ComplaintsforJackson Eye Associates PLLC

• Initial Complaint

  12/19/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  *** charged me more for my wife's eye surgery on 10-16-2023 than what my insurance company says I owe. I have talked to them several times, but to no avail. I told them that I would accept the charges if they can show me the proof. They filed with my insurance company $1000.00 for the lens, but charged me $1305.00. My insurance company told me that for lens, they should have charged me $1000.00. They should have filed $1305.00 to my ***************** instead of $1000.00. If my insurance company says on the explanation of benefits that I owe it, would have no problem. I need it for proof when I file for taxes this year.

  Business response

  12/28/2023

  This patient received an "elective" procedure which insurance only pays a fixed amount regardless of what the price of the procedure is.  We have explained to the patient that the *** only represents what insurance will pay NOT what we should or should not charge.  The cost for this procedure was "X" and the patient paid the correct amount to us, nothing more.  The patient is not due any refund.  Again, this has been explained to the patient.  This was an elective procedure and insurance does not dictate what any provider should not charge.  

• Initial Complaint

  06/11/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  January 23, 2023 After a routine visit to JEA, during checkout, I was told that there was a fee of $45 due. I had never had a copay. It was explained to me that there was a test done that no insurance company would cover. Confused, I told them to send me the bill and I would contact my insurance company. Immediately, the clerk said there would be an additional fee of $25 unless I paid the bill that day. Upset, I left the office. I called the office several times, unsuccessfully, to speak with the office manager. Eventually, I received the bill for $25 (the fee for sending the bill). Not wanting to ruin my credit, I paid the $25 bill.

  Customer response

  06/11/2023

  The test preformed by the doctor was medical and not part of the routine diabetic care. 

  Business response

  06/12/2023

  Hello, the item in question is called a "refraction".  It is the part of the eye exam that determines the prescription for glasses or contacts.  This service rarely, if ever, is covered by any insurance.  This has been the case in ophthalmology for almost 20 years.  That said, we inform patients of this on our financial policy, in our waiting room (flyers) and at check out.  We do so to make sure this doesn't surprise the patient upon check out.  All eye care providers charge for this as it is an actual service that the doctor provides.  Our office collects 100% of what the patient owes at each time of service.  We don't "bill patients".  We train our check out staff to communicate what this service is and why we collect for it.  In the event that an insurance does come back and pay, which rarely ever happens, we immediately refund this to the patient and make notes on their account.    When patient's do not pay what is due at the time of checkout, a billing fee is added to the account in order to cover the time that the billing dept incurs to work/bill/mail statements for services that should have been paid for at the time of service.  This policy is also in our financial policy and posted at check out stations.  That is what occurred for this particular patient visit.   Had the patient asked to speak to a dept manager or a billing staff member this would have likely been avoided.  Thank you.  

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