ComplaintsforAndrea V. Gray, MD, PC

• Initial Complaint

  11/15/2022

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Answered

  More info

  On Wednesday, April 20th of 2022, I went into this optometric practice to see if my eye had been damaged by slag which had flown into it. I was taken into a back room and seen for about five minutes, at which point the presiding doctor deemed my eye fine. I went to pay for the service, and specifically asked what the ** pay would be, and they told me there was none. Months later, I recieved threatening letters from them telling me that I was late on a 40 dollar **pay, and they had added another additional 40 dollars to the charges for "administrative fees". Shortly after, they called me and I tried to get some understanding of the situation, and see if I **uld just pay the original billed amount, as I had tried to do to begin with, but they were extremely rude over the phone, specifically their agent *******, and told me they were just going to slap another 10 dollars on it and send it to **llections. I would simply like to be able to handle this matter like reasonable adults, and not have to pay for hidden, possibly illegal charges that they unilaterally decided to add without **nsultation on a service I had already explicitly tried to pay for to avoid this very thing, and they told me there was no needed ** pay.

  Business response

  11/30/2022

  Please see attached answer by letter, as well as copies of our financial policy and insurance statement.

  Business response

  11/30/2022

  *********************** came into our office asking to be seen as an emergency work-in. We agreed to see him even though he did not have an insurance card with him. We accepted the ********** Blue Shield number that he provided to us, and we billed that insurance. Without the insurance card in hand, we did not know what, if any his copay might be. We informed him that we would bill his insurance and would inform him if any amount was owing. We extended this free credit to him until we received a statement from his insurance. 
  

  The statement from his insurance clearly stated that the patient owes for the office visit copay. That amount is set by the insurance, not by this office. We mailed the patient four billing statements and received no payments or phone calls from the patient. The last three statements had late fees according to established policy. 
  

  The patient was very aware of the $10.00 late fee charges for balances overdue by 30 days, as he had signed the financial responsibility form when he was in the office. We have included this financial policy disclosure form with ****************** signature from the date of his service. 
  

  As a courtesy, we call all past due accounts to give them one more chance to pay the amount owing, by setting up a payment plan before turning the account over to our collection agency. At this point the patient owed $70.00. We charge late fees to partially cover our costs of sending extra statements managing the account, communicating with the patient by phone, and extending credit. When our billing assistant called the patient, she asked if she could verify his mailing address to make sure he was receiving the statements. He stated immediately, "I have been getting the statements, I just refuse to pay because you should have collected when I was in the office." He began yelling and telling my billing assistant that her job was not productive, and he does productive work. He also stated that she should have called during the summer when he was working and had money. 
  

  Due to his abusive demeanor, his disregard for his bill, and for trying to ruin our reputation on ****** (using a fake name) by publicly accusing us of fraud, as well as turning us over to the BBB, we have dismissed this patient from the practice. If he does not pay his $70.00 bill, his account will be turned to collections. This action is per our written policy as disclosed to and acknowledged by ************** on several occasions. 

  Customer response

  12/06/2022

   
  Complaint: 18409560
  
  I am rejecting this response because:
  
  Sincerely,

  Well, to begin with I tried to pay you at the point of service and I was told there was NO copay, I was not told there was going to be any in the future and I extensively asked at the time specifically to try to avoid this. As for the insurance card, having a picture of the card or just knowing the number is entirely sufficient to use it, since it is all handled by a central database tagged by number anyway, so I'm not sure why you would bring that up as it has no bearing on the current matter. I didn't recieve any notice of billing until you were already trying to tack late fees on months after the visit in question, which I also doubt was an emergency visit because I did make an appointment, unless all your visits by appointment are considered emergency for some reason. I was aware that you would charge late fees if I didn't pay at the time of service, which I did try to do, I wasn't aware you were going to charge me months later then try to play a loan shark game with it. When your agent called and asked me to pay the late fees, I explained the situation to her and was effectively told that they don't care and it doesn't matter. As for the fraud, due to the text of the 2022 No Surprises bill explicitly prohibiting surprise billing and explicitly requiring a good faith cost estimate at the time of service, I have good reason to believe that your company may have broken the law in this matter, and honestly from looking at ****** reviews it seems like you have a habit of doing this, which I'm sure is somewhat widespread in the industry and why there was need for the No Surprises act. Also I never did yell at your collections agent, I just tried to negotiate as normal humans do in the matter and was systematically rebuffed, because apparently you guys think you're 100% correct in doing this kind of thing when it's actually questionably legal to begin with. As for turning you over to the BBB, I find your choice of language fascinating, was there something that you wanted to remain secret from overseeing bodies? This BBB complaint certainly is not a legal matter but they do have a website specifically set up for the reporting of No Surprises act violations, and I've considered using it. Here is the text of the No Surprises act. https://www.congress.gov/bill/116th-congress/house-bill/3630/text 

  I would however prefer that the matter is resolved here, if you're willing I will pay you the 40 dollars you should have allowed me to pay at the visit and should have (legally, mind) given me a good faith estimate of.
  
  *******************

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