Pediatric & Adult Vision Care

I was extremely concerned after reading this complaint, as we have never had a complaint of this natureWe strive to provide the best quality service for every patient, every timeThis complaint took me by complete surprise, as many of the statements in this complaint are inaccurateThe patient stated that he spoke to a female office manager in JuneI was the practice manager during that time and am currentlyI am male and I have never spoken with himHe did however speak with our billing specialist, who informed him that we had done an internal review of our patient balances to ensure 100% accuracyWe have not been “audited for overcharging insurance companies”, as the patient claimedIn fact, we were not audited at all, by anyoneWe did not “overcharge” any insurance companyAdditionally, as stated by the patient, we did not "defraud" anyoneIt appears as if this patient does not fully understand how insurance works..If there is a co-insurance or a deductible that falls as the patient’s responsibility, per their plan, it will be billed to the patient after receiving payment from their insurance companyThe balance of $reflected on their statement was in fact an accurate statement balanceIt has been verified in our records and matches the EOB that the patient’s insurance company sent to us, as well as them, with the detailsWhen patients are responsible for a portion of their bill, we still expect payment for the services that we provided The above paragraph is my response to the complaint receivedI am asking that you please consider disregarding this complaint, as it is a-very inaccurate portrayal of our business, our customer service, and all other online reviews which we have worked very hard to earn and maintainWe have minutes of documented time spent on the phone explaining to the patient what the balance of $represents.'! know that it is up to your discretion whether or not to post complaintsI ask that this one be revoked, as it is 100% inaccurate and a misrepresentation of their experience, and our officeAs stated above, we maintain a very high standard of excellence and integrity extending to every aspect of what we provide and believe inThank you for your consideration Sincerely, [redacted]

Pediatric & Adult Vision Care has contacted me for the second time regarding a billIn June of 2014, Pediatric & Adult Vision Care contacting me about an outstanding balance of $from my son's October (2013) appointmentMy insurance was billed and my wife paid the remaining "balance in full" using her credit card before she left the office in October Again, I have received a bill (dated November 20th, 2014) and a threat involving a collection agency for that October bill that was "paid in full"I submitted a complaint 9/29/and thought it was resolved - apparently notRevdex.com ID: ***Succinctly, to send a bill to a client months after they leave your office having already "paid the balance in full" is appalling! The reason for the charges: "we overcharged insurance companies" - that is what I was told in a telephone conversation by a billing specialist that, according to a letter I received from the CEO (name withheld - Revdex.com policy), misrepresented herself as the "office manager"In that letter, the gentleman stated that I, the client, did not understand insurance billingThe insurance company was "billed"My wife used her credit card to pay the amount (balance due) that was above or exceeded the insurance company's reimbursementEight months later (June 2014), Pediatric & Adult Vision Care sent an invoice to collect moreIn fact, when this bill appeared, I thought it was from the appointment in spring whereby my wife and son showed up, waited, and were asked to leave because the doctor had left for the day! Quality service: client drives two hours, waits for one hour, then is asked to leave! That is a different complaint and space is limitedBottom-line, already "paid in full" and then re-billed again months laterExtortionCollection threatsPediatric & Adult Vision Care can accept the amount that my insurance company reimbursed them and REFUND the amount that my wife PAID that exceeded the standard reimbursementORPediatric & Adult Vision Care can accept the amount that my insurance company reimbursed them and RETAIN the amount that my wife PAID that exceeded the standard reimbursementMost importantly, Pediatric & Adult Vision Care should cease from sending me more "re-bills" months after payment received in full

Fortunately, Pediatric & Adult Vision Care did the right thing by not re-billing months after the appointment was paid in full. In fact, any reputable organization's accounting department should have caught the discrepancy (if any "true" discrepancy existed) before the next payroll or most definitely at the time taxes were submitted for the year 2013. Attempting to re-bill clients months after they have "paid in full" is unscrupulous. Also, the fact that a female employee posed as "office manager" on the telephone is suspect. It would appear that an internal audit is indeed necessary to check the integrity not only of the accounting department but also the individuals in the front office. It is insulting for a company to make accounting errors and then attempt to bully clients months later into paying for their supposed internal imbalances and audits! Regarding the April appointment, my wife drove our year-old son hours to the Pediatric & Adult Vision Care Office. She immediately took him to the rest room upon arrival and check-in. She and my son proceeded to wait minutes in the waiting room - at that time she was informed that the doctor had left for the day. No, she did not call WHILE driving to the office. The question still remains, why would Pediatric & Adult Vision Care make a patient wait for half an hour before informing them that the appointment would not commence? They could have informed her as soon as she and my son came out of the rest room and reentered the waiting area. Finally, as a health-care provider, I understand that the patient is to be valued as the pinnacle of the care pyramid; unfortunately, Pediatric & Adult Vision Care doesn't share that ethical viewpointThe settlement is satisfactory that Pediatric & Adult Vision Care accepted payment from my Vision Plan PLUS the out-of-pocket charges paid by my wife via credit cardCaveat Emptor. ?

Revdex.com:Service rendered by this patient was on 10 17 14 as stated by the patient. The patient in fact, asstated, paid $423.19 using a Visa credit card for the purchase of glasses, a refraction and a laserretinal scan, which are services the medical insurance company does not cover.The services rendered for the exam as well as the sensorimotor exam were submitted to theinsurance company via a tlaiiT. ~o be adjudicated and finalized. Once the claim was finalized thepatient’s responsibility, per the insurance EOB, was transferred to reflect a balance due forcoinsurance per their insurance plan.It is untrue that there was any misrepresentation as to whom the office manager is and that therewas an “overcharge to the insurance company” Attached is their Highmark EOBAs stated by this patient a statement was sent to them on 6/16/14 for $44.80 after an internal auditwas performed on all open balances on all of our accounts. A second statement was sent on July16111 followed by a statement on 9/9/14. There was a letter, as attached, sent as a final attempt tocollect as we proceed in a collections process.As stated by this patient, there was an appointment on 4/2/14 at 6:45 pm (the last appointment forthe day) that they showed up for 25 minutes late. There was no phone call made to our office toinform us that they were running late at which point we would make arrangement to stay later, aswe often times do, to insure our patients receive proper care in which we pride ourselves in.In the hopes of not further irritating this patient, I propose to accept the second option that thispatient has proposed with the verbiage of:Pediatric & Adult Vision Care will accept the amount that Highmark has paid for servicesrendered per the contract that the company has with Highmark. The amount paid by the patientfor the glasses that they willingly purchased, that were not submitted to a vision plan, because thepatient does not have a vision plan, will be accepted as paid in full by the provider and the patientbalance of $44.80 will be written off.

I was extremely concerned after reading this complaint, as we have never had a complaint of this nature. We strive to provide the best quality service for every patient, every time. This complaint took me by complete surprise, as many of the statements in this complaint are inaccurate. The patient...

stated that he spoke to a female office manager in June. I was the practice manager during that time and am currently. I am male and I have never spoken with him. He did however speak with our billing specialist, who informed him that we had done an internal review of our patient balances to ensure 100% accuracy. We have not been “audited for overcharging insurance companies”, as the patient claimed. In fact, we were not audited at all, by anyone. We did not “overcharge” any insurance company. Additionally, as stated by the patient, we did not "defraud" anyone. It appears as if this patient does not fully understand how insurance works..If there is a co-insurance or a deductible that falls as the patient’s responsibility, per their plan, it will be billed to the patient after receiving payment from their insurance company. The balance of $44.80 reflected on their statement was in fact an accurate statement balance. It has been verified in our records and matches the EOB that the patient’s insurance company sent to us, as well as them, with the details. When patients are responsible for a portion of their bill, we still expect payment for the services that we provided.
The above paragraph is my response to the complaint received. I am asking that you please consider disregarding this complaint, as it is a-very inaccurate portrayal of our business, our customer service, and all other online reviews which we have worked very hard to earn and maintain. We have 45 minutes of documented time spent on the phone explaining to the patient what the balance of $44.80 represents.'! know that it is up to your discretion whether or not to post complaints. I ask that this one be revoked, as it is 100% inaccurate and a misrepresentation of their experience, and our office. As stated above, we maintain a very high standard of excellence and integrity extending to every aspect of what we provide and believe in. Thank you for your consideration.
Sincerely,
[redacted]
[redacted]

Review: My son had an appointment in October 2013. Our insurance was billed and my wife paid the balance not covered by the insurance using her credit card when she left the office. In June of 2014, I received a bill from Pediatric and Adult Vision. I called to inquire why I received a bill for an appointment paid in full 8 months previous. I spoke with the office manager, she stated that Pediatric & Adult Vision was audited for overcharging insurance companies and that I needed to remit payment. It is not my financial responsibility, having already paid in full after receiving services in October, to pay MORE 8 months later - especially when Pediatric & Adult Vision was audited for defrauding Third Party Payers by overcharging!Desired Settlement: It is Pediatric & Adult Vision Center's responsibility to charge Insurance companies accurately. In fact, the amount paid by my insurance company for pediatric vision services should suffice; however, my wife paid "out-of-pocket" an additional amount using her credit card! She left the office in October "paid in full". The ethics of Pediatric & Adult Vision Center is in question. I intend to contact my insurance company to determine if other fraudulent charges exist.

Business

Response:

I was extremely concerned after reading this complaint, as we have never had a complaint of this nature. We strive to provide the best quality service for every patient, every time. This complaint took me by complete surprise, as many of the statements in this complaint are inaccurate. The patient stated that he spoke to a female office manager in June. I was the practice manager during that time and am currently. I am male and I have never spoken with him. He did however speak with our billing specialist, who informed him that we had done an internal review of our patient balances to ensure 100% accuracy. We have not been “audited for overcharging insurance companies”, as the patient claimed. In fact, we were not audited at all, by anyone. We did not “overcharge” any insurance company. Additionally, as stated by the patient, we did not "defraud" anyone. It appears as if this patient does not fully understand how insurance works..If there is a co-insurance or a deductible that falls as the patient’s responsibility, per their plan, it will be billed to the patient after receiving payment from their insurance company. The balance of $44.80 reflected on their statement was in fact an accurate statement balance. It has been verified in our records and matches the EOB that the patient’s insurance company sent to us, as well as them, with the details. When patients are responsible for a portion of their bill, we still expect payment for the services that we provided.

The above paragraph is my response to the complaint received. I am asking that you please consider disregarding this complaint, as it is a-very inaccurate portrayal of our business, our customer service, and all other online reviews which we have worked very hard to earn and maintain. We have 45 minutes of documented time spent on the phone explaining to the patient what the balance of $44.80 represents.'! know that it is up to your discretion whether or not to post complaints. I ask that this one be revoked, as it is 100% inaccurate and a misrepresentation of their experience, and our office. As stated above, we maintain a very high standard of excellence and integrity extending to every aspect of what we provide and believe in. Thank you for your consideration.

Sincerely,