Inland Eye Specialists

Revdex.com: I have reviewed the response made by the business in reference to complaint ID 12692782, and find that this resolution is satisfactory to meThank you for your help [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 12562161, and find that this resolution is satisfactory to me.We greatly appreciate your assistance in this matter

Miriam, I have spoken to MsStango and resolved her issue We are processing a check (check #34460) in the amount of $which will be sent to MsStango She then will repay her insurance company the overpayment Please reflect this resolution to case #
Sincerely, Mark Nilsen Practice Administrator Inland Eye Specialists, an ESP Company o: www.InlandEyeSpecialists.com

We are sorry to hear that this patient had a negative experienceThe doctor did provide the patient with a new prescription that objectively improved his distance vision. However, while improving his distance vision, the patient was told that the new prescription would decrease intermediate
vision unless a trifocal or progressive lens was usedWhen the patient returned for a check two weeks later complaining about his intermediate range vision, the patient was given a new prescription with no changes to the distance vision and a decreased add that would provide clear intermediate visionAgain, the doctor discussed with the patient that the new lens would provide clear distance and intermediate vision but near vision would be blurryWe are sorry that the patient is unsatisfied with the glasses even though their function was fully explained to the patientA refund has been processed and will be reflected on the patient's credit card before the end of this week

Initial Business Response /* (1000, 5, 2016/07/21) */
It is standard procedure at Inland Eye Specialists to verify the benefits of each patient to ensure that each patient is accurately charged and to ensure that each patient receives all of the benefits to which he or she is entitledIn this
case, after verifying the benefits of the patient, we discovered that the explanation of benefits (EOB) sent to the patient by her carrier included a mistakeThe insurance carrier was contacted to discuss the discrepancy and readily acknowledged the mistake on the EOB sent to their patientThe carrier will be preparing and sending out a corrected EOB to the patientAll of this was explained to the patientWe also provided the patient with the name and telephone number of the contact at the insurance carrier so she could speak to them herselfHence, when the patient's glasses were dispensed, we collected the correct amount from the patient in accordance with the insurance contract even though the amount differed from the incorrect EOB by $
Even though the amount collected by Inland Eye Specialists was accurate and completely in compliance with the patient's insurance contract, we have already submitted a request to refund the patient the $she feels she is dueWe are committed to providing her and all of our patients the highest level of service and value to ensure that our relationship with them, their family, and their friends lasts for many years to come
Initial Consumer Rebuttal /* (3000, 7, 2016/07/23) */
(The consumer indicated he/she DID NOT accept the response from the business.)
I received the same explanation of benefits from Kaiser Permanente, *** *** Appeals Specialist XXX XXX-XXXX, he stated in his letter to me and I quote the explanation of benefits is correct and it will not be any changes to itDate of service is 3-22-Per the explanation of benefits charges was $578.00, disallowed amount $79.00, allowed amount from Kaiser $and member responsibility $On 6-24-Mr*** fax a copy of the explanation of benefits to Idalia, fax number XXX-XXX-XXXX, she did receive it because we had a conference call confirming she did receive itOn 7-21-I received a call from Inland Eye Specialist stating if I gave them another copy of the explanation of benefits I would receive my $backAs of today I have not received anythingI am willing to post my explanation of benefits showing this company is over charging patientsNo one has to pay the disallowed amount on an explanation of benefits, that is a write offInland Eye Specialist needs to read the contract between them and Kaiser PermanenteKaiser just doesn't send patients to any company, only companies they are contracted withPlease have Inland Eye Specialist review the contract they have with KaiserI just can't give my money away like that, $is a lot of money to meThe government is taking everything away I just can't afford itMy next is the Department of Consumer Affairs or whoever will listen
Final Business Response /* (4000, 9, 2016/07/25) */
We are sorry for the conflicting information that has been provided by the patient's insurance carrierAs stated in our previous response, a refund of $is being processed and should be received by the patient within a week
Final Consumer Response /* (2000, 14, 2016/08/11) */
Per consumer, refund was received

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 12692782, and find that this resolution is satisfactory to me. Thank you for your help. [redacted]

Our usual and customary fee for the type of office visit this patient's husband had is $150.00 for an office visit plus $59.00 for a refraction, which totals $209.00.  The $59.00 fee for refraction was paid on the date of service because it is not a covered benefit by Medicare....

Accordingly, our practice billed Medicare for $150.00. The husband's deductible had not yet been met; consequently, Medicare did not pay on the claim and we billed the husband for the Medicare allowable rate of $131.00. Upon further investigation, we have discovered that the husband also had a secondary insurance which we were told would cover the deductible. However, we inadvertently neglected to bill the secondary insurance. Because of this oversight, we have written off the outstanding balance of $131.00. Because the patient did not have Medicare and did not use private insurance for her exam, we charged her our courtesy cash price of $99.00.  Offering patients a private pay discounted rate is a perfectly ethical and acceptable practice in the industry. We are sorry for any misunderstanding.Sincerely,[redacted]Director

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 12213707, and find that this resolution is satisfactory to me.I have just received the check referenced and payment has been forwarded to the insurance company to allow for close out of issue. I'd like to thanks Mr. Nilsen for his assistance in resolve of this issue.