Dr. Andrew C. Kartesz & Associates, P.C.

Refund my money as I was dissatisfied with their service and I gave back the prescriptions. As I didn't keep the prescriptions, I would like to act as if the appointment never took place.

Ms. [redacted] called into our office
on December 3, 2014, at 8:24 a.m. and spoke with [redacted] to make an...

emergency
appointment. 
I encountered Ms. [redacted] on
December 3, 2014, at the front counter to check her into the office.   As I was getting the patient information
sheets ready for her, I asked for her health insurance card.   She advised that she did not have one.  Our front office is an open air space and at
times it can be difficult to hear our questions.  A normal practice for our office is to ask
the patient again to make sure they understood what we are asking for and this
is also done for patients that state that they do not have insurance, to make
sure that they do not have coverage on their health plan that they are not
aware of.  In many instances we are able
to find insurance coverage for our patients. She stated that she did not have
health insurance.  At no time, did I roll
my eyes or talk down to Ms. [redacted].  The only
time I turned my back to her was to begin working on her file. Each patient
whether they have no insurance, commercial insurance or state funded insurance is
treated with equal respect
My next interaction with Ms.
[redacted] was upon her return to our office later that day.  Ms. [redacted] and a man approached [redacted] at the
front desk.  I could hear Ms. [redacted] from
my desk due to her loud and angry tone. She was confrontational and loud in our
front office, with other patients sitting in the waiting room.  [redacted] advised me that Ms. [redacted] aggressively stated
that she wanted the appointment to be canceled and that she was not going to
have the prescriptions filled. So that our other patients would not witness a
further scene, I brought her and her companion to another room. I calmly asked
if there was something that I could help her with.  She said no, that she would wait until “the
man she just saw comes in here”.   Upon
return to the room with Dr. [redacted], Ms. [redacted] began cursing and complaining
(to be more specific she stated that she was “[redacted]”) and accused me of
rolling my eyes, due to the fact that she did not have insurance.  She then went on to explain that Dr. [redacted]
made a joke about the fact that she did not have insurance so she could pay for
the prescriptions, which is also a false statement.  At one point Ms. [redacted] advised that she wanted
to physically damage our office, more specifically she stated, “what I really
want to do is push your [redacted] on the floor and show my [redacted]”. 
Our office prides itself on our professionalism.  Every one of our employees strives to go
above and beyond to help our patients in the most respectful manner.  Ms. [redacted] was disrespectful, rude and belligerent.
Dr. [redacted] upon receipt of this
complaint, although unfounded and false, had made the decision to refund Ms.
[redacted] her payment of $127.00. Unfortunately, Ms. [redacted] did not wait for
resolution through the Revdex.com complaint, a process she chose,
and put a stop payment on the check that she presented to our office for
services rendered, causing a $10.00 charge to our account.  We are now seeking a $10.00 payment from Ms.
[redacted] to cover the stop check charge.

Review: I went into the office of Dr. Kartesz in the fall of 2015 for a routine examination. As I was leaving, I paid this with my credit card. I was prescribed new contacs. I took the prescription to [redacted] and bought the contacs there. I was instructed to come back a week later for a follow up. I did so. As I left, I stopped by the payment window and was told that I was paid in full as my initial visit paid for that. However, I later received a bill from Dr. Kartesz. I paid the initial visit on my own. However, the second bill was billed partially to my insurance and then I paid the balance. On 1-15-16, I purchased a pair of glasses for $105. I paid for these in full on my [redacted] card. I was told by [redacted], the office manager, that they would have to charge me a lot more if they billed it to my insurance. I told the lady that fitted my glasses about how I had been treated prior to this. She showed me my chart that shows that I had paid $189 prior to the $105 and that I was paid in full. Before I left, the office manager said that they had forgotten to charge me for my initial visit and she would bill it to my insurance. This was a real shocker. They went ahead and billed that to my insurance and sent me an invoice this week that I owe them $30 and it is over 120 days late. I completely disagree with this. This office has told me too many times that I am paid in full and then they come up with new charges. I was a former patient of Dr. [redacted] when he was in downtown. When his office closed and he started working here, I came here as a patient. I did see Dr. [redacted] there in 2014. All of that was paid for then. Dr. [redacted] was a kind and a fair man. I was surprised when I went in this year for an exam and Dr. [redacted] is no longer there. However, I should not be too surprised as I can very well see that Dr. [redacted] would not be a good fit for such corrupt and unfair business practices as what take place at this office.Desired Settlement: This office owes me an apology over their bad methods of record keeping plus they need to adjust the $30 off of this bill. My insurance company and I have paid enough.

Business

Response:

In response to the complaint made by Mr. [redacted], I have attempted to reach out to him numerous times. We have called him with the number we have on file with no response from Mr. [redacted]. When patients come in to the office they are not always aware of their insurance. Some policies have deductibles, coinsurance , and copay’s. We filed Mr. [redacted]’s insurance after he made us aware that he had insurance coverage for us to file. As a result of filing his insurance he has coinsurance of $30.00 that is due for the date of service 09/25/2015. We have no control over what type of coverage the patient has. We try to help the patient out to the best of our ability filing their insurance for them and trying to keep the cost down as well. In regards to the glasses Mr. [redacted] purchased when he came into the office he did not present insurance again. He called back to let us know he in fact had coverage for his glasses. Mr. [redacted] had already paid $ 105.00 for the Spectacle package. We checked on his vision benefits with [redacted]. His benefits indicated he has a discount plan. With the plan he would have received a discount on his frame and lense. He would have paid $50.00 on the lense, $21.00 on the frame, and $40.00 for the standard polycarbonate which would total $111.00. We spoke to Mr, [redacted] to let him know that the discount plan would have cost him more money, and he was actually saving $6.00 by purchasing the Spectacle package. We have spoke with Mr. [redacted] on numerous occasions to help him understand the insurance coverage and the discount plan. The coinsurance is $30.00 per his medical insurance plan. If there is anything else we can help you with please let us know. Sincerely,Dr. Andrew C Kartesz

Consumer

Response:

I have reviewed the response offer made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

[I do not accept this reply. I was told by the front desk that upon departure of my first and second visit in the fall that I was paid in full. I paid the eye exam in full from my own pocket. Dr. Kartesz office waited six months and then told me that what I had paid was something else that they were billing me for. They have NOT tried to contact me numerous times. The information in his response is incorrect and unacceptable. I do not owe him anything else. I have dealt with a very rude and mean office manager there. Another thing that told me was that they would have to charge me $140 out of pocket for the eyeglasses if I used my insurance. Now, he is saying that they said only $111.00. I find their ways of doing business to be completely wrong and unacceptable]

Regards,

Review: lEmergency office visit on December 3, 2014 at 10:00 a.m., I was spoken to first by [redacted], in a very short curt manner. Once she asked for a copy of my health insurance, I advised that I had none. She immediately rolled her eyes with a look of disgust and turned and walked away. I was then put into the exam room, in a short amount of time Dr. [redacted] came in and we discussed my problem. At this point he was informative and did answer my questions. After looking at my eye with a q-tip in hand, he then added drops to both eyes. Immediately asked me to read the exam screen, which I could not see. The then tells me by dmv regulations I am not allowed to drive. As I was there for an eye infection not DMV eligibility, this was not his to determine as I do have glasses for driving purposes. My 6 minute exam was now over and he explains the prescriptions he is giving me. I asked for a generic or a sample if he had any because I do not have health insurance. His response was "Well since you don't pay for your health insurance you should have money for your medicine." Visit over, come back in a week. The cost of this 6 minute appointment was $127.00. Only to find out the 2 prescriptions carry a price of over $300.00. I work with the public on a daily basis, and have for over 25 years and never have I been treated like this. Rude and unprofessional are polite terms. Their actions and attitudes because I had no insurance made me feel like I wasn't worth their time. Looked down upon would be a good description. The mannerisms were so bad I left in tears. The exam cost is in question and part of my complaint, but the majority of the complaint was how horribly they spoke to me because I have no insurance. I was not worthy of their time, is how it felt.Desired Settlement: I am not sure how you could settle this event, I felt people need to be made aware of the horrible customer service these two individuals provided me.As I have never filed a complaint against anyone in my life, I don't know how the process works. If there is something that can be done, I will gladly speak to someone about those options. Thank you for reading my long drawn out details.

Consumer

Response:

Refund my money as I was dissatisfied with their service and I gave back the prescriptions. As I didn't keep the prescriptions, I would like to act as if the appointment never took place.

Business

Response:

Ms. [redacted] called into our office

on December 3, 2014, at 8:24 a.m. and spoke with [redacted] to make an emergency

appointment.

I encountered Ms. [redacted] on

December 3, 2014, at the front counter to check her into the office. As I was getting the patient information

sheets ready for her, I asked for her health insurance card. She advised that she did not have one. Our front office is an open air space and at

times it can be difficult to hear our questions. A normal practice for our office is to ask

the patient again to make sure they understood what we are asking for and this

is also done for patients that state that they do not have insurance, to make

sure that they do not have coverage on their health plan that they are not

aware of. In many instances we are able

to find insurance coverage for our patients. She stated that she did not have

health insurance. At no time, did I roll

my eyes or talk down to Ms. [redacted]. The only

time I turned my back to her was to begin working on her file. Each patient

whether they have no insurance, commercial insurance or state funded insurance is

treated with equal respect

My next interaction with Ms.

[redacted] was upon her return to our office later that day. Ms. [redacted] and a man approached [redacted] at the

front desk. I could hear Ms. [redacted] from

my desk due to her loud and angry tone. She was confrontational and loud in our

front office, with other patients sitting in the waiting room. [redacted] advised me that Ms. [redacted] aggressively stated

that she wanted the appointment to be canceled and that she was not going to

have the prescriptions filled. So that our other patients would not witness a

further scene, I brought her and her companion to another room. I calmly asked

if there was something that I could help her with. She said no, that she would wait until “the

man she just saw comes in here”. Upon

return to the room with Dr. [redacted], Ms. [redacted] began cursing and complaining

(to be more specific she stated that she was “[redacted]”) and accused me of

rolling my eyes, due to the fact that she did not have insurance. She then went on to explain that Dr. [redacted]

made a joke about the fact that she did not have insurance so she could pay for

the prescriptions, which is also a false statement. At one point Ms. [redacted] advised that she wanted

to physically damage our office, more specifically she stated, “what I really

want to do is push your [redacted] on the floor and show my [redacted]”.

Our office prides itself on our professionalism. Every one of our employees strives to go

above and beyond to help our patients in the most respectful manner. Ms. [redacted] was disrespectful, rude and belligerent.

Dr. [redacted] upon receipt of this

complaint, although unfounded and false, had made the decision to refund Ms.

[redacted] her payment of $127.00. Unfortunately, Ms. [redacted] did not wait for

resolution through the Revdex.com complaint, a process she chose,

and put a stop payment on the check that she presented to our office for

services rendered, causing a $10.00 charge to our account. We are now seeking a $10.00 payment from Ms.

[redacted] to cover the stop check charge.

Review: I went to an appointment on April 25, 2013. I told them I did not have Eye Insurance coverage. When I left the appointment, because of poor service. I went to the desk and asked, "What do I owe?" I was charged. $35.00. Over a month later, I recieved a bill for $60 stating it was overdue 30-60 days. When I contacted the office, I was told the bill was $95 for an eye exam. When I asked why I was not charged the full amount while I was at the office, I was told: They were doing me a favor by attempting to bill my insurance company, even though I told them I did not have coverage. I was not told at the appointment there was an outstanding amount due and they would be trying to bill my insurance. I would have told them not to try and would have paid the full amount at the time of service. This bill did not show up until after they realiized I was not returning to them as a patient. The office manager blamed the issue on me. There was also no explanation of charges on the one and only bill I received. I had to contact the office to find out what this bill was for.Desired Settlement: I would like to have them to remove the charge which was added on over a month after my visit. I would like them to tell customers how much charges are up front and give them a choice of running it through insurance companies they don't have coverage with or accepting payment when it is offered. I would like them to acknowledge the poor service I received instead of blaming it on me.

Business

Response:

: ID #[redacted] Mr [redacted] came to our office on 4/25/13. He advised that he did not have any routine vision coverage under his insurance plan. We noted this on his chart. During his visit, Dr Kartesz indicated a possibility of glaucoma. He wanted to do additional testing for this, but the patient did not wish to remain to have these tests done. When his chart arrived at the window for check out, Dr Kartesz had marked the visit to be billed medically through his [redacted] insurance due to the glaucoma indicators. We advised the patient that on that day he owed $35.00 which is his specialist co-pay. We billed the patients medical insurance for the difference in hopes that they would cover as a non-routine medical visit. Any time we can bill insurance instead of the patient, we do. The claim was sent to [redacted] on 4/25. It normally takes 15-30 days to receive remittance from insurance. On 5/24/13 we receive denial from [redacted] on this claim. The balance of $64.00 was transferred back to Mr [redacted] as patient responsibility. The balance due was mailed to the patient on his June statement from the period ending 5/31/13. this is a normal billing cycle. Our exam fee was $99.00 less Mr. [redacted]'s previous payment of $35.00 leave a balance due of $64.00.Thank you. [redacted] Office Manager Kartesz Family Eye Care

Consumer

Response:

I have reviewed the response offer made by the business in reference to complaint ID 9600383, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below. No offer was made. As I stated in my original complaint, I told the people at Dr. Kartesz's office, I do not have vision coverage with my new insurance plan. Dr. Kartesz says due to the glaucoma indicators he tried to bill it through my medical insurance. This is not true. I spoke with my insurance and I was told Dr. Kartesz tried to bill my insurance for a routine vision claim, an office visit and determination of refractive state. This type of submission would only be covered under a routine vision rider, not medical insurance. This is the nature of my complaint. I told them I did not have vision coverage. I asked how much I owed them and instead of giving me the total amount they tried to bill my insurance plan using codes which would have only been paid if I had a vision rider. I believe if he was truly trying to bill it under my medical insurance he would not have coded it as a: routine vision claim, office visit. Adding a code for: "determination of refractive state," is boarder line insurance fraud, because I did not stay long enough for him to have enough information to make a determination of my refractive state. No where on the claim, to my insurance, did it mention I left his office AMA. I am still requesting the removal of any outstanding balance.Regards,[redacted]

Consumer

Response:

I need to amend my response to the response offer, I sent in today. In my response I said, "Adding a code for: "determination of refractive state," is boarder line insurance fraud, because I did not stay long enough for him to have enough information to make a determination of my refractive state. "This statement is not correct, I miss understood, "determination of refractive state," to be the test Dr. Kartezs was doing when I left his office. I now know determination of refractive state was completed during my routine office visit. This means submitting it would not be borderline insurance fraud. It is definitely part of a routine eye exam. This information, in no way changes my rejection of the response offer. Determination of refractive state, and office visit are what you would bill, anyone who had routine eye care rider on his insurance. Which I told them, "I do not have." Dr. Kartezs did not even attempt of have the coding, look like something that would be billed to medical insurance. Regards [redacted]

Business

Response:

In response to the complaint from Mr [redacted], First, let me clarify that this is Vision, not Dental as Mr [redacted] stated in his previous response. When a patient calls to schedule an appointment, we ask for their Medical insurance information as well as any seperate vision coverage they may carry. We ask for the Medical information so that if during the routine exam the doctor discovers any issues outside of normal vision screening, we can attempt to bill medically. If during schedulilng of the appointment the patient indicates that they do not carry vision coverage, they are advised that the exam fee will be $99.00. I feel that Mr [redacted] was advised of this because he did furnish us with his Medical insurance information. During the exam, Dr Kartesz asked our Opticians for some additional testing due to some signs of possible glaucoma. When the Opticians attempted to complete the testing, Mr. [redacted] said he did not wish to remain in the office & did not want the tests done. Dr Kartesz brought us the file & said, please try to bill his medical insurance if you can & please reschedule him for the testing that he needs. Mr [redacted] was very agitated & quite hateful to our billing clerk & when he asked what he owed for the visit that day, he was advised only of a co-pay amount. This was due to be balance being billed to his medical insurance. When we attempted to bill Medically, it was denied due to the fact that we were only able to complete the routine portion of the exam since the patient left. We were only able to complete a routine exam on the patient which he would have been advised previously would be $99.00 & since he only paid $35.00 at the time of his visit, the additional $64.00 is due. This has been explained to the patient in detail on more than one occasion. During my converstion with Mr [redacted], he advised that he would pay the $64.00 that he knows is due, but that he would "take his sweet time doing it". We have been nothing less than professional while dealing with Mr [redacted] as we are with all of our patients. We feel that we are due payment for the comprehensive routine exam that he received while in our office. Thank you.

Superior care and service from my first visit.