ComplaintsforEyecare of Denton

• Initial Complaint

  01/22/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I had an appointment with this office on December 29th and was informed that my contact lense exam was not covered due to their office being a premium office. I contacted my insurance and they do not have premium offices and that the type of lense that is prescribed is what determines if its a standard or premium contact lense exam. The insurance provided me with their definition of standard v premium lense, premium lenses are typically contact lenses to correct astigmatism, colored contacts and bifocal contacts. I do not have any of these conditions so by definition I would have a standard prescription. The office refuses to correctly bill my insurance due to them only providing premium contact lense exams. This was the first time to visit this office so how would they know what type of lense I needed or what my prescription consisted of? How can they only provide premium contact lense fittingsdoes that mean everyone who walks in the door has a complex prescription? They are incorrectly billing every patient that walks into their office for a premium contact lense exam when they may not have a premium prescription. They originally did not bill my insurance for the contact lense exam until I contacted them asking why I was charged the cash price minus 10% discount, the insurance informed me the claim was not submitted until January 7th. I just want my claim to be billed correctly and not be taken advantage of. It seems like this office bills for the most expensive option whether its medically correct.

  Business response

  01/31/2024

  I am writing in response to a complaint sent in by *********************, ID ********.
  
  When ***** arrived at our office, she was informed that her vision insurance covered her eye exam at $10 and 10% off her contact lens evaluation.  She was offered the chance to cancel the appointment if she preferred to find a different provider with lower contact lens evaluation fees.  She elected to proceed with a routine eye exam with a contact lens examination, as well as her retinal imaging. 
  
  She was quoted and charged for our lowest contact lens evaluation, since she does not have an astigmatism, colored lenses, or multifocals - as she correctly described.  We initially incorrectly filed the claim for her eye exam only without the contact lens evaluation, and later refiled only to add her contact lens evaluation. All the fees she was charged did not change from her initial conversation prior to her exam. She signed our financial responsibility disclosure which we have attached, and includes all her charges we presented up front to her with her signature at the bottom.   

  Customer response

  02/02/2024

  I am rejecting this response because: my insurance was charged for the most expensive contact lens exam. My insurance has two different options one being standard contact lenses examination which by definition with the insurance is what I have. The second one being premium which I was charged for which by definition is lenses that are for colored lenses or multifocal. 

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