In response to Ms [redacted] 's complaint, Ohio Eye Alliance, Inc, would like to offer the following information: On March 18, [redacted] was seen in our Alliance office by Dr [redacted] * [redacted] as a new patient for a complete medical eye examHer medical insurance, [redacted] , was billed for the examOur 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 shopHowever, the statement that she could not get her prescription to purchases glasses elsewhere is untrueShe was given her prescription when she left our office on March 18, so she could purchase her eyeglasses elsewhereThe 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 untrueWe bill the medical insurance company with which we are contracted and must adjust all claims to the amount the insurance company allowsIn this case, [redacted] allowed $for the new patient office visit and applied the entire amount to the patient deductiblePer our contract with [redacted] (and all insurance companies), it is a contract breach to adjust any patient responsibility amountsTherefore, the patient received a statement for the balance of $which [redacted] stated was the patient's responsibilityAdditionally, 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 followedTherefore, our physicians are very careful to bill the correct code, and the correct code was submitted for this visitThe complainant also states that their insurance covers one eye exam per yearUpon calling [redacted] , we were told that the patient's vision insurance pays $towards one eye exam for "vision" purposes per yearBecause we are a medical practice, our claims are processed correctly under "medical" insuranceWe normally do not bill vision insurance, but as a courtesy for this patient, we have resubmitted the claim to her vision insuranceOnce this resubmitted claim is processed by [redacted] , we will apply any payments received and bill any patient balances per the new insurance remittance adviceAs 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 themOhio Eye Alliance, Inchas 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 careWe 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 doctorsTherefore, we take any complaints seriously and have offered our reply as stated above
In response to Ms [redacted] 's complaint, Ohio Eye Alliance, Inc, would like to offer the following information: On March 18, [redacted] was seen in our Alliance office by Dr [redacted] * [redacted] as a new patient for a complete medical eye examHer medical insurance, [redacted] , was billed for the examOur 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 shopHowever, the statement that she could not get her prescription to purchases glasses elsewhere is untrueShe was given her prescription when she left our office on March 18, so she could purchase her eyeglasses elsewhereThe 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 untrueWe bill the medical insurance company with which we are contracted and must adjust all claims to the amount the insurance company allowsIn this case, [redacted] allowed $for the new patient office visit and applied the entire amount to the patient deductiblePer our contract with [redacted] (and all insurance companies), it is a contract breach to adjust any patient responsibility amountsTherefore, the patient received a statement for the balance of $which [redacted] stated was the patient's responsibilityAdditionally, 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 followedTherefore, our physicians are very careful to bill the correct code, and the correct code was submitted for this visitThe complainant also states that their insurance covers one eye exam per yearUpon calling [redacted] , we were told that the patient's vision insurance pays $towards one eye exam for "vision" purposes per yearBecause we are a medical practice, our claims are processed correctly under "medical" insuranceWe normally do not bill vision insurance, but as a courtesy for this patient, we have resubmitted the claim to her vision insuranceOnce this resubmitted claim is processed by [redacted] , we will apply any payments received and bill any patient balances per the new insurance remittance adviceAs 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 themOhio Eye Alliance, Inchas 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 careWe 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 doctorsTherefore, we take any complaints seriously and have offered our reply as stated above