ComplaintsforPeachtree Corners Eye Clinic, P.C.

• Initial Complaint

  03/22/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  This issue pertains to the business having incorrect information about which insurances they accept posted on their website.The eye exam and transaction took place on 3/14/23. I paid the business $183. The business's website stated that they accept VBA insurance, this was not true. When I confronted them about this after the fact via a forum on their website, they admitted via voicemail that the information on the website was out of date and incorrect. They claimed the bill was processed through VSP (my old insurance) even though that should not be possible because I'm not currently a VSP member. The business has told me there is nothing they can do because they don't accept VBA insurance. If my insurance was actually accepted an processed, I would have paid the business $54. My desired outcome is at least a refund for the $129 that I should not have had to pay, or ideally a full refund due to the negligence of the business to maintain accurate information on their website. I'm attaching a copy of my receipt. I have a .amr file of the voicemail mentioned that I can not attached due to file type restrictions but I'd be happy to provide it if necessary.

  Business response

  03/30/2023

  ****** did come in for an eye exam on 3/14/23.  Because he was an existing patient (last exam was on 1/27/22), my staff looked up his vision plan from his previous carrier that was VSP.  They were able to find a current VSP policy under his name that was still active and I've attached it to this response.  This policy is a quite unique one that we had not previously come across but it plainly lays out the rules which we are obligated to follow under our VSP provider agreement.  We were to charge ****** 80% of our usual and customary fees for an eye exam.  Those codes are a ***** (comprehensive eye exam on an established patient- $180) and ***** (refraction- $45).  If ****** was going to get a pair of glasses, there was a specific set of discounts laid out for us follow, and his above exam fees would be reduced to only $50.  He mentioned that he was looking for glasses but couldn't do it that same day, so the associate told him that when he returned for his glasses, we would honor the $50 exam fee and credit the remainder paid today towards his glasses.  He paid $144 (80% of 180) for his exam plus $39 for the retinal photo which is not covered by his insurance.  She did not charge for his refraction as a courtesy as that would have added another $36.

  After leaving, ****** called back and said that the insurance he has is actually *** and not VSP.  Although at one point we were *** providers, we no longer were due to lack of patients in our area and poor coverage for them and reimbursement for us.  He was informed that we were not *** providers. ****** did call his *** plan after the fact and was also told that we were not currently providers for them. Due to that fact that we were not *** providers, we couldn't even look him up in their system to verify benefits.  ****** is correct in that our website still erroneously had *** listed as one of the vision plans we provided care for.  We hadn't noticed it until it was brought to our attention and I explained to ****** that we were currently working with a developer on a new version of our website and that our team unfortunately missed it.  

  If ****** would have known his new vision provider when he initially came in for his exam, he would have been told that we are out of network with the plan and what is options would have been. It is not our responsibility to know what other policies exist for a patient. 

  As a resolution for ******, I explained to him that the best I could do was decrease the bill to the amount the *** would reimburse him for out of network benefits plus his copay.  This was done as a courtesy for the confusion, even though we could get in trouble for doing this under our VSP contract.  I've included the updated receipt after his refund. 

  Customer response

  04/03/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *************************

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩