We are writing to you concerning the complaint filed by Mr. [redacted]. We are more than happy to address Mr. [redacted]'s concerns and are surprised that we did not know of these concerns prior to receiving your letter.We purchased this practice over 2 yrs ago and have worked diligently to provide...
the best care while offering the latest technology and medical treatments. We offer services within this medically-oriented eye care practice within the proper guidelines and protocols of insurance companies. Our pricing on exams and how we file for eye exams are based on the problem that the patient presents with, what tests are performed, and what medications are prescribed. We never charge an additional fee for a dilation and the dilation is performed to evaluate the health of the eye and is necessary in all patients, regardless of age.Contact lens evaluations are ¡n addition to any eye exam. We evaluate the health of the eye and review additional measurements so that we can make sure the patient is not over wearing the contact lens, the contact is not causing changes in the shape of the eye, and that the eye is getting enough oxygen through the contact lens. Even if the patient feels that there are "no problems," based on our contact lens evaluation, we can determine if there are changes with the health of the eye. We often recommend newer technology in contacts in order to increase the oxygen supply and to reduce risk of infection/adverse changes with the eye.When patients present with an injury, red eye, medical condition causing changes with the health of their eye, we are required to bill the medical insurance for the visit. We cannot control what the insurance will cover and are required to collect the deductibles and co-pays that the insurance states are necessary. Mr. [redacted] was seen at the beginning of July for his eye problem and we had just received notice from his medical insurance that the balance was his responsibility at his August visit. It will often take 4-8 weeks from filing a claim to get an explanation of benefits or payment from the insurance. He may have not known of his remaining balance at the August visit because we had just received notification from insurance.When treating a red eye, especially in contact lens wearers, a small injury can quickly turn infectious,For this reason, we often prescribe newer- generation antibiotics so that we can be diligent with any infection that may be present. We electronically-prescribe medications and will often get alerts from the insurance concerning formulary compliance while we are ordering the medication. In some instances and with some insurance companies, we do not. With his insurance no notification was posted. Once we obtained notification from the pharmacy, we were more than happy to change his medication to help with cost.With the changing health care environment, insurances are setting higher deductibles and passing higher-cost copays and responsibility to the patients. We are not able to write-off amounts on patients' accounts that insurance companies state we must collect from the patient. We feel it would be in Mr. [redacted]'s best interest to contact his health insurance carrier to see if we may modify his responsibility on those visits.We appreciate the opportunity to discuss this complaint with you and look forward to a reasonableresolution.Sincerely,[redacted], O.D.[redacted], O.D.
We are writing to you concerning the complaint filed by Mr. [redacted]. We are more than happy to address Mr. [redacted]'s concerns and are surprised that we did not know of these concerns prior to receiving your letter.We purchased this practice over 2 yrs ago and have worked diligently to provide...
the best care while offering the latest technology and medical treatments. We offer services within this medically-oriented eye care practice within the proper guidelines and protocols of insurance companies. Our pricing on exams and how we file for eye exams are based on the problem that the patient presents with, what tests are performed, and what medications are prescribed. We never charge an additional fee for a dilation and the dilation is performed to evaluate the health of the eye and is necessary in all patients, regardless of age.Contact lens evaluations are ¡n addition to any eye exam. We evaluate the health of the eye and review additional measurements so that we can make sure the patient is not over wearing the contact lens, the contact is not causing changes in the shape of the eye, and that the eye is getting enough oxygen through the contact lens. Even if the patient feels that there are "no problems," based on our contact lens evaluation, we can determine if there are changes with the health of the eye. We often recommend newer technology in contacts in order to increase the oxygen supply and to reduce risk of infection/adverse changes with the eye.When patients present with an injury, red eye, medical condition causing changes with the health of their eye, we are required to bill the medical insurance for the visit. We cannot control what the insurance will cover and are required to collect the deductibles and co-pays that the insurance states are necessary. Mr. [redacted] was seen at the beginning of July for his eye problem and we had just received notice from his medical insurance that the balance was his responsibility at his August visit. It will often take 4-8 weeks from filing a claim to get an explanation of benefits or payment from the insurance. He may have not known of his remaining balance at the August visit because we had just received notification from insurance.When treating a red eye, especially in contact lens wearers, a small injury can quickly turn infectious,For this reason, we often prescribe newer- generation antibiotics so that we can be diligent with any infection that may be present. We electronically-prescribe medications and will often get alerts from the insurance concerning formulary compliance while we are ordering the medication. In some instances and with some insurance companies, we do not. With his insurance no notification was posted. Once we obtained notification from the pharmacy, we were more than happy to change his medication to help with cost.With the changing health care environment, insurances are setting higher deductibles and passing higher-cost copays and responsibility to the patients. We are not able to write-off amounts on patients' accounts that insurance companies state we must collect from the patient. We feel it would be in Mr. [redacted]'s best interest to contact his health insurance carrier to see if we may modify his responsibility on those visits.We appreciate the opportunity to discuss this complaint with you and look forward to a reasonableresolution.Sincerely,[redacted], O.D.[redacted], O.D.