ComplaintsforDavis Vision Inc

Vision Insurance

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Initial Complaint
06/24/2024
Complaint Type:
Product Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I went for a routine eye exam and ordered glasses. I ordered and paid &207 for progressive and they were blurry and could not see. Office said take them home and you will adjust. Had to go back and instead of them correcting issue they said they can’t make me progressive and they would have to do bifocals and I assume I would be reimbursed like **** told me $90. I filed an appeal and was approved and then they come back and say no we can’t do a refund after they said they would. I had same type of glasses for over 15 years and never had an issue.
Business response
06/28/2024
We apologize for the delay regarding the refund of your progressive lenses. After an investigation, the refund has been processed and a check will be mailed to your address on file within the next 30 calendar days.
Initial Complaint
05/01/2024
Complaint Type:
Billing Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
On February 28, 2024, I went to ***** *** ********* which is part of the **** ************ ******* ****** * **** ******** ****** and received an eye exam, refraction, and contact lens evaluation/fitting. According to my HR benefits under my Davis Vision insurance (see *********************************************************************************), all of these services should have been covered with $0 copay. And in the past when I have gone to this provider and gotten the same services, I have not been charged (because all of the services are supposed to be $0 copay). However, I received a bill on April 25, 2024 which specified that I owed $60. I contacted the provider who was unable to explain why I was charged this amount. Then I contacted Davis Vision. The customer service representative claimed that I owed $60 because I did not purchase contact lenses from the provider on the same day of the visit. The benefits documentation for this vision plan does not specify that the $0 copay is contingent upon purchasing contact lenses from the provider on the same day. Essentially, they are claiming that I need to pay more money because I received fewer services.
Business response
05/09/2024
Davis Vision takes customer service seriously and aims to address member’s concerns in a diligent manner.

Davis Vision has reviewed ****** *******’s complaint, and it has been found that the claim for date of service 2/28/2024 was submitted for routine eye exam and refraction only. The claim was approved and paid. For calendar year 2024, there are no denied claims on file and no claims that include charges for a contact lens fitting. To have the fee for the contact lens fitting considered for coverage ****** *** ********* must submit a claim to Davis Vision.

Customer response
05/15/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********. I find the response from Davis Vision satisfactory and will reach out to the ***** *** ********* as it sounds like they did not correctly bill Davis Vision.

Regards,

****** *******
Initial Complaint
03/11/2024
Complaint Type:
Customer Service Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
I am trying since Dec 2023 to get Explanation of Benefits/EOB for my son's vison exam from 9/25/2023. I have called Davis Vision 5 times requesting it. The customer service representatives indicated that I would get the EOB within 10 days from each call. I still have not received it. The last call was on 02/20/24. By not having the EOB, Davis Vision is preventing me from getting the benefits of the second insurance I have,
Business response
03/22/2024
Davis Vision has outreached with the complainant directly via email on March 22, 2024. Davis Vision will submit a copy of the EOB statement to the complainant via the email address that was provided. Davis Vision takes customer service seriously and aims to address member concerns in a diligent manner. We apologize for any inconvenience this issue may have caused.
Customer response
03/25/2024
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.

Regards,

***** *******
Initial Complaint
01/17/2024
Complaint Type:
Customer Service Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I submitted a claim to Davis Vision via mail months ago. They have not contacted me to inform me of the processing of my claim, NOR have I received any money from this claim. I no longer have Davis Vision for my insurance, and without my Member ID I cannot get in touch with anyone on the phone. I have submitted messages on their online portal and still, nobody is reaching out to me. I'm about to move and worried that if they eventually send a check, I won't receive it. I desperately need someone from the company to contact me, because I paid $300 out-of-pocket for a visit and need the money I am owed.
Business response
01/19/2024
Issue:
****** ******* alleges that she went to an out-of-network provider on August 8th, 2023 to receive services. She stated that she paid $300.00 for the services and completed the out-of-network claim form; however she has not received her reimbursement for the services.
Requested Resolution
****** ******* is requesting to receive a reimbursement payment of $300.00
Benefits Review:
Analyst **** *** conducted a benefits review on ****** *******’s plan on January 18th, 2024. The following determinations were made based on the review:
****** *******’s plan operated on a 12-month cadence based on the previous years’ service date.
****** *******’s plan allows for her to receive 1 routine eye examination, and either 1 pair of eyeglasses or one pair of plan or non-plan contact lenses.
****** *******’s plan allows her to see either an in-network or an out-of-network provider.
If ****** ******* receives services from an out-of-network provider, she would be entitled to reimbursements in the following amounts based on the services provided:
Routine Eye Examination- $45.00
Frame: $45.00
Single Vision lenses: $52.00
Bifocal Vision lenses: $82.00
Trifocal Vision lenses: 101.00
Lenticular lenses: $181
Contact lenses (Specialty, disposable, gas permeable, sclere, and dispostable: $97.00
Medically Necessary Contact Lenses: $285.00

Claims Review:
Analyst Phil L** conducted a claims review on ****** ******* on January 18th, 2024. The following determinations were made based on the review:
****** ******* had a claim processed from an out-of-network provider on August 8th, 2023 for the following services:
1 routine eye examination
A pair of contact lenses

Davis Vision approved claims and processed the payment on October 30th, 2023
Davis Vision mailed a check (Check # *******) to ****** ******* on October 31st, 2023.
The total amount of the reimbursement was $142.00 based on ****** *******’s plan set up for out-of-network claims.
Analysis of Findings:
Based upon the investigation, the following determinations have been made:
Davis Vision submitted a payment to ****** ******* on October 31st, 2023 via Check # *******.
Actions Taken:
****** ******* will need to review her checking account to confirm that she has not received the payment.
If she confirms that she has not received the payment, she can contact the Versant Health customer service unit at ***** ******** to request a replacement check payment and a check investigation for Check # *******
Note the check investigation will take 30-days from the date of request to complete. Additionally, as part of the investigation, Versant Health will engage in a recoupment action on Check # ******* to recoup the funds from any account that they were deposited into.
Sincerely Yours,
Phil L**
Quality Analyst
Customer response
01/23/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
Regards,
****** *******

Customer response
01/24/2024
Hello! I understand that Davis Vision said they sent me a check - I never received it. I am unable to call their customer service line, because it requires a Member ID to be connected to a customer service agent. I no longer have my Member ID, as I have new vision insurance now. Being unable to call the number as well as not having any of my emails or website submissions answered, I am genuinely unable to contact them in any way. I am hoping that they can establish a line of communication with me so I can provide an address for my check.
If I was able to call the customer service number and connect to someone, I could resolve this on my own. But again, I don't have a Member ID to enter when prompted, so I am unable to connect.
Business response
01/31/2024
Issue:
****** ******* alleges that she went to an out-of-network provider on August 8th, 2023 to receive services. She stated that she paid $300.00 for the services and completed the out-of-network claim form; however, she has not received her reimbursement for the services.
Requested Resolution
****** ******* is requesting to receive a reimbursement payment of $300.00
Benefits Review:
Analyst **** *** conducted a benefits review on ****** *******’s plan on January 18th, 2024. The following determinations were made based on the review:
•****** *******’s plan operated on a 12-month cadence based on the previous years’ service date.
•****** *******’s plan allows for her to receive 1 routine eye examination, and either 1 pair of eyeglasses or one pair of plan or non-plan contact lenses.
•****** *******’s plan allows her to see either an in-network or an out-of-network provider.
?If ****** ******* receives services from an out-of-network provider, she would be entitled to reimbursements in the following amounts based on the services provided:
oRoutine Eye Examination- $45.00
oFrame: $45.00
oSingle Vision lenses: $52.00
oBifocal Vision lenses: $82.00
oTrifocal Vision lenses: 101.00
oLenticular lenses: $181
oContact lenses (Specialty, disposable, gas permeable, scleral, and disposable: $97.00
oMedically Necessary Contact Lenses: $285.00
Analysis of Findings:
Based upon the investigation, the following determinations have been made:
•Davis Vision submitted a payment to ****** ******* on October 31st, 2023 via Check # ********
Actions Taken:
•****** ******* will need to review her checking account to confirm that she has not received the payment.
?If she confirms that she has not received the payment, she can contact the Versant Health customer service unit at ***** ******** to request a replacement check payment and a check investigation for Check # *******
?Note the check investigation will take 30-days from the date of request to complete. Additionally, as part of the investigation, Versant Health will engage in a recoupment action on Check # ******* to recoup the funds from any account into which they were deposited.
Update Action:
•Analyst **** *** outreached to client billing on January 29th, 2025 to put a stop payment on Check * ******* and recoup the funds that were paid out; the process will take between 30-60 days to complete.
•Analyst **** *** submitted a request to have a replacement check in the amount of $142.00 sent out to ****** *******. The amount of $142.00 is reflective of the out-of-network reimbursement that ***** ******* would be entitled to based on her plan benefits. ****** ******* can expect to receive the replacement reimbursement check within 30 days.
Sincerely Yours,
**** ***
Quality Analyst
Initial Complaint
01/13/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Cannot get ahold of anyone in the company to submit an out of network reimbursement claim. When you call you have to enter a member ID, which I do not have. Their site gives an error when I try to login even after multiple password resets. Have emailed the company multiple times over the last month trying to get ahold of someone to give me the needed information with no response. My union switched to Davis for vision a couple years ago and it has been a headache dealing with them ever since. The resolution I am seeking is the ability to talk to a human so that I can submit my claim, but that has turned out to be impossible.
Business response
01/18/2024
Issue:
***** ****** alleges that he has made multiple requests to Davis Vision to be sent an out-of-network claims form so that he can receive a reimbursement for his order; however, he further alleges that to date he has been unable to receive one.

Requested Resolution
***** ****** would like assistance in receiving an out-of-network claim form and in having it processed.

Benefits Review:
Analyst Phil L** conducted a benefit review of ***** ******’s benefits on January 17th, 2024. The following determinations were made based on the review:
***** ******’s benefits with Davis Vision were terminated effective December 31st, 2023.

In calendar year 2023, ***** ******’s plan consisted of the following benefits:
Beginning January 1st of each year, ***** ****** had 1 routine eye examination and 1 contact lens evaluation, fitting and follow-up.

Beginning January 1st, of each year, ***** ****** had an allowance of $350.00 to go t***** the cost of any plan or non-plan eyeglasses; the allowance would go t***** the cost of frames, spectacle lenses, lens options (i.e. anti-reflective coating), or non-plan contact lenses with an in-network provider.
***** ****** would be responsible for any out-of-pocket charges that exceeded the $350.00 allowance.

If ***** ****** submitted an out-of-network claim, he would submit an out-of-network form, which would provide him to receive $40.00 for a routine eye examination and a total of $175.00 for the materials.

***** ******’s plan also included a secondary benefit which could be used to purchase a pair of safety glasses.
The safety glasses benefit could only be used with an in-network provider; the secondary benefit did not include out-of-network benefits.

Claims Review:
Analyst Phil L** conducted a claims review on ***** ******’s plan on January 17th, 2024. The following determinations were made based on the review:
***** ****** did not file any claims (approved, pended or denied) in Calendar Year 2023.

Member Contacts:
Analyst Phil L** conducted a review of the contacts that Davis Vision received from ***** ******. The following determinations were made based on the review:
Davis Vision did not receive an outreach call from ***** ****** during Calendar Year 2023
The most recent call received from ***** ****** was dated March 23, 2022

Actions Taken:
Analyst Phil *** has mailed out an out-of-network claims form to ***** ****** on January 17th, 2024; additionally, an out-of-network claims form has been attached to this write up.
***** ****** will need to complete and submit the reimbursement form within 365 days from the date of service with the following items:
A copy of the billing receipt from the provider; the receipt must clearly show that the services were paid for.
Note- the claim must have had a service date in Calendar Year 2023; any service date prior to 2023 or in 2024 cannot be approved
Customer response
01/30/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.

The person responding is claiming I requested full reimbursement of $300. I do not know where they came up with this claim or this number. I never once requested full reimbursement of $300. They also provided a phone number to their customer service line which I have repeatedly stated is unusable due to my member ID being inactive because of the service date ending on December 31. This is the entire reason this complaint was filed. The representative I spoke with is Named Hollis H***** and she thankfully was finally able to resolve the matter for me and my claim for myself and my 3 dependents was paid out. This matter is now closed through my own means of finding assistance. I wish for this complaint to stay active on the BBB page so that others are able to use it before a making a decision about an insurance provider. The only thing I was requesting was a serviceable contact for customer service. This is something the company needs to address if they are not intentionally trying to prevent people from having access.
Regards,

***** ******
Customer response
02/02/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
The company reply was blank. I'm assuming they have nothing left to say in their defense and are unwilling to make any changes to their system. If this case can be closed with an unsatisfactory reply go ahead and close it. I will not accept their response as satisfactory however.
Regards,
***** ******
Initial Complaint
12/31/2023
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
On 12/31/23 I had an eye exam and I was told that Davis vision refused to pay for contrast drops a $35 value to help image the back of my eyes. Davis vision refused to pay for a service my doctor deemed medically necessary. They choose to pay for an old and outdated service and that is unprofessional and exploitative of me because I pay my premiums in full.
Business response
01/04/2024
Good Morning Mr. Mossel, I received the complaint that you had filed with the New York State Better Business Bureau on December 31st, 2023. In order to fully investigate the issue presented, I will need to receive additional information that was not provided in your initial complaint. Please provide the following information:The name of the provider/provider office that you went to on December 31st, 2023A copy of the paid receipt showing that you had to pay out-of-pocket monies for the service.A claim number on the date of service; per your claims history, Davis Vision has not received any claims from a provider with a date of service of December 31st, 2023.The above information can be submitted using the following modes:Email: Please submit the above information via email to **********************- ATTN **** *** ** * *******Fax: Please fax the above information to ***** ******** - ATTN **** *** ** # *******Once this information has been received, I can begin the investigation process and provide a final resolution to the referenced complaint.
Initial Complaint
10/27/2023
Complaint Type:
Order Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
Glassed returned and refunded, but the insurance eligibility not reinstated. 9/18/2023, I bought a pair of glasses from ***** ******, which is an in-network provider, billing directly to my insurance. Then I returned it for the wrong frame size. 10/2/2023, ***** ****** emailed me that the return has been accepted and the refund has been issued. However, the insurance eligibility is not reinstated. 10/5/2023, I called Davis Vision, the representative helped file the request to reinstate the eligibility. Not worked. 10/11, 10/17, 10/19, 10/25, I called again and again, never worked. They took my glasses, but never give my money back. If it passes this year, then this year's eligibility will be over due. Is this how they planed?
Business response
10/31/2023
Issue: ****** ** went to ***** ****** on September 18th, 2023 to purchase a pair of eyeglasses. ****** ** returned the eyeglasses on October 2nd, 2023 because she alleged that the frames were the incorrect size. ***** ****** advised ****** ** that they would retract the claim so that she could use her benefits, however the claim was not retracted. Requested Resolution ****** ** would like to have her benefits reinstated. Benefit Review: Analyst Phil L** reviewed the provider panels for each provider on October 30th, 2023. The following determinations were made as a result of the review. ****** ** has a claim on file (Claim # APG-********) with a date of service of September 18th, 2023; the claim was active as of October 30th, 2023. Provider Outreach: Analyst P. L** outreached to ***** ****** on October 30th, 2023; He spoke with patient representative ******. The following determinations were made from the interaction. Per patient representative ******, ****** ** did place an order for a pair of eyeglasses on September 18th, 2023, and subsequently returned them on October 2nd, 2023. Per Patient Representative ******, ***** ****** retracted the claim after the eyeglasses were returned. Analysis of Findings: Based on the information, the following determinations have been made: Claim # APG-********* was processed by ***** ******, however the claim was not retracted. Actions Taken: Analyst Phil L** submitted a ticket to the Claims Team on October 30th, 2023 to retract Claim # APG-********. The claim was retracted on October 30th, 2023. As of October 31st, 2023, ****** ** is able to use her material benefits to purchase eyewear. We apologize for any inconvenience that this has caused to ****** **.
Customer response
10/31/2023
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. Regards, ****** **
Initial Complaint
05/01/2023
Complaint Type:
Service or Repair Issues
Status:
Unanswered
The business failed to respond to the dispute.
On April 3rd I purchased contacts from Walgreens. I submitted the receipt for the contacts, that has worked in the past and with EyeMed. It has now been rejected twice apparently a receipt with an item breakout is not a receipt with an item breakout. It should not be this hard. I even talked to someone on the phone and when she saw it she said yes, this should be good. If you are going to reject claims at least have a real reason and setup a competent system. This really needs to be reviewed as I am going on a month trying to work with this company.
Customer response
05/01/2023
My policy number is *********
I am the policy holder: **** ******
DOB: **********
Initial Complaint
04/16/2023
Complaint Type:
Service or Repair Issues
Status:
Unanswered
The business failed to respond to the dispute.
Oh, this is the most useless vision insurance co. around. Davis. For years they're plagued with the same ineptness and incompetency that they've always have had. We had a legitimate out of network claim and all we're seeking is the $35.00 insurance money that they still owe us! Their EOB says it's been paid when in fact it has NOT been.
Initial Complaint
03/30/2023
Complaint Type:
Delivery Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
On January 11, 2023 I ordered a pair of prescription sunglasses through a local opticians office. My insurance company *** **** ****** dictates that the order is fulfilled through Davis Vision. I have been waiting for almost 3 months now and still don’t have my sunglasses. The opticians office says they will only tell her that the order is in process. I reached out to my insurer in late February and was told that the lenses were on back order until early March. I called the health provider again on March 28th and asked for a supervisor, no one was available and I was told that someone would call back within 24 hours. I haven’t heard back. I just want my sunglasses and would like to know when to expect to get what I paid for. Three months is too long to make a pair of glasses that should only take 2 weeks.
Business response
04/12/2023
We have researched this matter for the member. It has been observed that ** **** ******* ********* online portal shows that the lenses are still on backorder. We have contacted the Lab on 4/4/2023 and were advised that the lenses are now scheduled to be received by mid-April 2023. The member was contacted on 4/4/2023. While speaking to the member, we offered the opportunity to have this order canceled to have services performed with another participating provider. During this call to the member, the member declined our offer to resolve this issue and decided to wait for the lab. The member has been advised to call our office if they wish to proceed with our offer in an effort to resolve the member’s concern.
Customer response
04/18/2023
MBetter Business Bureau: I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below. The lab said the lenses were on back order until mid February, then said the backorder was until early March, then until mid March then early April, now they say the backorder is until mid April. I don’t trust anything they say anymore. As a result of these repeated lies I have cancelled the order and will go to a different lab that can actually provide me with glasses even if I have to pay the entire amount out of pocket. Vision insurance is worthless if you can’t get the glasses. I appreciate the help from BBB, unfortunately it seems the lab never intended to fulfill my order. I will change my vision insurance provider next year to a company that doesn’t work with Davis Vision. Regards, ******* ********

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