Premier Eye Care Group, Inc.

Review: I went to Premier eye care for a eye exam and they said I had to have two eye exam's I stated that I never had to have two before! They replied that health care was a dying business. that they weren't making any money due to Obama Care. I replied that I wasn't on Obama Care. Then they said that they couldn't bill insurance for two exams the same day. I said that I never needed two before. They said because I had Diabetes I needed two exams. I then informed them that the last time I had my eyes examine it was all in one. They said they changed it to a medical eye exam and a routine eye exam. I said I am not getting two eye exams. they said get this one today and you don't have to pay the 15.00 dollar copay today. then come back tomorrow and pay the copay for the eye exams then. so they ask me for the co-pay at the reception desk and I told them what they stated so she made me a appointment for the next day. I went got the eye exam and payed the 15.00 dollar co-pay they said nothing about the day before. now they sent me a bill for a second co-pay. I called them they looked it up and told me [redacted] insurance wants the 15.00 dollar copay. The insurer has never ask me for a copay before. So I said why did you send me a bill. [redacted] insurance should have sent me the bill. So come to find out [redacted] wants the copay from them so now they are asking me to pay the bill. now I ask the place that makes my eye glasses if they do it all in one exam or two. they said most cases they do only one exam which was [redacted] Eye Care. so now Premier wants to bill you for the one that they said not pay. Which is a classic form of bait and switch! My girl friend was at both visits and she heard me tell them what I was told. The inconsistencies should tell it all first it was due to Obama Care when I said I wasn't on Obama Care then it was unfortunately health care was a dying business we aren't making any money. That is why they split it up into two different exams and can't bill insurance twice in the same day for the same thing. Just don't pay the copay today and come back tomorrow and pay the 15.00 copay then. they didn't say pay two then also I told them I wasn't going to pay two copay's for the exam I would go some where else. They told me that so I would get it done and they would just bill later for the one they said not pay. I wouldn't have a choice but to pay it makes them they a very dishonest business the fact that they stated they weren't making any money reiterates what I have said through out this whole complaint. They will never get any more business from me ever in my life time!!!!!!Desired Settlement: not to have to pay for what they said not pay for and I will never darken their door step again Thank you very much!

Business

Response:

September 15, 2014Dear [redacted],This is in follow up to your letter dated September 8, 2014 concerning a recent complaint about our business, ID #[redacted].I personally spoke to the gentleman involved with this complaint on 8/27/14. The patient also had complained to a staff person at [redacted] concerning the complaint of the second co-pay. In a discussion with the provider who cared for this patient, it was decided to not bill the balance of the co-pay, for the vision insurance, that is typically paid at the exam to the provider, for the amount of $15,00 and the amount was written off. Pt was made aware of this as was Jan at [redacted] on 8/27/14. Pt stated to us that he will go to [redacted] eye next time. We reminded the pt that he is a diabetic and needed to keep up with appts for his eyes, no matter where he goes.In writing off the balance of $15.00 we are in no way admitting that the pt should not be responsible for the balance of the co-pay of his vision insurance. The patient’s vision insurance is intended to provide the patient with a basic or routine eye exam. Vision insurance exams do not cover the management or treatment of medical problems such as diabetics. Because of changes in healthcare, billing laws and insurance coverage, PECG has found it necessary to have two distinct exams for the patient when a medical exam is needed, and when a vision exam is necessary, as have many other eye offices. Several insurances do allow us to bill for both vision and medical exams, although this patients insurance coverage does not.PECG has implemented this new policy only within the past several months. Ultimately, the patient is responsible for being aware of their insurance coverage, the co-pay amount at each exam, deductibles and/or co-insurance fees beyond the monthly payments to have the insurance coverage. PECG does discuss with patients that regular eye examinations are important to maintain their vision for their lifetime. The patient should know that it is important that each patient be aware of their insurance benefits and how they apply to your visit: so you will know how billing will be handled.Thank you for your attention in this matter, complaint was resolved as the patient requested.do feel that this patientsSincerelyLisa S RN, MHA, BSNClinical Administrator