Chesterbrook Eye Dr. O.D.

The complaint has NOT been resolvedBilling amounts are still under dispute

[redacted], ID [redacted], sThe choice of word, the tone, and how a person tell the story say a lot about him as a person. If apatient is going to tell his/her story, he/she should have told the entire story:"For...

a total of 20 times, I verbally and in writing contacted both my medical and vision insurances. They repeatedly responded verbally and in writing that Dr. T[redacted] has the credential, she is contracted to code the exam from her viewpoint, they cannot tell Dr. T[redacted] how to code hér exam, it's absolutely normal for an optometrist to code and bill the way Dr. T[redacted] did, the amount shown on my statement is correct, I am financially responsible for that amount, they absolutely cannot tell Dr. T[redacted] to void my medical bill, they did a full investigation, and their decision is final. I had also contacted government agencies X, Y, Z, but they also have NOTWhat is the patient hiding when he/she did not tell the entire story? What is he/she hiding when he/she  did not release copies of insurances written responses?Insurance billing is a private matter between insurances and us. Patient’s signature is not on that contract. Attempting to determine or to dispute the correctness of a claim is nothing more than asserting a right that the patient has never had.Our officé does indeed has a perfect patient's billing record. No patient of ours has ever received any written letter from any insurance or agency that stated otherwise.

Review: I have been a client of Dr. [redacted] (Chesterbrook Eye Dr) since 2005-06. A couple of months ago I went to see her for a routine eye exam. In addition to my vision plan information, she asked for my health insurance card. I didn't pay much attention as to why an optometrist needed my health insurance card. She performed the eye exam and gave a prescription for eye glasses.

A week or two later the insurance company sent us the explanation of benefits. Dr. [redacted] had not only filed with my vision plan, she also had filled with my health plan. My wife and I stopped by Dr. [redacted]'s retail shop which is very close to our house to ask about her insurance filings. Her explanation was that I had complained about blurry eyes and that constituted a medical problem! Therefore, she saw herself entitled to file with both plans. We simply left her shop and I told her that I would never go back to her shop and that she just lost me as a client. A couple of days later, I received a bill from her for $177.08! The haphazardly put together line items in the bill go back as far as 2006-7. Some are for 2009. When I went back to her shop yet again to get an explanation of the bill, she was very rude and unprofessional. She failed to explain the bill to me. A couple of days later, she adjusted the bill to $197.08 stating on the bill that previously she had given me a $20 courtesy discount and now she is reversing the discount. My wife has been in touch with our insurance companies. Contacting the insurance companies have been painfully time consuming to us since I have changed employment since 2009 and tracking the companies that we dont have coverage with is not an easy undertaking. Today our vision plan going back to 2006-07 told us that she had been fully paid and that she should not have sent us any additional charges.

My complaints about Dr. [redacted] and her retail shop, Chesterbrook Eye Dr., are:

1- why did she file not only with our vision plan but also with our health plan? All I asked her to do was a routine eye exam.

2- why is she sending us bills that go back to 2006-07 and 2009? In an email she wrote to us that had we contacted her office and inquired whether we owed her any money or not, she would have acted more expeditiously. Is this a normal practice for consumers to contact businesses and ask about their account or is this business's responsibility to send bills to their customers on a timely and periodic manner?

3- why she has been extremely rude to us?Desired Settlement: We have contacted the insurance companies that have provided coverage to us since 2006. We will continue to follow up with them. If we owe Chesterbrook Eye Dr. any outstanding balance, we will gladly pay what we owe in full and at once.

Meanwhile, we'd like to ask Dr. [redacted] to please leave us alone and stop contacting us and stop sending us new bills with a $10 late fee attached to them while the insurance companies are investigating the nature of the charges, how much they have paid Dr. [redacted] and how much we have to pay if any.

Business

Response:

8/27/13

RE: Case [redacted], Patient [redacted]

Dear **. [redacted]:

We are writing to response to your Aug 22, 2013 letter. First and foremost, we would like to thank you for giving us an opportunity to response. We appreciate that Revdex.com recognizes that “there are always two sides to every dispute” and that the “Revdex.com makes no judgment on the validity of this complaint”.

Second, it is our policy to not give unanimous response. We require that the Revdex.com keep our response intact as is. There is no law that requires us to give unanimous response. To us, a response without identification of the patient has no use.

Our response is: all accusations are either:

1. false and without proof. We do not know what the insurance told **. [redacted], but they had told us that we are in full compliance with their rules and that all requested copays are corrected: Whatever the insurance told **. [redacted], he needs to make them put it in writing. If it is not in writing, it’s not legal and cannot be accepted. The reason this patient did not bring any proof is either because a) he is not telling the truth, b) he did not understand what the insurance told him, or c) that the insurance gave him wrong information and refused to put it in writing.

OR

2. directed to the wrong party. Any questions regarding benefit, coverage, billing rules should be directed to the party who wrote it, i.e. the insurance. Any request to make billing changes should be made with the party who has the absolute authority to do so, i.e. the insurance. The insurance prohibits us from making any changes. If **. [redacted] disagrees, he needs to bring back an insurance letter to prove otherwise. We had told him this exactly ten times (8 of which is in writing). We cannot be responsible for his lack of comprehension.

We treat all our patients with care and respect. We had asked **. [redacted] to name what we did was “rude and unprofessional”, he did not name one. In his world: a) sending a billing, b) not forgiving his debt, c) not violating the insurance rules to make him happy, d) not doing insurance’s job, e) not agreeing to his wrongful accusations, f) not standing there to submissively listen to him yelling in uncontrolled anger “fxxx you bxxxch” a dozen times are unprofessional and rude. We have never seen: a patient like that misbehaves and use foul language like **. [redacted]. In his letter, he said that has been a loyal patient of us. He is not. Our records show that he left us at least twice in the past. He then left his new doctors to return to us the following year.

Thank you,

Customer Service

Review: I went to this eye doctor and asked for an annual eye exam which is covered by our [redacted] Vision insurance. On the registration form, Dr. [redacted] asked me to fill in both my vision and medical insurance information. I asked why she needed our medical insurance and told her I only wanted an annual check covered by our vision insurance. She told me that was just in case. But she ended up billing both my vision and medical insurance company because she said that during my regular eye exam, she found "medical" issues. I didn't authorize her to do any medical exams and asked her to adjust the billing statement. She showed me the paperwork that I signed and used that an excuse for this unjustified charge. I told her even I signed the paperwork, she could not do any procedure / exam on me that she was not authorized and asked to do. I very specifically asked her to do an annual vision exam involving only my vision insurance and she "did" this additional thing that I didn't ask for.

Even taking one step back saying that she did some medical exam. For a simple less than 20 minutes exam, she charged me more than $220. My vision insurance paid her $50 and she wanted another $170. My husband and I have visited different eye doctors including both O.D. and M.D. and have done exactly the same exam. The O.D. we visited used our vision insurance and the cost is completed covered by the vision insurance. The M.D. my husband visited charged him only about $80 including both insurance payment and his co-pay. I didn't see any reason why Dr. [redacted]'s $220 charge is justified and it is absolutely not a common practice by eye doctors. I believe she was trying to hoax us to sign the paper work and try to double charge us for both medical and vision issues. That $220 is definitely overcharged and I have read many reviews only about she doing the same unethical practice.Desired Settlement: Drop the medical portion charge which I didn't authorize.

Business

Response:

1/31/14Dear [redacted]:We are writing to response to your Jan 27, 2014 letter. We understand participation is voluntary. We would like to provide you with our response.First and foremost, we would like to thank you for giving us an opportunity to response. We appreciate that Revdex.com recognizes that “there are always two sides to every dispute” and that the "Revdex.com makes no judgment on the validity of this complaint”.Our summary of response is: all accusations are false. We were told by appropriate authorities that all services and all billing were done appropriately. We were also told that doing those any other way constitutes fraud. We are sorry but we will not be making any changes.Please allow us to elaborate on that:First, we have a signature on file from [redacted] to authorize us to provide adequate optometric care and proper billing as required by healthcare law. We had never agreed to provide substandard care and improper billing. We are simply following the law. Hypothetically, even if we were not to have her signature on file, we are still obligated to follow healthcare law. Our office has a perfect record anywhere from adequate patient care to proper billing. In [redacted]'s case, we have not received any kind of communication that indicates otherwise. According to the law, lack of such communication is an indication that we are correct. Please understand that [redacted] is not optometrist and has no authority to determine whether adequate care was provided or not.Secondly, all services and all billing were determined to be done correctly. In [redacted]’s case, we have not received any kind of communication whatsoever from any appropriate authorities to indicate otherwise. Again, according to the law, lack of such communication is an indication that we are correct. Please also understand that [redacted] is not an optometrist. She has never done optometric billing. Most important of all, she has no authority to determine whether billing was done properly or not.Thirdly, our fee is the nationalized contracted fee with major medical insurances. If [redacted] has a problem with the fee, please ask her to submit a petition to lawmaker in Washington. Our office is not allowed to change the nationalized contracted fee.Lastly, we would like to response to the reviews she read elsewhere:It is our passion to provide the best eye care. However, best care does not mean making patients happy by breaking the law. Everything in healthcare from patient care to billing is governed by law. The only one who has authority to determine if we are right or wrong is the lawmakers. The patient has no authority to make that decision or to override it. We can tell you that our office does in deed have a perfect record. We cannot be right and wrong at the same time. After being told by lawmakers that we are correct, some patients lie and say the exact opposite. Whatever happened to honesty and integrity? We sure hope that they do not lie and make threat to their employers, coworkers, and others around them. Those patients do not dare to go against the giants such as healthcare lawmakers, insurances, and employers who write the law and insurance benefit. They cowardly make threat against one doctor who simply follows the law.The dishonesty does not stop at there. Those patients praised our service as "best exam, best doctor, best glasses, best of everything, I am happy and I will be back..." prior to receiving the bill. Literally the exact moment they receive the bill, they dishonestly changed their response to the exact opposite. We call it dishonest because a service cannot be the best and the worst at the same time.Fortunately, the majority of our patients understand billing and appreciate the level of standard care we provide.Attached is our most recent Q&A list. Please refer to the list as it has all of the detailed answers to her concerns.Our records show that we had previously provided [redacted] with the following information: copy of the signed contract.Q&A listPlease feel free to contact us if you have any questions.Sincerely,Customer Service

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:Before I

state my argument, I would like to comment on the response letter by Dr. [redacted].

They apparently have no sense of “customer service”. The whole response letter

was trying to say that they do it “legally” rather than they do it “correctly”.

I strongly doubt their willingness to resolve the issue rather than just

respond for the purpose of response.

I want to

make a confession: I signed the paper work without reading the clauses

carefully. But honestly, who does? And even if I read, I’m not sure that I can

catch the clause that Dr. [redacted] used to argue against me. Again, I want to say

this clearly, when I walked into Dr. [redacted]’s clinic, I asked her to do an annual

exam which is COVERED BY my VISION INSURANCE. I DID NOT provide my medical

insurance information to her (actually, I didn’t put my insurance number on the

form and she used my SSN to claim the insurance) because I DO NOT want any

medical exam. It is true that I am not an OD that I do not know which “problem”

I have. But I am a consumer and I believe even if I signed the paperwork that

she hoaxed me to sign (and then use against me), I have the right to say no to

any exam that I do NOT WANT. She didn’t inform me before she did any exam that

will involve medical insurance / additional charge so I believe I have the

right to say no to those charges.

In addition

to my last point of “unauthorized charges”, I want to clearly state that Dr.

[redacted]’s charge is way over the industry standard and is not justified. Again, as

I stated in my origin complaint, both my husband and I have done similar eye

exams at OD or MD’s office in the past 2 years. For the OD visit, both of us

paid only $20 copay and the vision insurance (and ONLY the vision insurance)

covered the rest of the cost. For my husband’s MD visit, he paid $60 copay and

the medical insurance paid about $20. The exam I had at Dr [redacted]’s office was

less than 20 minutes, I do not think charging both vision and medical insurance

is justified and normal. I do not think charging $300 for such an exam is

NORMAL and JUSTIFIED. My vision insurance already paid her about $120, and she

is now charging another $220 for the medical part. I know doctors charge a lot,

but again, I don’t think about $350 for less than 20 minutes at an OD’s office

is JUSTIFED, especially for just an annual exam.

Lastly, my

problem is not an individual case. After I encountered my problem with Dr.

[redacted], I did some online search (which I should have done before I visited her

clinic), many people had similar issue with Dr. [redacted] and paid extremely high

fees for simple annual exam. I’ve attached some of the reviews I found online

for your reference (see Appendix).

In summary,

(1) I did NOT authorize Dr. [redacted] to do any additional exam besides the annual

eye exam covered by my vision insurance. I even purposely did not provide my

medical insurance because I did not want that to be involved. (2) I believe Dr.

[redacted]’s charge is way above normal and unjustified. I even think someone should

investigate whether their practice is ethical or legal. (3) Many customers have

encountered similar problem as I did.

Again, thank

you for following up. I am looking forward to getting this issue resolved and

more important, no more customers will encounter this problem.

I have been a client of Dr. [redacted] (Chesterbrook Eye Dr) since 2005-06. A couple of months ago I went to see her for a routine eye exam. In addition to my vision plan information, she asked for my health insurance card. I didn't pay much attention as to why an optometrist needed my health insurance card. She performed the eye exam and gave a prescription for eye glasses.

A week or two later the insurance company sent us the explanation of benefits. Dr. [redacted] had not only filed with my vision plan, she also had filled with my health plan. My wife and I stopped by Dr. [redacted]'s retail shop which is very close to our house to ask about her insurance filings. Her explanation was that I had complained about blurry eyes and that constituted a medical problem! Therefore, she saw herself entitled to file with both plans. We simply left her shop and I told her that I would never go back to her shop and that she just lost me as a client. A couple of days later, I received a bill from her for $177.08! The haphazardly put together line items in the bill go back as far as 2006-7. Some are for 2009. When I went back to her shop yet again to get an explanation of the bill, she was very rude and unprofessional. She failed to explain the bill to me. A couple of days later, she adjusted the bill to $197.08 stating on the bill that previously she had given me a $20 courtesy discount and now she is reversing the discount. My wife has been in touch with our insurance companies. Contacting the insurance companies have been painfully time consuming to us since I have changed employment since 2009 and tracking the companies that we dont have coverage with is not an easy undertaking. Today our vision plan going back to 2006-07 told us that she had been fully paid and that she should not have sent us any additional charges.

My complaints about Dr. [redacted] and her retail shop, Chesterbrook Eye Dr., are:

1- why did she file not only with our vision plan but also with our health plan? All I asked her to do was a routine eye exam.

2- why is she sending us bills that go back to 2006-07 and 2009? In an email she wrote to us that had we contacted her office and inquired whether we owed her any money or not, she would have acted more expeditiously. Is this a normal practice for consumers to contact businesses and ask about their account or is this business's responsibility to send bills to their customers on a timely and periodic manner?

3- why she has been extremely rude to us?