Puyallup Vision Source

Complaint: ***
I am rejecting this response because:
Sincerely,
It is not true that this problem has arisen during the last visit to DrL*** officeDuring the last visit, we were billed twice for a follexaminationMy wife went in for a test with an instrument in DrL*** office, which proofed to be inconclusive, so she was called in again to do another exam with the same instrumentWe were then billed twice, once for each exam, I complained at that time that that we should not be billed twice because it was the same examTo make this clear: if a measurement has to repeated with the same instrument because something was not done correctly or the result does not come out as expected, then I should not be billed twice for the same measurementThis first visit has nothing to do with my this year's visit.What we came in for this year visit is to get new prescription for my wife, not a medical exam, to make this clearAs a consumer, we have the right to get a standard prescription examI did not ask for a medical exam, nor was I appropriately informed that this exam would not be a standard medical prescription examThe statement "Mr*** has asked for our office to bill his wife’s visit with a diagnosis" is absolutely untrueI have asked for a standard yearly eye examination for a prescription.In addition, the exam that Dr*** did with my wife was not anything different than a standard eye examination, which I know for a fact, because I sat in on my wife's exam and observed that it was exactly the same examination that my son and I myself had received a few days earlier.Dr*** ***

Tell us why here...This a response to Mr*** complaint related to billing for a recent examination of his wife in our office. Mrs*** has a potentially *** *** condition that was detected on her last examination in our office. Once diagnosed, it is medically prudent to
do appropriate follow-up, as dictated by standard of care for the condition. Mr*** raised the same questions after her prior visit and an extensive explanation was given for the appropriateness to treat the visit as a medically oriented exam, versus a routine vision visit, when billing for the visit. It was made clear to him then that future follvisits would be medically orientedWritten notes were kept of this dialogue. His assertion that he was not informed is not accurate. I am very aware that medical insurance billing is complex and at times difficult to comprehend. As a medical practitioner, I am bound to bill insurance appropriately. Mr*** has asked for our office to bill his wife’s visit with a diagnosis other then that determined by the presenting problem for that visit. This would be fraudulent billing and illegal. Our office did not “cheat” this family in this transaction, and I am troubled to understand that Mr*** feels this way. I understand that the cost of medical care is often a strain on the finances of a family, and I am empathetic to those with health problems that require a higher level of care Gary L*** OD

Tell us why here...In response to the response by Dr*** to my response to his complaint:I am bound by HIPPA regulations not to discuss in this forum the specific tests performed, or the condition diagnosed. Dr*** contends that he was unaware that we would be reevaluating his wife (*** ***) during her exam this year for possible advancement of the medical condition found on her prior exam. At the time of that prior exam in he was clearly counseled that this condition was chronic and potentially vision threatening, and should be monitored on an annual basisAfter Mrs*** Jan exam, special tests were performed, which had highly suspicious *** that might be diagnostic of the condition being evaluatedThe test was performed again to confirm the negative or exclude outcome. This is standard medical practice for this condition. The test is subjective in nature and can have varying resultsAfter Dr*** objected to the second billing for this test, our office, as a gesture of good will, wrote of the bill for that testDr*** seems to have forgotten thisAfter the testing in 2016, Dr *** (and Mrs***) were counseled to have Mrs*** return in year for a follexamination to look for progression of the conditionMrs*** failed to return for that examination. She did return this year for examination, year later then directedThe medical condition was again evaluated, as recommended after the testing, and finding were discussed. Instruments used during the exam are common to both routine testing and medically oriented exam. The difference is not often apparent to a lay person observing, and is differentiated by the degree of medical decision making made by the doctor, the difficulty of the exam, and risk of morbidity to the patient of the condition at handEvaluation of a known condition in follconstitutes a more medically oriented exam. It is important to note that during this medical evaluation, a refraction to establish the best correctable degree of vision is done to determine the extent, if any, of vision lossThat finding in her case was made available to have new glasses produced. Had a glasses exam, as Dr*** indicates have been done the first day, it would still have been necessary for Mr*** to return for the medical portion of the exam, which would require an addition visit , and have no cost savings. If I understand Dr*** assertion that they were only seeking a refractive examination, and planned to exclude the medical portion of the exam, then I wound conclude that this would be risky and not prudent medical care. I hope this response helps to finally shed light on the apparent misunderstandings in this situation.