Wellington Eye Care

The copays are for different services and dates:1) Comprehensive examination performed on 9/26/ This is the general evaluation including the refraction ("what's better, one or two?")2) Dry Eye evaluation performed on 10/10/ This was the evaluation where [redacted] was prescribed.I hope this helps clear up any confusion Have a great day!Larry E***, O.D

I can not speak for anyone else's examination findings I can only comment on the findings of this patient's examination We did try to file the refraction with ***, however per our conversation with [redacted] from [redacted] on January 26th at 2:35PM MDT [redacted] will not pay the refraction on that date The cause of the chief complaint is medical, and we are bound by contract with BOTH BC/BS and [redacted] to bill the claim as we have This is NOT our determination, and we did try a second time to get [redacted] to pay for the refraction

Please review our faxed documentation You will see that the charges on our bills exactly match those posted by the patient’s insurance carrier on the Explanation Of Benefits It can be confusing because sometimes a balance has to be transferred from a date of receipt to a date of service, but it is illustrated clearly where this has occurredOur staff know when contact lenses are fit, they are to collect the fee for it This is CPT code I elected not to charge this patient for the fitting fee and contact lenses dispensed, and she was issued a refund checkThank you for your time.Sincerely,Larry E***, O.D

Complaint: ***
I am rejecting this response because:
This is not accurate. We did speak to our insurance prior to speaking to your office and we were told that we were to only have one co-pay for a visit. We were charged for co-pays on one visit. At the very least we should be reimbursed for the second co-pay for the visit
Regards,
*** ***

The patient's insurance policy with *** *** *** *** dictates what the patient owesWe are contractually obligated to collect this amountIf the patient is looking for a policy that has lower out of pocket expense in clinic they may want to contact their employer and find such a
plan. I have included the response from the insurance company as an attachment.
Thank you for your time

Complaint: ***
I am rejecting this response because: After talking with the head of the EHS department at *** *** my employer I learned that they as a representative at our health fair and one of the eye doctors to visit for company issued prescription safety glasses should have went through our *** insurance and not our medical insuranceI talked with *** today and they stated the vision place only needs my name and social security number to access my informationI have discussed what is taking place with the EHS department in FtCollins and they are very interested in what is taking place and want me to keep them updated on the results
Regards,
*** ***

The patient's insurance policy with *** *** *** *** dictates what the patient owesWe are contractually obligated to collect this amountIf the patient is looking for a policy that has lower out of pocket expense in clinic they may want to contact their employer and find such a plan. I
have included the response from the insurance company as an attachment. Thank you for your time

I can not speak for anyone else's examination findings.  I can only comment on the findings of this patient's examination.  We did try to file the refraction with [redacted], however per our conversation with [redacted] from [redacted] on January 26th 2016 at 2:35PM MDT [redacted] will not pay the refraction on that date.  The cause of the chief complaint is medical, and we are bound by contract with BOTH BC/BS and [redacted] to bill the claim as we have.  This is NOT our determination, and we did try a second time to get [redacted] to pay for the refraction.

Complaint: [redacted]
I am rejecting this response because:No I was charged two $30 co-pays for the 26th.  If you look at your records you will see this.  We have shown our copy of the insurance receipt that shows the two co-pays for the 26th.
Regards,
[redacted]

All charges including copays and co-insurances have been posted in accordance with this patients insurance policy.  By doing so, we have fulfilled our contractual obligations dictated by her insurance carrier.  If there are any further questions please do not hesitate to call us, and I...

encourage the patient to call her insurance company for further clarification as well.Best regards.Larry E[redacted], O.D.

Complaint: [redacted]
I am rejecting this response because: This receipt from the insurance with 2 different claim #s that they submitted proves that I was charged 2 co-pays on the date in question unlike their claim that I was not.  Therefore,  they still owe me the second $30 co-pay.  They also told me that my co-pay was $50 because he was a "specialist" and they were submitting this to my medical not my eye care.  This was not disclosed to me until my second appointment on 10/10.  When we got the insurance invoice it was $30 and then all of a sudden I had a $50 credit and not a $30 credit. . The rest of the invoices they sent Revdex.com was not detailed in the charges like the one we were given.  Glad they are changing that part at least kind of it is still very unorganized and confusing.  I do not have a way to download the one we were given that only has charges $$ not any explanation of charges.  The woman my husband spoke to on several occasions kept changing her story on what the charges were for because it was not detailed on the invoice and she was unsure of the charges.  I acknowledged the $50 refund in my complaint, but it should have been $80.  They wanted to leave it as a credit for future appts and we requested the money back as we will not be returning after this. 
Regards,
[redacted]

Please review our faxed documentation.  You will see that the charges on our bills exactly match those posted by the patient’s insurance carrier on the Explanation Of Benefits.  It can be confusing because sometimes a balance has to be transferred from a date of receipt to a date of service, but it is illustrated clearly where this has occurred. Our staff know when contact lenses are fit, they are to collect the fee for it.  This is CPT code 92310.  I elected not to charge this patient for the fitting fee and contact lenses dispensed, and she was issued a refund check. Thank you for your time.Sincerely,Larry E[redacted], O.D.

The 2 copays are for 2 different services and dates:1) Comprehensive examination performed on 9/26/2017.  This is the general evaluation including the refraction ("what's better, one or two?")2) Dry Eye evaluation performed on 10/10/2017.  This was the evaluation where [redacted] was prescribed.I hope this helps clear up any confusion.  Have a great day!Larry E[redacted], O.D.

Complaint: [redacted]
I am rejecting this response because: After talking with the head of the EHS department at [redacted] my employer I learned that they as a representative at our health fair and one of the eye doctors to visit for company issued prescription safety glasses should have went through our [redacted] insurance and not our medical insurance. I talked with [redacted] today and they stated the vision place only needs my name and social security number to access my information.
I have discussed what is taking place with the EHS department in Ft. Collins and they are very interested in what is taking place and want me to keep them updated on the results.
Regards,
[redacted]