Response:

Revdex.com [redacted]

Complaint ID# [redacted]) - [redacted]

**. [redacted] was seen for a comprehensive vision and contact lens eye exam on October 17, 2013.

She purchased a pair of eyewear and an annual supply of contact lenses.

Her prior eye exam here was June 9,2009.

Whitaker Eye Works has not participated with [redacted] Health Plan East since January of 2010.

It is not our responsibility to notify our patients about which plans we accept. When a patient asks if [redacted] Health Plan East will pay for an eye exam, our answer is an emphatic no. Most choose to pay out of pocket anyway and we submit the insurance for them for reimbursement from [redacted] at a later date.

The tenor of **. [redacted]'s letter suggests we intentionally misled her and surprised her by insisting upon payment she did not expect. This tact would certainty put us out of business, as we generate business primarily by word of mouth.

The only time insurance companies reimburse patients is when they choose an out of network provider.

This letter is a really unfair and untrue. We NEVER say "Any changes to your insurance?" That assumes we would accept insurance for payment and we don't. This is the language of physician offices and is not spoken here.

We were more than fair with **. [redacted].

Firstly, no insurance company pays for the contact lens portion of the exam = $75.00.

Secondly, the patient either gets a portion of their glasses or contacts discounted, never both.

**, [redacted] paid $59.00 for her frame. The cost of a frame here ranges from $139.00 to $550.00.

(Her glasses were discounted)

Her ophthalmic lenses cost $150.00 - standard fare.

She also ordered Colored contact lenses and was charged $90,00-fair again. Colored contacts are not covered by any insurance company, let alone along with discounted glasses.

Bottom line - [redacted] needed to pay $125,00 for an eye exam because we are not [redacted] Vision providers. About 50% of us aren't. She chose a contact lens exam, never covered by insurance $75.00.

She then went shopping, bought glasses at a steep discount and contact lenses which would have not been covered by insurance.

I stand by our very fair treatment of **. [redacted].

If we said we would "make it up to her next time," we meant through service and maybe offer a small discount. I have come to know this was already offered and accepted by paying $59.00 for a frame.

We are good people. We have been terribly misrepresented and, candidly I am disappointed and unhappy about it.

There will absolutely be no refund offered. We, in fact, deserve an apology.

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because: