Complaints

• Initial Complaint

  07/03/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My initial interaction with this establishment seemed ok but then things started to get sketchy. I went in with my previous years prescription which worked just fine but then ******************* did an exam to determine that my current prescription was too strong, I obliged and wanted contacts. ******************* put in a trail pair of contacts that day, I wore them while driving during the day but by nightfall I couldnt see a thing. Well I expressed this to ******************* and he put me in a different trail pair, well we did this about two more weeks until I finally got tired of calling every week asking if the contacts were in. They had already billed and charged my insurance company for contacts that I never received but how can they even order contacts for me if I wasnt satisfied with the trail pair! I then expressed that I just wanted a pair of glasses because the contacts were such an inconvenience, I went into the office and picked out a pair of glasses only to be put through the same issue as the contacts. I asked the office manager and the Dr to adjust the claim they submitted to my vision insurance for contacts, to change it to glasses but they refuse to do so. My vision insurance company has reached out to them and they refuse to adjust the claim, I heard that this is a form of insurance fraud, billing for services that the patient did not receive. I will be filling an complaint with the board of optometry

  Business response

  07/14/2023

   I am sorry that this patient is dissatisfied.  Since ************** came in as a new patient, she was examined and fit with contacts on her initial visit.  We require all contact lens patients to return after a week so that the prescription , fit and comfort are all acceptable.  Until all of those criteria are met, the prescription is not finalized.  For the majority of patients, one follow up appointment is all that is needed.  In this case, because the patient wasn't satisfied, adjustments were made on each subsequent visit to address her complaints.  She ultimately decided she didn't want contacts, and wanted to get glasses.  It was explained that the amount paid toward the contacts would be applied toward the purchase of glasses.  Professional fees such as the eye exam and contact lens fitting are non-refundable.  While I don't specifically recall being asked to adjust the insurance claim, we do that frequently and can still do that for her.  Our goal is patient satisfaction and are more than willing to work with ************** to achieve a solution.

  Customer response

  07/17/2023

   
  Complaint: 20271349
  
  I am rejecting this response because:
  I have asked the business to adjust the claim that was presented to my insurance company several times and they refused. To put things in a better perspective my insurance company called and asked them on two occasions to adjust the claim for contacts since I did not get them and they still refused, I even have a letter from my insurance company stating that they have asked this company to adjust the claim and they refused. How can you charge me for a full year of contracts when I was even satisfied with the trail pair. For them to act as if I didnt request a claim adjustment is an insult to any patient that has been to this practice, I specifically spoke with ******************** and **** regarding this matter, ******************* stated that he would adjust the claim but then **** stated that he wasnt going to. 
  Sincerely,
  
  *************************

  Business response

  07/27/2023

  The patient was originally fit with contact lenses.  She returned for one progress visit where her concerns were addressed, and the doctor made an adjustment to her prescription.  Her only complaint was tail lights were blurry at night.  She returned a second time and now said her computer was blurry at work, and lights were still a problem.  A second adjustment was made to the prescription.  After this, she decided she didn't want to fool with contact lenses any more.

  On the date of the exam, the patient was given a contact lens contract, which she read and signed, and the contents were thoroughly explained to her.  The only remaining action was for her to either bring an eyeglass frame or select one here, and the amount she paid for the contact lenses would be applied to the cost of the glasses.

  We didn't here anything else from this patient until we received a complaint letter from her insurance company in June, four months later.

  We  have talked to the insurer on this matter, and they agreed with the content of the contract

  Customer response

  08/09/2023

   
  Complaint: 20271349
  
  I am rejecting this response because:
  What insurer did they contact because my insurer is still waiting for them to adjust the fraudulent claim. I did sign a consent for contacts and paid for a year supply of contacts per office policy. However I did not receive contacts nor was I satisfied with the three trail pairs, they fitted me for. This company does not operate on integrity, customer is not satisfied and all they have to do is adjust the claim for contacts and change it to glasses, since I actually received a pair of glasses from them. Are they waiting to submit another fraudulent claim. All they have to do is adjust the claim so that I can use my benefits somewhere else, where they care about their patients and not their benefits.
  Sincerely,
  
  *************************

  Business response

  08/22/2023

  First of all, we take offense at this person repeatedly referring to this as a fraudulent claim.  It was not.  If as she states, she has already received glasses in lieu of contacts, then in reality she has used her benefit for the year.  Adjusting the claim will do nothing to restore her benefits.  As stated in previous replies to this complaint, the exam and contact fitting are professional service that have already been rendered, and are non-refundable.  The only item in question is the amount she paid for the actual contacts.  As also previously stated, and as part of the contract she signed, the amount paid toward contacts is applied to the purchase of eyeglasses.

  Customer response

  08/23/2023

   
  Complaint: 20271349
  
  I am rejecting this response because:
  I DID NOT receive contacts from this establishment but they used my benefits for contacts. I received a pair of glasses from this establishment at the end of May but they are saying that I didnt, I have attached photos of the glasses that I received from them. That is considered a fraudulent claim, filed a claim for contacts that was never ordered or received and they had plenty of time to adjust the claim but refused to even when my insurance company called on several occasions. I received glasses but yet that claim was NEVER filed through my insurance company, so the money that I paid for the contacts couldnt have been applied to the glasses because that claim was NEVER filed through my insurance so how would they know what I had to pay or not pay? The receptionist lack integrity, he know that what he is doing is not right but they dont care about their patients, it seems as if they only care about the benefits that the patients bring in.
  Sincerely,
  
  *************************

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