Dr John F. Laneve

Review: In Feb 2013 I went to Dr Laneve's office for a routine eye exam. At the receptionist desk I pulled out my [redacted] card and the receptionist told me she didn't know if he accepted the card. Instead of checking she charged me $75 upfront before I could see the doctor. My daughter chose [redacted] Medicaid insurance because it covered medical, dental, and prescriptions. When I told her what happened and she researched it she told me that I should not have paid anything for the co-pay. I contacted [redacted] and they attempted to contact Dr. Laneve's office to no avail. My daughter contacted the office and spoke to the receptionist who informed her in error that it was my responsibility to check the coverage of my plan and as per my insurance company it is the provider's responsibility. [redacted] contacted me and left a message on my answering machine stating how much my glasses would cost after subtracting the $75 but I don't believe it reflects the fee schedule that [redacted] provides. It has been 6 mo and this issue still has not been resolved.Desired Settlement: I request that my $75 be refunded to me since I should not have paid a co-pay at all. Also, I would like an itemized listing mailed to me of what my glasses will cost based upon the listing that [redacted] provides. Since my daughter is now my authorized representative with Humana, any questions you have will go through her and her phone number is the number I listed.

Business

Response:

[redacted] I wanted to let you know I received the info - my secretary is not working today - due to[redacted] appointment. I have located almost all of the details in order to make a couple of decisions regarding this matter. I don't have an employee named > [redacted] < so there is some confusion about the statement made in her complaint about >>> a message left on an answering machine stating the price of the glasses. My question is - did she respond back to our office about such message ? This I will ask my secretary. I somewhat remember some of this confusion with not knowing her vision plan. The [redacted] plan cards can be somewhat confusing as far as information other than major medical. Most of the vision plan indicators on the insurance cards do NOT state the details about copays. They don't have any of the plan details on them. Sometimes when we search for a patient - they do NOT have vision coverage even though they are carrying a "card". There is a procedure I do with every eye exam which is not covered by any of the plans and the charge is only $10-$15 This would be in addition to any co-pays NO MATTER WHAT THE VISION PLAN IS. Patients are explained this but often times forget and have to be told again. ( It is a minimal charge for a very important piece of information I obtain about the eyes and can save it to a computer for future reference - most of the plans state a co-pay of $39.00 for this procedure. ) As far as glasses - I can tell you - most patients just do not understand the way the vision plans are laid out and do NOT pay attention the fine details and breakdowns in the plans (and can't understand the calculations). We do a lot of explaining and guiding patients as to how they can use their particular plan to their benefit and choice. A BRIEF EXAMPLE - There is usually a co-pay for each item / service with additional percentage discounts over certain amounts. Patients can control their own costs easily and I guide / explain to them how. For glassed - the lenses have many factors involved = each with their own copay. Lens material Lens coatings Lens style ( bifocal OR single vision OR progressive lens ) Tinting etc etc Each of those has a copay and additional discounts do apply when appropriate. Those copays add up and many patients don't follow how until I break down each and every selection. To complicate it more - there are a number of vison plans available. When I talked to Mrs [redacted] about the glasses = it was not known if she had a vision plan or not. So I quoted her the regular price - minus a senior discount. I told her we would check into the vision plan. I found the proper info and went back and changed her charges to reflect those copays and discounts associated with her [redacted] plan. Had my secretary call her and let her know and that we would correct the total charges (and the original 75.00 would be taken into consideration and deducted accordingly ). Evidently - she still thought the charge was incorrect / too expensive. ??? In this case - she did not return in order to let me explain that to her = and obviously she was not happy talking to my secretary about it. I do not know whether her daughter contacted my office or not. BUT I can easily find out = as it is a small office and it's just me and the secretary. The only thing I can remember - my secretary stated Mrs [redacted] would contact us about following thru with her order. At 4 months past - we had not heard from her and assumed she had decided to not make an order at this time. I don't think calling her is the solution as she will ( or her daughter will ) want to see the charges in writing as per the request. I will mail those to her in a letter. I will also enclose in that letter a check for $65.00 as her co-pay amount would have been $10.00 at the time = as per my note at the top of this letter about the procedure not covered by any of the vision plans. So I'm deducting this from the amont she paid at time of service. I will provide an explanation regarding this matter. [redacted] [ I will send you a copy of the letter I send to the patient. ] [redacted] I can assure you - when this has happened previously - the patients have come in and we have corrected any confusion / charges / etc etc. Evidently she did not feel comfortable doing that in her case. I have no problem with it - as I can access patient info on their vision plans on the internet (but not at my office) and print out the information to show them face to face while discussing it. Some patients bring pre-printed info and it is easier to explain to them the very first day. Thanks Dr John Laneve Lynchburg Va

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved. You may reach me at ###-###-#### if you have any other questions. Thank you.Regards,[redacted]