February 1, 2018Dear [redacted] : With regards to the above referenced complaint, we are somewhat limited in our response due to federal health privacy laws.We routinely tell all patients that the only "vision insurance" we take is [redacted] (***)However, we are on nearly all insurance for medical eye problemsThe patient informed us of her medical insurance and that the child was referred by the pediatrician because of a failed vision screen and concern for possible laze eye (amblyopia) Most medical insurance companies cover under the medical plan for the exam of a child with ”amblyopia suspect" or "failed vision screen”.There is also a charge for the refraction portion of the exam which is not typically covered by insuranceFor a routine exam where there is no suspicion of any medical eye problem we charge between $and $The only vision plan we accept for payment in this case is *** In this specific case the child was referred by the pediatrician to rule out any vision issue such as amblyopiaDuring the exam, the doctor determined that the child's eyes were healthy, but needed glassesThe doctor asked it the patient has [redacted] and was told by the parent that she thought they didTherefore, instead of charging the medical and refraction charge (which was more expensive), the doctor billed it as a routine exam that would be a lesser charge and only require a $co-payHowever, the front desk personnel was able to determine that the patient did not in fact have ***, but another vision plan with which we do not participateTherefore, the doctor switched the billing to a low level medical exam with a refraction to enable the medical insurance to be billed as the patient had been referred by the pediatricianAgain, this was done to minimize costs to the patientThe patient's parent was charged the $for the refraction and the medical portion was billed to the insuranceThe parent was unhappy because she has not met her medical deductible and felt we should have told her ahead of time that we did not participate with her "vision plan”The doctor called the parent and explained the entire situation—that we clearly state the only vision plan we participate with is [redacted] and that most vision plans contract with optometrists who do not go to medical school and are not board certified medical physicians with years of specialty training, including fellowship training in pediatric ophthalmologyHe explained that he was trying to minimize the patient's out-of-pocket expenses, even though it reduced what the practice would be paid for the exam.Nevertheless, the parent did not want insurance to be billed for the exam and we thereforealready reduced the fee to an intermediate follexamWe stand by these practices as they are standard practices nationally and in the community.Sincerely,Carla R.Billing Manager
February 1, 2018Dear [redacted] :? With regards to the above referenced complaint, we are somewhat? limited in our response due to federal health privacy laws.We routinely tell all patients that the only "vision insurance" we take? is [redacted] (***)However, we are on nearly all insurance? for medical eye problemsThe patient informed us of her medical? insurance and that the child was referred by the pediatrician because? of a failed vision screen and concern for possible laze eye (amblyopia).? ? Most medical insurance companies cover under the medical plan for? the exam of a child with ”amblyopia suspect" or "failed vision screen”.There is also a charge for the refraction portion of the exam which is? not typically covered by insurance.? For a routine exam where there is no suspicion of any medical eye? problem we charge between $and $The only vision plan? we accept for payment in this case is ***.? In this specific case the child was referred by the pediatrician to rule? out any vision issue such as amblyopiaDuring the exam, the doctor? determined that the child's eyes were healthy, but needed glassesThe? doctor asked it the patient has [redacted] and was told by the parent that she? thought they didTherefore, instead of charging the medical and? refraction charge (which was more expensive), the doctor billed it as a? routine exam that would be a lesser charge and only require a $co-payHowever, the front desk personnel was able to determine that the? patient did not in fact have ***, but another vision plan with which? we do not participateTherefore, the doctor switched the billing to a? low level medical exam with a refraction to enable the medical? insurance to be billed as the patient had been referred by the? pediatricianAgain, this was done to minimize costs to the patientThe patient's parent was charged the $for the refraction and the medical portion was billed to the insuranceThe parent was unhappy because she has not met her medical deductible and felt we should have told her ahead of time that we did not participate with her "vision plan”The doctor called the parent and explained the entire situation?"that we clearly state the only vision plan we participate with is [redacted] and that most vision plans contract with optometrists who do not go to medical school and are not board certified medical physicians with years of specialty training, including fellowship training in pediatric ophthalmologyHe explained that he was trying to minimize the patient's out-of-pocket expenses, even though it reduced what the practice would be paid for the exam.Nevertheless, the parent did not want insurance to be billed for the exam and we thereforealready reduced the fee to an intermediate follexam.? We stand by these practices as they are standard practices nationally and in the community.Sincerely,Carla R.Billing Manager
February 1, 2018Dear *** ***:? With regards to the above referenced complaint, we are somewhat? limited in our response due to federal health privacy laws.We routinely tell all patients that the only "vision insurance" we take? is *** *** *** (***)However, we are on nearly
all insurance? for medical eye problemsThe patient informed us of her medical? insurance and that the child was referred by the pediatrician because? of a failed vision screen and concern for possible laze eye (amblyopia).? ? Most medical insurance companies cover under the medical plan for? the exam of a child with ”amblyopia suspect" or "failed vision screen”.There is also a charge for the refraction portion of the exam which is? not typically covered by insurance.? For a routine exam where there is no suspicion of any medical eye? problem we charge between $and $The only vision plan? we accept for payment in this case is ***.? In this specific case the child was referred by the pediatrician to rule? out any vision issue such as amblyopiaDuring the exam, the doctor? determined that the child's eyes were healthy, but needed glassesThe? doctor asked it the patient has *** and was told by the parent that she? thought they didTherefore, instead of charging the medical and? refraction charge (which was more expensive), the doctor billed it as a? routine exam that would be a lesser charge and only require a $co-payHowever, the front desk personnel was able to determine that the? patient did not in fact have ***, but another vision plan with which? we do not participateTherefore, the doctor switched the billing to a? low level medical exam with a refraction to enable the medical? insurance to be billed as the patient had been referred by the? pediatricianAgain, this was done to minimize costs to the patientThe patient's parent was charged the $for the refraction and the medical portion was billed to the insuranceThe parent was unhappy because she has not met her medical deductible and felt we should have told her ahead of time that we did not participate with her "vision plan”The doctor called the parent and explained the entire situation??"that we clearly state the only vision plan we participate with is *** and that most vision plans contract with optometrists who do not go to medical school and are not board certified medical physicians with years of specialty training, including fellowship training in pediatric ophthalmologyHe explained that he was trying to minimize the patient's out-of-pocket expenses, even though it reduced what the practice would be paid for the exam.Nevertheless, the parent did not want insurance to be billed for the exam and we thereforealready reduced the fee to an intermediate follexam.? We stand by these practices as they are standard practices nationally and in the community.Sincerely,Carla R.Billing Manager
February 1, 2018Dear [redacted]: With regards to the above referenced complaint, we are somewhat limited in our response due to federal health privacy laws.We routinely tell all patients that the only "vision insurance" we take is [redacted]). However, we are on nearly...
all insurance for medical eye problems. The patient informed us of her medical insurance and that the child was referred by the pediatrician because of a failed vision screen and concern for possible laze eye (amblyopia). Most medical insurance companies cover under the medical plan for the exam of a child with ”amblyopia suspect" or "failed vision screen”.There is also a charge for the refraction portion of the exam which is not typically covered by insurance. For a routine exam where there is no suspicion of any medical eye problem we charge between $141.19 and $327.83. The only vision plan we accept for payment in this case is [redacted]. In this specific case the child was referred by the pediatrician to rule out any vision issue such as amblyopia. During the exam, the doctor determined that the child's eyes were healthy, but needed glasses. The doctor asked it the patient has [redacted] and was told by the parent that she thought they did. Therefore, instead of charging the medical and refraction charge (which was more expensive), the doctor billed it as a routine exam that would be a lesser charge and only require a $10 co-payHowever, the front desk personnel was able to determine that the patient did not in fact have [redacted], but another vision plan with which we do not participate. Therefore, the doctor switched the billing to a low level medical exam with a refraction to enable the medical insurance to be billed as the patient had been referred by the pediatrician. Again, this was done to minimize costs to the patient. The patient's parent was charged the $55 for the refraction and the medical portion was billed to the insurance. The parent was unhappy because she has not met her medical deductible and felt we should have told her ahead of time that we did not participate with her "vision plan”. The doctor called the parent and explained the entire situation—that we clearly state the only vision plan we participate with is [redacted] and that most vision plans contract with optometrists who do not go to medical school and are not board certified medical physicians with years of specialty training, including fellowship training in pediatric ophthalmology. He explained that he was trying to minimize the patient's out-of-pocket expenses, even though it reduced what the practice would be paid for the exam.Nevertheless, the parent did not want insurance to be billed for the exam and we thereforealready reduced the fee to an intermediate follow-up exam. We stand by these practices as they are standard practices nationally and in the community.Sincerely,Carla R.Billing Manager
February 1, 2018Dear [redacted] : With regards to the above referenced complaint, we are somewhat limited in our response due to federal health privacy laws.We routinely tell all patients that the only "vision insurance" we take is [redacted] (***)However, we are on nearly all insurance for medical eye problemsThe patient informed us of her medical insurance and that the child was referred by the pediatrician because of a failed vision screen and concern for possible laze eye (amblyopia) Most medical insurance companies cover under the medical plan for the exam of a child with ”amblyopia suspect" or "failed vision screen”.There is also a charge for the refraction portion of the exam which is not typically covered by insuranceFor a routine exam where there is no suspicion of any medical eye problem we charge between $and $The only vision plan we accept for payment in this case is *** In this specific case the child was referred by the pediatrician to rule out any vision issue such as amblyopiaDuring the exam, the doctor determined that the child's eyes were healthy, but needed glassesThe doctor asked it the patient has [redacted] and was told by the parent that she thought they didTherefore, instead of charging the medical and refraction charge (which was more expensive), the doctor billed it as a routine exam that would be a lesser charge and only require a $co-payHowever, the front desk personnel was able to determine that the patient did not in fact have ***, but another vision plan with which we do not participateTherefore, the doctor switched the billing to a low level medical exam with a refraction to enable the medical insurance to be billed as the patient had been referred by the pediatricianAgain, this was done to minimize costs to the patientThe patient's parent was charged the $for the refraction and the medical portion was billed to the insuranceThe parent was unhappy because she has not met her medical deductible and felt we should have told her ahead of time that we did not participate with her "vision plan”The doctor called the parent and explained the entire situation—that we clearly state the only vision plan we participate with is [redacted] and that most vision plans contract with optometrists who do not go to medical school and are not board certified medical physicians with years of specialty training, including fellowship training in pediatric ophthalmologyHe explained that he was trying to minimize the patient's out-of-pocket expenses, even though it reduced what the practice would be paid for the exam.Nevertheless, the parent did not want insurance to be billed for the exam and we thereforealready reduced the fee to an intermediate follexamWe stand by these practices as they are standard practices nationally and in the community.Sincerely,Carla R.Billing Manager
February 1, 2018Dear [redacted] :? With regards to the above referenced complaint, we are somewhat? limited in our response due to federal health privacy laws.We routinely tell all patients that the only "vision insurance" we take? is [redacted] (***)However, we are on nearly all insurance? for medical eye problemsThe patient informed us of her medical? insurance and that the child was referred by the pediatrician because? of a failed vision screen and concern for possible laze eye (amblyopia).? ? Most medical insurance companies cover under the medical plan for? the exam of a child with ”amblyopia suspect" or "failed vision screen”.There is also a charge for the refraction portion of the exam which is? not typically covered by insurance.? For a routine exam where there is no suspicion of any medical eye? problem we charge between $and $The only vision plan? we accept for payment in this case is ***.? In this specific case the child was referred by the pediatrician to rule? out any vision issue such as amblyopiaDuring the exam, the doctor? determined that the child's eyes were healthy, but needed glassesThe? doctor asked it the patient has [redacted] and was told by the parent that she? thought they didTherefore, instead of charging the medical and? refraction charge (which was more expensive), the doctor billed it as a? routine exam that would be a lesser charge and only require a $co-payHowever, the front desk personnel was able to determine that the? patient did not in fact have ***, but another vision plan with which? we do not participateTherefore, the doctor switched the billing to a? low level medical exam with a refraction to enable the medical? insurance to be billed as the patient had been referred by the? pediatricianAgain, this was done to minimize costs to the patientThe patient's parent was charged the $for the refraction and the medical portion was billed to the insuranceThe parent was unhappy because she has not met her medical deductible and felt we should have told her ahead of time that we did not participate with her "vision plan”The doctor called the parent and explained the entire situation?"that we clearly state the only vision plan we participate with is [redacted] and that most vision plans contract with optometrists who do not go to medical school and are not board certified medical physicians with years of specialty training, including fellowship training in pediatric ophthalmologyHe explained that he was trying to minimize the patient's out-of-pocket expenses, even though it reduced what the practice would be paid for the exam.Nevertheless, the parent did not want insurance to be billed for the exam and we thereforealready reduced the fee to an intermediate follexam.? We stand by these practices as they are standard practices nationally and in the community.Sincerely,Carla R.Billing Manager
February 1, 2018Dear *** ***:? With regards to the above referenced complaint, we are somewhat? limited in our response due to federal health privacy laws.We routinely tell all patients that the only "vision insurance" we take? is *** *** *** (***)However, we are on nearly
all insurance? for medical eye problemsThe patient informed us of her medical? insurance and that the child was referred by the pediatrician because? of a failed vision screen and concern for possible laze eye (amblyopia).? ? Most medical insurance companies cover under the medical plan for? the exam of a child with ”amblyopia suspect" or "failed vision screen”.There is also a charge for the refraction portion of the exam which is? not typically covered by insurance.? For a routine exam where there is no suspicion of any medical eye? problem we charge between $and $The only vision plan? we accept for payment in this case is ***.? In this specific case the child was referred by the pediatrician to rule? out any vision issue such as amblyopiaDuring the exam, the doctor? determined that the child's eyes were healthy, but needed glassesThe? doctor asked it the patient has *** and was told by the parent that she? thought they didTherefore, instead of charging the medical and? refraction charge (which was more expensive), the doctor billed it as a? routine exam that would be a lesser charge and only require a $co-payHowever, the front desk personnel was able to determine that the? patient did not in fact have ***, but another vision plan with which? we do not participateTherefore, the doctor switched the billing to a? low level medical exam with a refraction to enable the medical? insurance to be billed as the patient had been referred by the? pediatricianAgain, this was done to minimize costs to the patientThe patient's parent was charged the $for the refraction and the medical portion was billed to the insuranceThe parent was unhappy because she has not met her medical deductible and felt we should have told her ahead of time that we did not participate with her "vision plan”The doctor called the parent and explained the entire situation??"that we clearly state the only vision plan we participate with is *** and that most vision plans contract with optometrists who do not go to medical school and are not board certified medical physicians with years of specialty training, including fellowship training in pediatric ophthalmologyHe explained that he was trying to minimize the patient's out-of-pocket expenses, even though it reduced what the practice would be paid for the exam.Nevertheless, the parent did not want insurance to be billed for the exam and we thereforealready reduced the fee to an intermediate follexam.? We stand by these practices as they are standard practices nationally and in the community.Sincerely,Carla R.Billing Manager
February 1, 2018Dear [redacted]: With regards to the above referenced complaint, we are somewhat limited in our response due to federal health privacy laws.We routinely tell all patients that the only "vision insurance" we take is [redacted]). However, we are on nearly...
all insurance for medical eye problems. The patient informed us of her medical insurance and that the child was referred by the pediatrician because of a failed vision screen and concern for possible laze eye (amblyopia). Most medical insurance companies cover under the medical plan for the exam of a child with ”amblyopia suspect" or "failed vision screen”.There is also a charge for the refraction portion of the exam which is not typically covered by insurance. For a routine exam where there is no suspicion of any medical eye problem we charge between $141.19 and $327.83. The only vision plan we accept for payment in this case is [redacted]. In this specific case the child was referred by the pediatrician to rule out any vision issue such as amblyopia. During the exam, the doctor determined that the child's eyes were healthy, but needed glasses. The doctor asked it the patient has [redacted] and was told by the parent that she thought they did. Therefore, instead of charging the medical and refraction charge (which was more expensive), the doctor billed it as a routine exam that would be a lesser charge and only require a $10 co-payHowever, the front desk personnel was able to determine that the patient did not in fact have [redacted], but another vision plan with which we do not participate. Therefore, the doctor switched the billing to a low level medical exam with a refraction to enable the medical insurance to be billed as the patient had been referred by the pediatrician. Again, this was done to minimize costs to the patient. The patient's parent was charged the $55 for the refraction and the medical portion was billed to the insurance. The parent was unhappy because she has not met her medical deductible and felt we should have told her ahead of time that we did not participate with her "vision plan”. The doctor called the parent and explained the entire situation—that we clearly state the only vision plan we participate with is [redacted] and that most vision plans contract with optometrists who do not go to medical school and are not board certified medical physicians with years of specialty training, including fellowship training in pediatric ophthalmology. He explained that he was trying to minimize the patient's out-of-pocket expenses, even though it reduced what the practice would be paid for the exam.Nevertheless, the parent did not want insurance to be billed for the exam and we thereforealready reduced the fee to an intermediate follow-up exam. We stand by these practices as they are standard practices nationally and in the community.Sincerely,Carla R.Billing Manager