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Ohio Eye Alliance, Inc

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Ohio Eye Alliance, Inc Reviews (1)

In response to Ms. [redacted]'s complaint, Ohio Eye Alliance, Inc, would like to offer the following information: On March 18, 2015 [redacted] was seen in our Alliance office by Dr. [redacted] as a new patient for a complete medical eye exam. Her medical insurance, [redacted], was billed for the...

exam. Our practice is an ophthalmology practice and claims are billed as medical claims and not vision claims, unless the patient clearly states the only reason for the exam was to obtain glasses (which was not the case here). The patient was told that she could not order glasses or contacts through our office as we do not have an optical shop. However, the statement that she could not get her prescription to purchases glasses elsewhere is untrue. She was given her prescription when she left our office on March 18, 2015 so she could purchase her eyeglasses elsewhere. The second statement made by Ms. [redacted] that we billed her insurance company so much that the insurance company would not cover the entire bill is also untrue. We bill the medical insurance company with which we are contracted and must adjust all claims to the amount the insurance company allows. In this case, [redacted] allowed $146.77 for the new patient office visit and applied the entire amount to the patient deductible. Per our contract with [redacted] (and all insurance companies), it is a contract breach to adjust any patient responsibility amounts. Therefore, the patient received a statement for the balance of $146.77 which [redacted] stated was the patient's responsibility. Additionally, all physicians must follow stringent coding guidelines as not to upcode or downcode office visits and are subject to auditing if correct coding policies are not followed. Therefore, our physicians are very careful to bill the correct code, and the correct code was submitted for this visit. The complainant also states that their insurance covers one eye exam per year. Upon calling [redacted], we were told that the patient's vision insurance pays $60 towards one eye exam for "vision" purposes per year. Because we are a medical practice, our claims are processed correctly under "medical" insurance. We normally do not bill vision insurance, but as a courtesy for this patient, we have resubmitted the claim to her vision insurance. Once this resubmitted claim is processed by [redacted], we will apply any payments received and bill any patient balances per the new insurance remittance advice. As far as the request for the desired settlement of forgiving any balance owed, we cannot grant this as we would be breaching our contract with [redacted]. We apologize that this patient feels that the person she spoke to when she called our office "did not seem to care". This certainly is not acceptable behavior by our staff, and will be reviewed with them. Ohio Eye Alliance, Inc. has three ophthalmologists and an optometrist offering specialized eye care for the treatment of glaucoma, diabetic retinopathy, macular degeneration, strabismus, and cataracts along with routine eye care. We strive to offer the best treatment possible to our patients, and want them to be satisfied with the treatment and service they receive from our doctors. Therefore, we take any complaints seriously and have offered our reply as stated above.

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Address: 985 Sawburg Avenue, Alliance, Ohio, United States, 44601

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