Bernet, Dan E. - OD

Dear Sirs,The fees the surgeon and I charged are Medicare allowed industry standard for surgery and pocareI doubt anyone in this region is different unless they do not accept assignment, in which case they would likely be higherEveryone here takes annual classes on Medicare and insurance billingIt is necessary because the system is complicated, so it is no surprise that Mrs [redacted] does not understand itFew patients doWe strive to follow the rules exactlyI have no doubt Mrs [redacted] is stresses by the situationWe explained to her again the amount of refund which she is entitledShe was convinced she was entitled to more and chose instead to get a complete refundWe have done so, and sent checks to her insurance companies to reinstate herHopefully, going forward she will have a better experience with another provider.Thanks for what you do, [redacted] ***

I am rejecting this response because:We received your letter of 9/21/2017, yesterdayAs far as we are concerned our business with Anderson Vision Center and DrDaniel Bernet is overHowever, the money he claims to have returned to our insurance had not been cleared off the books yetThis has help up any attempt on our part to get new glassesI faxed to *** a copy of Anderson Valley Center's check to us for the amount we paid them, which stated only that it, was a refundIn a call yesterday to ***, claims representative at *** who is handing this complaint, she again stated his check did not state that we returned the glasses and their money paid to DrBernet for the glasses is processed off the books, they still show that we have the glassesShe did advised that we could make contact with a Medicare providers, names given to us by Medicare, to have new glasses made, but our insurance cannot pay for themSo though he did self-righteously return our money, we are still without glasses and without the ability to have them replacesSo we cannot move forward!We have been checking out several optometrists who do not accept Medicare, and find DrBernet's claim regarding comparison of costs grossly untrue. We have been dealing with our insurance providers for years and Medicare for years, and have found their printed and verbal explanations of services and payments exceptionally patient, clear and understandableWe have never had garbled explanations and outright lies and distortions, which contradict Medicare and our insurance carriers as DrBernet's practice doesNor have we been forced to pay up front before services are preformedBy not reporting this payment up front to Medicare and insurance, DrBernet's words and actions indicate his efforts to bilk the system and unjustly line his own pockets, particularly by seniors who rely on Medicare. We did make a huge mistake for which DrBernet can be thankfulWe accepted the our payment backHad we chosen rather to keep the glasses, and reported his refusal to refund our money to Medicare and our insurance, then he would have been investigated for Federal charges for failing to report that we had paid up front and for fraudHowever, Medicare and *** now have his name on radar.We will not respond to any further communicate from DrBernet since his communication is distorted, unreliable and self-servingHowever, we will answer honestly questions by our acquaintances as to why we can't participate in many usual activities and to what happened to our glasses and why we haven't been able to get them replacedIt goes without saying, he will not get any favorable recommendations through us

Upon Mrand Mrs***'s return visit following cataract surgery, billing and charges were explained in full as to the policy in which the office followsWe have records and paperwork that was shown and explained to each patient on fileOn the date of June 21st, 2017, materials were chosen and
agreed to place an order forCharges for the materials chosen were thoroughly explained as to why there would be an overage for two deluxe frame charges that Medicare would not pay and that was agreed to be paid out-of-pocketThe two charges for $were pomedical visit charges with the doctor, one charge per eye, per patientThe dates that were billed are the surgery dates which Medicare requests be noted on the claimIt was thoroughly discussed that upon payment from the secondary insurance, an appropriate reimbursement would be givenThis office is not in network with *** therefore we require payment up front until the insurance pays the claimThe appropriate amount to be refunded is not the initial total paid due to the agreement that there was an overage on the two patients frames, not covered my MedicareThe initial payment was $and the amount to be reimbursed is $92.56, $would not be returned because this is the amount of the deluxe frame overages for both Mrand Mrs***This was again explained to the patientThe patient was told that a phone call to Medicare would be made to confirm that the overages were to be paid by the patient and not covered under the insurance, in which a return voicemail was left with the patients confirming thisThe patients did not want to return to the office for the three-month follow up check regarding this misunderstanding in Medicare billing processThe patients then proceeded to become angry as to why an appointment had not been scheduledThe date for their three-month follow up would be three months from 06/21/and today is 09/11/For this reason, a recall had not yet been sent to the patientsThe billing process, amounts, EOB's, and receipts were sent to and thoroughly explained to the patients numerous times from this office, Medicare, and ***

I am rejecting this response because: We received your letter giving the response from Anderson Vision Center to our letter of 9/5/2017 regarding the Anderson Vision Center's practice of requiring clients to pay up front the difference between the Medicare Approved Amount and the provider's charged amount.As I stated in my first letter, Anderson Vision Center keeps changing their story and their written response to you varies from the facts. I will try to respond to you with the verifiable facts only, and as briefly as I can. But first I would like to say that this experience has been extremely stressful because of non-communication and refusal to properly refund the overpayment they charged up front. I have been very upset when they have changed stories and refuse to adhere to the agreements made with Medicare, [redacted], or verbal promises to us. Their words are based of deception, denial, and falsification of true facts. Our frustration and stress is certainly not over.These are the facts, most of which are verified by Medicare, [redacted], or their own statements:1. On February 23, 3017, after eye examination Dr. Bernet recommended that we both have cataract surgery and that the office assistant would arrange for referral. The office assistant told us that Medicare would pay for the cataract surgery and for the first pair of glasses. We were required to sign forms that we would follow-up after surgery with Anderson Vision Center prior to referral being made to the eye surgeon.2. Medicare paid Dr. Bernet $552.00 up front for follow-up care after cataract removal: ($138.00 for eye surgery on 4/18/17, 5/2/17, 4/25/17, and 5/9/17). Anderson Vision Center told [redacted] and myself in a conference call that the payment was for 2 follow-up visits for each eye one month and three months after surgery. The first visit for all four eyes was on 6/21/17. The second follow-up exam was on 9/13/17.3. June 21, 2017: First follow-up appointment. Dr. Bernet examined our eyes and prescribed glasses. The office assistant then selected several frames from which we were to choose and measured the lenses for ordering. Without any discussion or explanation, we were told we owed $197.56 and had to pay up front before the glasses could be ordered. Surprised because we had been lead to expect that Medicare would pay for the first pair of glasses, we asked what this charge was for and were more expensive than Medicare would allow. While still in the office we verified via phone with [redacted] that the frames would be covered by our co-pay before they would order the glasses. We asked for an itemized list of the charges, but was told only that each of our glasses and frames amounted to $330, for a total of $660.00. We pointed out that $197.56 was more than our copay of 20% even if Medicare approved the entire amount. They were relentless but assured us that they would be reimbursed us when they received the insurance's payment. Still protesting that this was not reasonable, we paid them $197.56 by [redacted] Credit Card. Though Dr. Bernet stated we needed a follow-up visit in two  months, we were told it was too early to make that appointment, that they would call us to schedule it later.4. Medicare was billed a total of $660.02, without reference to the fact that we had paid anything to the provider. Medicare approved $431.14, paid $338.02, stipulating the maximum we may be billed as $86.22. Medicare sent to claim to [redacted], who paid the $86.22. for a total insurance payment of $424.24.5. I called Anderson Vision Clinic to inquired about getting our refund and making the two month second follow-up appointment. I was told they had not yet received the payments from [redacted]. I was told that it was too early the make the next appointment that would be two months after the first follow-up appointment on June 21st. They said they would contact us after August 23rd. I noted it on the calendar.6. I was called in August and was told Anderson Vision Clinic was ready to process a refund for the amount [redacted] had paid $86.22. I said, "NO!" and read the statements from Medicare's and [redacted]'s EOBs about the provider's agreement to accept the Medicare-Approved Amount as full payment for covered items. I told them before we would accept a partial refund, I was going to call Medicare herself. I asked for a itemized list of their charges. I received only copies of Statements of Charges and Payments of what Medicare was billed for the follow-up care, and lenses and frames.7. Several days later she left a message on our answering machine stating they would refund the amount in full, but said nothing about making a second follow-up appointment.8. After Labor Day she called asking if we had gotten her message, and I replied "no", not knowing my husband had heard the message, but had not mentioned it to me. I then said we had not gotten the expected call to schedule for our second appointment. She said we had not gotten the expected call to schedule for our second appointment. She stated it wasn't time to schedule it because it hadn't been three months, not until September 23rd. (It had actually been five months since the last eye surgery on May 9th). I insisted that she make an appointment now because I had been fighting my glasses ever since I got them. She scheduled an appointment for September 13th, and asked that we come in with our credit card so she could complete the refund. We decided we could wait on the refund until the day of the appointment.9. On the second follow-up visit, September 13th, Dr. Bernet reexamined my eyes after I complained I had been fighting the glasses since the day I got them, that I could not read the television screen across the room, and had to close my right eye if I really want to see something clearly or read. He examined my eyes and said the prescription in the right eye was indeed incorrect and needed to be changed.10. My husband told him that communication with his office staff had been very stressful. Dr. Bernet then stated he had gotten our letter to the Revdex.com. He became defensive reneged on a full refund. He tried to explain the charge as the amount not covered by Medicare because we had chosen expensive delixe frames and Medicare didn't cover the full charge for the frames. He claimed that neither did we understand what materials and skills of grinding made multi-focal lenses cost more than single focus lenses. We had difficulty accepting this convoluted explanation because it did not address why he charged us for what Medicare disallowed and [redacted] said we didn't have to pay. To believe him would mean that we could not believe or trust Medicare's statement that we were not responsible for the amount reduced by Medicare because of Federal, State, and local rules.11. Dr. Bernet stated that he would give us a choice: either we could accept the partial refund that [redacted] had paid them, or we could return the glasses and he would give us a full refund and we would have to go somewhere else to get our glasses. He threatened us with the statement that we would find it much more difficult than we imagined to find a provider who would provide us with as glasses as cheaply as he had. He emphasized we would have to choose less expensive frames.12. I demanded an itemized charge list and received only a Statement of Charges and Payments. Though these documented copies are difficult to decipher, they clearly state the $197.56 we paid is the exact amount between what Anderson Vision Center billed Medicare ($660.02) and what they expected or estimated both insurance to pay ($462.46).13. Dr. Bernet does not agree the Medicare-Approved Amount as full payment for covered items or services or to abide by the Medicare's stated Maximum Amount the Client May Be Billed. Rather his billing process requiring the client to pay up front without reporting it to Medicare permits him to bill the patient for what Medicare disallows and then refund only that the secondary insurances pays, falsely claiming that the up front payment had been thoroughly explained and that the client fully agreed to pay charges out-of-pocket. At no time have we ever agreed to any such fraudulent practice.14. We decided to return the glasses for our full refund and were given a check for $197.56, which states only that it was for "Pt refund for glasses," showing only that the overage we paid was refunded, but does not state that the glasses were returned. He did not give us a receipt for the return of the glasses.15. Finally, when we started to leave the office the office staff tried to charge us for this second follow-up visit. We stated, "The doctor has already been paid for this follow-up visit." But we were informed that wasn't so, that this was a separate visit with a new charge. Dr. Bernet saw that we were not going to pay another charge without objecting and consequently  told his office receptionist not to charge us for this visit.16. When we returned home without glasses on September 13th, we called [redacted] then Medicare to report that we had returned the glasses, and to inquire what we needed to do to find another provider who could order glasses and frames and bill Medicare and [redacted]. We were informed that new glasses and frames and bill Medicare and [redacted]. We were informed that new glasses cannot be ordered until Dr. Bernet has refunded the amount Medicare and [redacted] had paid and a written statement that the glasses had been returned. After that may take up to a month before the refund has been processed off the books. Until then, their records show we still have the glasses that have been completely paid for. We can only keep checking back until then. We were also advised that this sounds very much like fraud and to contact The Federal Inspector General, Medicare, an [redacted] to report our experience for possible investigation of fraud. There is no reason to believe that Dr. Bernet does not do the same with all his clients who rely on Medicare and Insurance to help pay their bills.In summary, only two of the statements in Dr. Bernet's Message From Business to Revdex.com bore relevance to the truth. At no time were we shown any policies, records, paperwork, EOBs, or relevance to the truth. At no time were we shown any policies, records, paperwork, EOBs, or receipts either before or after we demanded copies of them. At no time were billing process, prices of frames, services, schedules for follow-up visits, discussed or thoroughly explained to us until after we had been presented with a bill for payment up front before we objected and demanded an explanation. At no time did their explanation do anything but try to bamboozle us. Calls to [redacted] and Medicare for clarification and verification were made simply because things were not discussed, explained, or agreed to. At no time, did we agree to overage charges. We demanded itemized copies of prices, but never received them, because we did not understand their "overage" charges, or how the frames presented for our choice were deluxe and overpriced. That is not our personal style; we are simple, plain people who abhor flamboyance for ourselves. At no time did we accept or agree to out-of-pocket charges. We wrote to the Revdex.com the first time because we did not understand their billing and business practice and did not agree with it. Both that letter and this one bear witness to their poor communication, our confusion and non-agreement.We are deeply concerned and stressed through this experience. It causes us sorrow to have be involved in reporting such an incident, but care about our community and want to prevent others from experiencing the same thing.Sincerely,[redacted]

Dear Sirs,The fees the surgeon and I charged are Medicare allowed industry standard for surgery and post-op care. I doubt anyone in this region is different unless they do not accept assignment, in which case they would likely be higher. Everyone here takes annual classes on Medicare and insurance billing. It is necessary because the system is complicated, so it is no surprise that Mrs. [redacted] does not understand it. Few patients do. We strive to follow the rules exactly. I have no doubt Mrs. [redacted] is stresses by the situation. We explained to her again the amount of refund which she is entitled. She was convinced she was entitled to more and chose instead to get a complete refund. We have done so, and sent checks to her insurance companies to reinstate her. Hopefully, going forward she will have a better experience with another provider.Thanks for what you do,[redacted]

Fees we charge for this particular insurance company are dictated by the insurance company. Person in question refused to pay deductibles, no showed appointments, was upset when we wouldn't see him on an unscheduled basis. Said he wanted to go elsewhere, we said fine.

Review: After my husbands initial appointment, the eye exam, they gave my husband contact lenses that were blurry and not made for an eye stigmatism while he waited for them to complete the prescription process. During this time, because of their hours of operation and scheduling conflict with my husband working full time he had to wait almost a month before his final eye appointment, where they were supposed to make any corrections before the prescription was finalized. Due to there lack of service in confirming or giving a reminder about his appointment my husband got the dates mixed up and when he showed up they laughed at him and told him his appointment was last week and he would have to reschedule because they couldn't see him that day. They also confronted him about addition money he would owe out of pocket even after charging his insurance a substantial amount of money. After having his insurance for a few years now and never having to pay anything addition out of pocket other than a 10 dollar co-pay, he called his insurance up concerned and confused. While on the phone his insurance company they confirmed that Anderson Vision Center was not telling him the correct information about the way the insurance works and were not being honest about what the chargers were for. The insurance went over the prices and what had happened and they suggested if he was not happy with Anderson Vision Center's customer service and lack of honesty to contact another provider and switch. So my husband did and his insurance even paid both practices, Anderson V Center and the new one, which was really nice. 30 days later after not hearing from Anderson Vision Center either through email or mail or phone we got an invoice saying we owed them $39.50 on 07-25-2015. I called them confused and left them a message and on 07-27 they confirmed it was a mistake and its not $39.50 but its actually $26.50, still confused I asked her to please break it down and she hung up on me. I called back and asked to speak to manager.Desired Settlement: Turns out the person that hung up on me was the manager. I was told from her she would remove the amount of $16.50 and $10.00 which totals $26.50 that we allegedly owed. She said she would notate her system and I requested a letter or invoice showing we owe them nothing and I never want to hear from them again. So once again in order to resolve this matter I just want a letter confirming that this issue is resolved and we do not owe them anything.

Business

Response:

Fees we charge for this particular insurance company are dictated by the insurance company. Person in question refused to pay deductibles, no showed appointments, was upset when we wouldn't see him on an unscheduled basis. Said he wanted to go elsewhere, we said fine.