Mark Breeden OD Inc

There are three parts to the patient's statement.  1.  'We over charged.'  The patient's insurance company did not tell us to collect his contact lens fitting copay.  As a result, my office undercharged the patient by that amount.  2.  'We billed for multiple claims for...

same visit.'  When the patient communicated that he wanted a refund on his contact lens order his insurance company was notified within the hour.  Part of  communicating the refund to his insurance company involved submitting a second claim that showed he did not order contacts.  This resulted in there being two different claims for the same day.  3.  'We billed for hardware the patient did not order.'  Our office used some of his hardware for his contact lens fitting fee.  A contact lens fitting is a separate service which has associated fees.  There were two ways to pay for this fee.  The patient can pay it out of pocket or, with permission from their insurance company, we can take the fee out of their hardware allowance.  We chose the latter option to help the patient receive his full insurance benefits and to keep the patient's out of pocket expense to a minimum.  Insurance billing is a complicated process which is happily offered to our patients as a courtesy.

Complaint: [redacted]I am rejecting this response because:There were several issues here we have, 1. my insurance was billed 3 x for the same visit on the same day, then another bill for hardware that I never ordered,- 2. There were orders made with out my knowledge and orders made on days they did not even do orders on- 3. I have 5 Voice mails saved from Jaime from the office with multiple issues.- 4. Jaime was abrupt and rude on the phone told me I don't need to worry about the insurance due to the error on their end which it did affect me, It took me to call my insurance company to find out what happened and to have their claims team call the doctors office and fix the issue which took weeks. -5. After all the wrong claims they made my allowance was out and I was being informed i'll have to pay out of pocket for my contacts. It took me to call and file a complaint to fix all the issues , the doctors office and staff was rude abrupt and non helpful and when the doctor called back he didn't really seem to care what happen. My Admin. HR had to call also to our insurance to resolve the issue. Over all there were many multiple mistakes and issues going on with the doctors office that never should of happened, and when Jamie proceeded to tell me I won't need to worry about my insurance after they made many claims that it was fine when it did affect me and it was not fine which caused all this issue. I called the office a few wks ago and asked them to mail my finalized prescription to me so I could go else where to order my contact and told them I need it to match what the old doctors RX was- I received the mail about 1 wk later with a copy of an old expired RX from the old doctors office it was a copy of it.  I called again left another detailed message stating what they sent me was incorrect and was an expired RX from the old doctors office, and stated I need the New Finalized RX from Dr. B[redacted] with the same prescription as the old doctor to be mailed to me. The office called back a few days later and wanted to confirm the contact RX which I called back and spoke to Jamie and finally the right one was sent to me.Sincerely,[redacted]

I appreciate the patient's response and any opportunity to improve my business.  The first issue I will address is that my staff should not be rude to anyone.  I am very sorry that the patient thought my staff was rude to him.  I have subsequently spoken with the staff member about conflict resolution.  The second issue I will address is the expected outcome from the patient which is a refund of his hardware.  As of 5-18-15, the patient's insurance company processed his refund allowing the patient to order contacts elsewhere.  The desired outcome as written on the Revdex.com website had already happened 12 days before the patient submitted his complaint.  I spoke with [redacted], a customer service representative from the patient's insurance company, on 8-3-15 and she added details to the timeline as follows:5-15-15  The patient called his insurance company wanting a refund on his hardware at 7:39 am.  His insurance company received a faxed corrected claim requesting a refund from me at 11:24 am.  Hisinsurance company did not call my office that day.  (I heard from Visionworks that the patient wanted a refund.  I faxed the refund paperwork to his insurance company before ever receiving a request directly from the patient/his insurance company/or his HR department.)5-18-15  His insurance company processed the refund.  The patient's entire hardware allowance was refunded except for the $45 contact lens fitting fee.  This fee did not include the patient's copay.  This fee is for the evaluation and fitting of contacts and is not for the dispensed trials.  We do not charge for trial lenses.  5-21-15  His insurance company's customer service received a call from client services asking about the refund and they were told the refund had been processed.  The patient's admin/HR department likely contacted client services which prompted this call. 5-28-15  The patient called his insurance company to inquire about his refund and representative [redacted] accidentally told him the refund had not yet been processed.  She called him back on the same day to tell him the truth: his hardware was refunded on 5-18-15.  She also told him the $45 fitting fee is non-refundable.  (I never told his insurance company that the fitting was non-refundable.)5-29-15  Patient submits complaint to Revdex.com that he wants a refund.  6-22-15  Patient calls his insurance company to inquire about his refund.  Representative [redacted] told him again that his refund was already processed on 5-18-15.  She also told him again that the fitting isnon-refundable.  6-29-15  Another doctor's office called his insurance company to inquire on his hardware and were told that all of his hardware, minus the fitting, was available for use. 7-2-15  Patient submits second complaint to Revdex.com that he wants a refund.  8-3-15  [redacted] told me she would call the patient to explain to him that he has been refunded his hardware.  I submitted the refund paper work to the patient's insurance company before he told my office he wanted a refund.  He told his insurance company he wanted a refund on 5-15-15 (Friday).  The refund was fully processed on 5-18-15 (Monday).  I am sorry that [redacted] took so long delivering our envelopes to the patient.  We do offer to fax or email requested documents for quicker delivery.