ComplaintsforA Proper View
Need to file a complaint?
BBB is here to help. We'll guide you through the process.
Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
12/27/2021
- Complaint Type:
- Customer Service Issues
- Status:
- Resolved
I reviewed a call from my eye doctors office which I have been a patient over a decade. Regarding my upcoming appointment to advise during there insurance verification process they were told my benefit had been used in July at a different medical provider. This was not accurate as I go to them exclusively. I contacted my carrier "***", and they researched the claim and it was made in North Carolina, at an office called "a proper view" on July 10th 2021. I have never been to this office or even that state. The insurance company verified that this office is not in their network, the claim was file via mail, and they cut a paper check. The person used my name, but a local NC address. *** filed to have this reversed to get my benefit back, and mentioned they could not do much to investigate the office further with being out of their network. I would like further action taken to find out from office how this could occur. If someone in office is filing fraudulent claims on purpose, as this is odd all of this was done manually in this day in age, and a check was sent to this person. The concerning part is that they did not just make a mistake with my insurance number, they actually used my name.Customer response
12/29/2021
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and I accept it.Hi Melissa,
Thank you for returning my phone call today. Per our conversation following up in writing on desired outcome. Dr. B******* reached out to me this morning regarding the situation and showed genuine concern. He explained that they have a patient with the same name and DOB. He explained not sure where the mix up occurred but was going to have his office further review ,but more than likely somewhere on the insurance end when they processed the claim via a third party. He was sincere and concerned for me being able to use my benefits as I had an appointment with my provider today. I let him know the insurance company correcting things on my end so I could go to my eye doctor. I am satisfied with the explanation and the apology.
Additionally he followed up this evening after contacting the insurance company to get clarity on how this occurred and they worked to get some safe guards in place in the system to flag so this mix up would not occur again. Which I am impressed with his office for doing that which protects their patients and myself from a future complication which is above and beyond.
I know you mentioned I cannot remind my complaint, but would like closed out in the most favorable way possible for the business. As, they demonstrated no fraud on patients end or mishandling and seems to have been a perfect storm of just unfortunate circumstance. Please let me know if you need anything additional.
Thank You,
***** *******
*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. ↩
BBB Business Profiles may not be reproduced for sales or promotional purposes.
BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.
When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.
BBB Business Profiles generally cover a three-year reporting period. BBB Business Profiles are subject to change at any time. If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile.
As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation.
Customer Reviews are not used in the calculation of BBB Rating
Customer Complaints Summary
1 total complaints in the last 3 years.
0 complaints closed in the last 12 months.