Spokane Eye Clinic, PS

I am very sorry you did not have a positive experience with my clinic. When we establish care with a patient, we provide the patient with our patient financial policy which explains we will bill your insurance and any remaining amount after insurance has paid is due within 30 days of the statement...

date. Our policy also states it is the patient's responsibility to know what is covered by his or her insurance plan. We provided our policy to your husband at his first visit. Our contract with your insurance company means we accept the payment terms from your insurance company  to include collection of co-pays, deductibles, and co-insurance amounts from the patient. In your husband's case, I confirmed your insurance company applied the allowed payment amount for both visits towards the deductible associated with your husband's plan, and since we are obligated to honor the terms of our contract with your insurance company, we cannot adjust our bill, since we have consistent billing and collection policies for all of our patients with that particular insurance. If your husband would like to contact me directly to discuss medical necessity for the testing done, I am happy to have that conversation with him. Out of respect for confidentiality of his protected health information, I am not at liberty to provide details about his care in this response, but am happy to discuss this further with him by phone, and again am very sorry for the misunderstanding.  Sincerely, Jan S[redacted], CEO Spokane Eye Clinic (509) 459-4599

Review: Medical clinics expect patients to be on time. The same should apply to a clinic and it's doctors. I have an eye problem, not an emergency, but annoying and distracting while driving; thus, a safety issue. I made an appointment to have my eye examined (at the E. Central office of Spokane Eye Clinic). I had to wait several months to get in. I arrived ahead of time on 10/24/14, paperwork completed. I checked in ahead of time. One-half hour AFTER my appointment time I returned to the reception desk to see what was up. The receptionist called the Dr.'s area but the call was never answered. She did nothing else. So I cancelled and got a refund of my co-pay. I had to waste more time making another appointment. (I did not need to see the same doctor, just someone in the same specialty, so I was flexible.) I informed the appointment receptionist of my problem but she did nothing to expedite my appointment. I have to wait seven more weeks to be examined.Desired Settlement: Spokane Eye Clinic should expedite my appointment, and examine me long before my next appointment date in December.

Business

Response:

We have completed our investigation of this complaint. We discovered the patient's encounter form, which is the "alert" to the clinical staff the patient has arrived and checked in, did not print in the clinical area as it should have. The Clinical staff should also be monitoring the computer as a back up, and unfortunately, given the number of visits that morning, this did not happen. When the patient asked the front registration desk about the reason for the delay, that person should have gotten up from her seat and gone directly to the clinical area to find out what was going on. WE are very sorry that did not happen. The employee involved has been informed of the situation and unless she is with another patient, she needs to take more initiative to respond to patients and get them an answer. Lastly, our office has been in contact with the patient and he had an appointment on Thursday 10/30/2014 so we were able to get him in to see the Doctor long before the date in December. Our office has also spoken directly with the patient to convey our apology and coordinate getting him an appointment sooner. I hope we have effectively resolved this matter in a satisfactory manner.

Review: When I called to make an appointment to have a chalazion removed, I informed the appointment setter that I am self pay, as I have no insurance. She informed me that I would need to pay $100 up front and would be billed the remainder. I asked if this is for the removal, as I have already seen 2 doctors who informed me that it would need to be removed but who could not remove it. She assured me that it would be removed that day. I explained that I can not afford 2 visits with that kind of down payment, and was informed that the down payment would count toward having the lump removed.After being seen by the doctor (and paying $100), I was informed that if I want it removed I would need to pay $195 up front-the full price of the procedure. When I argued, I was told that the $100 was for the consultation and does not cover the procedure, and that they do not bill for the procedure.This is obvious bait and switch, and due to this deceptive billing practice, I am now out $100 with no ability to raise the money for the procedure for several months, as I was expecting to be billed.Desired Settlement: I would like either a refund of the consultation fee for me to put toward my savings for the removal (since I'd already had the chalazion assessed twice, and a third time was a waste of money), or I would like to be billed for the price of the procedure as I was told I would be by the person who set my appointment.

Business

Response:

Dear Ms. [redacted],

Review: The billing department incorrectly billed my insurance which caused denial of the claim. I contacted my insurance company and was advised that my costs were eligible for coverage and to have Spokane Eye Clinic re bill the claim under the vision part of my insurance. They also said to have the billing department contact them with any issues. I contacted Spokane Eye Clinic. They refused to listen to the request to re bill and said they cannot call my insurance company for clarification. They are still charging me for the full amount.Desired Settlement: I want them to bill my insurance company properly and refund my payment.

Business

Response:

We are very sorry for the miscommunication regarding which insurance to bill for the patient's visit to our clinic in August. At the time the appointment was scheduled, the only insurance identified in our system was Premera. Our normal process is for our scheduler to request if the patient has any additional Vision insurance or vision benefit when scheduling a routine eye exam. There are no notes in our system to indicate this question was or was not asked. When the patient checked in for her appointment, the registration staff should have confirmed we would be billing her Medical Insurance for that visit, as that was the only insurance we had listed for her. Unfortunately there is no documentation in our system to indicate the patient was asked to confirm this information at the time. I have asked my Director of Scheduling and Registration to review this process with her employees to confirm they understand our process and are complying with it. My Director of Scheduling and Registration has confirmed new employee orientation includes this expectation.

The patient indicated she had contacted our clinic regarding the status of her bill. There is no evidence in our system to indicate a call was taken and our informatics department has confirmed nobody has accessed the account since the account was billed and subsequently denied by Premera, so I am unable to confirm with whom the patient may have spoken with when she called into the clinic.

As a result of receiving this complaint, our billing staff contacted Premera who confirmed the patient has a routine vision benefit through Vision Service Plan (VSP) and we are happy to re-bill this claim to VSP and then refund the patient.

My apologies for the confusion and subsequent frustration this misunderstanding caused the patient. Please know we are in the process of rectifying it.

Sincerely,

[redacted], CEO

Spokane Eye Clinic