Doctors On Sight

April 20, 2015
We have reviewed [redacted]'s account. Originally [redacted]'s balance was $181 resulting from insurance denials. Please understand that we make our best estimate of insurance benefits when a patient is in our office, however, we can make no guarantee of insurance...

payment. Any statement printed on the date of service may have shown a current $0 patient balance, but that would be pending final payment from the insurance company. Per our office policy, patients will always be responsible for any balance denied by their insurance. I have attached a copy of our policy that [redacted] did sign.Having said that, we did double check the account, and did discover a mistake in the posting of [redacted]'s insurance payment, and have now made the necessary correction. [redacted]'s correct balance is $83. The balance is the result of [redacted]'s insurance companying denying his exam, not the glasses. Our fee for the exam was a total of $105. The Explanation of Benefits we received from [redacted]'s insurance denied payment for the exam stating, “The amount is not payable either because it is not a covered expense under the member's plan or because the member has already exceeded the maximum amount allowed.” The insurance Explanation of Benefits did indicate we take a $22 write off per our contract with them. Therefore, the resulting balance on [redacted]'s account is $83. Per his insurance company, he is responsible for the balance.We do apologize for any confusion or misunderstanding, but based on all of the above, the outstanding balance on [redacted]'s account of $83 is correct. As this balance is now quite old, we would appreciate [redacted]'s prompt payment to clear the balance.Please feel free to contact me at [redacted] if you have any questions or need any additional information.
Sincerely Yours,Stacie B
Accounting Manager

Review: I have been a patient here for several years with the same insurance company ([redacted]. A division of [redacted] for military members and dependents). I had an appointment in Jan. upon which booking the appointment they confirmed my insurance. Upon arrival they took my insurance card and called the company to confirm benefit while I waited. I then had my exam.

Today my daughter (under the same insurance plan) arrived for an exam. Again, upon making the appointment they confirmed my insurance company (the same since 2008) for her appointment. She is covered under the same plan.

Upon arrival they collected such insurance card and called the company while we waited. The card was handed back and she had her exam. Halfway through the exam the front desk attendant ([redacted]) came in and said we were not covered and that I owed a balance from my Jan. appointment. When pressed she said it was because they no longer accept our insurance.

I never received a bill for my Jan. appointment.

My primary concerns:

If they called (upon making the appointments (Jan. and today) and confirmed coverage upon arrival and continued to let me have an exam (and my daughter's today)

why are they "surprising" clients with a fee upon exit?Desired Settlement: I am expressing interest in having the $94 balance waived from my Jan. appointment as well as a $49 refund for my daughter's exam fee today.