ComplaintsforSouthwest Eye Care

• Initial Complaint

  04/13/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  One 6/6/2022 I took two of my children in for eye exams. Prior to the appts I had provided the scheduler with my insurance information and on the date of the appt I also provided the receptionist with my ins. card via an image on my cell phone, both front and back of the card. I took my children to this facility because our ins. will cover a yearly check up at no cost to **, because Southwest Eye Care is an in network provider. I researched this thoroughly before scheduling. Fast forward 6+ months, to the end of December 2022, when we received a bill for each of my childrens visits on 6/6. I was surprised by this bill as more than 6 months had passed and this was literally the first bill that I had received. I immediately called my insurance and was told that the first time that the claim was submitted was Dec 12,2022, and this was past the timely filing requirements that the clinic has to submit the claim, which is 180 days. I then called the clinic and they said that my insurance denied it as not covered. I explained that this is not true and that it was a timely filing issue, they would need to appeal. One month later I received another bill, so I called and told the provider it is not my responsibility. I received another bill in February of 2023, and called again. In March, while speaking with my insurance company I was told the provider had not sent an appeal. I then called the provider to say that an appeal was never received by my insurance company. Today I got a call saying that their appeal was denied and they offered me a discounted rate. I told them that I was not liable for the charges because I had provided my ins. information prior to the appt and at the appt. I also verified with my insurance again and they said I was not liable, yet Southwest eye is trying to make me pay a discounted rate of $69 for each kid on a service that wouldve been covered at 100% had they submitted the claim to the proper claims address in the first place.

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