Eye Centers of Southeast Texas, LLP

Issue resolved - received $reimbursement checkThanks for your help

Complaint: 10401223 Looks like this issue is in the process of being resolved - I received two phone calls that the $40 reimbursement check is forthcoming. Thanks for your help. Sincerely, [redacted]

I am responding to a complaint made by *** *** on May 17, 2016. First, I apologize for Ms***’s unpleasant experience in my office. The physicians and staff at Eye Centers are dedicated to providing all of our patients with excellent eye care service and strive
continually to meet the growing needs of all our patients . Ms*** mentions in her complaint that she first requested to see Dr*** but was told he was ‘too booked to see her’. Dr***’s next available appointment for a complete eye exam is usually several months out; therefore, we always give patients who wish to come in sooner the opportunity to see one of our other doctors. Ms*** also mentions in her complaint that she wanted to be seen for a routine eye exam, which she has every year with Dr***. She has actually been seen a total of three times in the past years, and each visit was for a diabetic evaluation. This is not considered a routine eye exam, but a medical exam. She stated to the technician that she had diabetic reversal surgery, but still had diabetes genetically; therefore, we would still consider this an exam for a medical problem, and not a routine eye exam Ms*** was asked to pay $at her visit in May….$was her co-payment and $was her refraction fee that is not covered by her Humana Gold Choice PFFS plan. At her last visit in 2013, Ms*** also paid her co-payment and refraction fee. This is the standard policy in our office…all co-payments and co-insurances are due at the time of service. I apologize for the unsatisfactory way in which this payment policy was explained to Ms*** and will remind my front desk staff that it is important to communicate clearly and professionally all requests for payment from patients. Ms*** mentioned as well that she had an unsatisfactory experience with the technician that performed her preliminary testing prior to her seeing Dr***. I do apologize for this….all patients should be given every opportunity to read as far down on the eye chart as possible and then let the technician know when they can no longer read the letters. Although all of our clinical staff are properly trained and/or certified as Ophthalmic Assistants, they may not be aware of every medical procedure that is being performed in today’s medical communityThat being said, our staff should not doubt the validity of a patients statement regarding his/her medical history. I also apologize for any abruptness portrayed by Dr***. He is an extremely competent and thorough doctor who values his patients and takes pride in providing our community with his services I am also sorry she was not aware of the presence of a cataract in her right eye….she was diagnosed with a cataract in her right eye by Dr*** in 2010. With that being said, due to the presence of her cataract and genetic diabetes, Ms***’s eye exam was considered a medical exam and not a routine eye exam. Again, I apologize for the overall experience Ms*** had at Eye Centers at her most recent visit. We look forward to seeing her in months and hope we have the opportunity to improve her opinion of our doctors and staff. We appreciate her bringing this complaint to our attention. Although quality eye care and patient satisfaction are our most important goals for each patient at each visit, there is always room for improvement. If Ms*** has any further questions or concerns, we welcome the opportunity to address those with her as well. Thank you, *** ***, COT, Office ManagerEye Centers of Southeast Texas, LLP(409) 833-0444, x ***

Ms*** B*** was
referred to me by Dr*** ***.
She presented in my office on July 31, 2014, complaining of vision
changes and therefore underwent a comprehensive eye examination (CPT code 92004), as
well as a refraction (CPT code 92015).
Per our Contractual
Agreement
with her medical insurance carrier, TexanPlus Classic (a Medicare Replacement
Plan), one refraction per year is covered.
All refractions thereafter are considered the patients
responsibility. Because Ms*** had undergone
a refraction by Dr*** just prior to her visit with me, my office
collected the $refraction charge that was due at the time the service was
rendered.
Ms*** later received an
EOB from TexanPlus that is somewhat misleading.
The EOB states that the Plan’s Share and the Patient’s Share of the
refraction charge is $0.00. We have
contacted TexanPlus and informed them that the wording of their EOB’s is
misleading to the patient and contradictory to our contracted agreement. My Billing Supervisor, ***, also spoke with
Ms***'s daughter (*** ***) on two separate occasions and explained this. *** encouraged Ms*** to also call
TexanPlus and speak with a representative regarding the wording of the EOB and
have them confirm with her that her mother does owe the $refraction fee.Please let me know if you need additional information.Regards,*** ***

The Texas Board of Medical Examiners has set guidelines for physicians charging patients for medical records. Per the Texas Medical Board, physicians should charge a reasonable fee of no more than $for the first pages and then up to $for each page thereafter. It is the
policy of Eye Centers of Southeast Texas to charge patients $for their entire medical record (no per page fee after the first pages). If a patient chooses to not pay for the entire medical record, Eye Centers will release the last office visit and diagnostic testing at no charge. All of the patients medical and surgical history are included in the last office notes.We do apologize for any hardship or inconvenience this may have caused. We appreciate all of our patient's and will continue to do our best in providing excellent services to our community

Issue resolved - received $40 reimbursement check. Thanks for your help.

Complaint: 10401223
Looks like this issue is in the process of being resolved - I received two phone calls that the $40 reimbursement check is forthcoming.  Thanks for your help.
Sincerely,
[redacted]