ComplaintsforCascade Eye & Skin Centers

• Initial Complaint

  06/11/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Cascade eye and skin center. billing does not make sense. my last visit 05/08/2023 I was informed I had a pass due balance. I explain to representative at the desk during visit that not **rrect because I went online and submitted payment. instead of listening and allowing me to discuss with billing and resolve she kept insisting so I made payment in the office that day in the amount of $40.00. if my ** pay is required before I see the doctor and I pay that at time of visit. and injection ***** and I submit payment once bill online. I'm **nfused why cascade is sending text of pass due of ****** and why when I attempt to **ntact billing department I met with **ntention. I do not need nor did I ask for a ledger. I'm asking how and why is their a balance remaining if I submitted payment.

  Business response

  06/21/2023

  Patient came in 5/22.  ****************** is applying an additional $80 copay to the injection code and a small co-insurance to the drug.  It looks like instead of paying the full balance on her statements,shes been subtracting the $40 copay she paid in office.  This has resulted in a past due balance building up.  **** talked to patient when she called 5/12/23 and emailed the itemization for her to see how insurance was processing. 
  
  On 5/22 when patient checked in.  Patient was given a card to call us with questions and has not called back after receiving her itemization.  

  Patient's responsibility per her insurance is $40 copay for office visits, $80 copay for injections, and .33 co-insurance for each unit of drug injected.   Her 04/14 visit did not require a physician office visit.  

  See attached schedule of patient responsibility and payments.  The outstanding balance is a simple function of "due" vs "paid" - see attached spreadsheet.  

  Please let me know if you have any further questions.    ****** ************

  
  

• Initial Complaint

  07/19/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  At the beginning of the year I research on my insurance how much they would cover for a skin exam. I figured out that they would cover one consultation per year. I called Cascade ********** clinic in February 2022 and scheduled a consultation for May 11, 2022 and had to reschedule for June 15 of 2022. On the day of my appointment I went in for my consultation, The PA came in and asked if I had any skin concerns and I told her that my mother has rosacea and I was worried that I would get rosacea eventually, she prescribe me some medicine for that. I then told her that I had a broken blood vessel on my nose and she said they would take care of that today its Quick and easy and its about $50 and I agreed. All in all, the consultation lasted about five minutes. I then get a **** that says office visit 45 to 59 minutes, for $226. When I called billing they couldnt even provide me the definition of the difference between consultation vs office visit and then said they dont do consultations even though that is what they scheduled me for. They have not worked with me at all on this issue even though my insurance covers consultations, and they lied on my **** about how long I was in the office. On my **** it also says I was seen my a *************** but I was never seen by a man. Only the Physicians assistant. I have asked the front desk to explain to me the difference between an office visit and a consultation and they cant explain the difference to me either.

  Business response

  07/27/2022

  To *****************************************
   
  Regarding Complaint ID ********
   
  Called patient and had the following conversation:
  
  Apologized for any confusion on consultation vs office visit   Explained that consultation and office visit *** sometimes *** be used interchangeably during a scheduling call.   A true consultation only occurs in our ******************* and requires a minimum deposit to schedule.    
  
  Patients visit was considered anoffice visit.   New patients are generally assigned CPT-4 code ***** for billing purposes.  CESC does not **** based on time, but on the complexity and nature of the visit.  CPT-4 descriptions are defined by the American Medical Association.   Expressed we understand how the billing descriptor could be confusing as her visit was not ***** minutes and assured her the coding used was appropriate.  
  
  Regarding a physicians name on the ****, informed patient it is required for a physician to review the medical chart notes prior to insurance billing. 
  
  Patients insurance did process CESC billing.  Unfortunately, the allowable amount of her insurance was below the patient minimum deductible and therefore, the allowable amount of $226.87 is fully the  patients responsibility. 
  
  CESCs  interest in building a long-term relationship with a new patient, and given some initial miscommunications, CESC offered to settle the account in full for $50.  Patient agreed to settlement.   
  
  cc: ***********************
  

  
  

  Customer response

  08/01/2022

   
  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.
  
  Sincerely,
  
  ***********************

• Initial Complaint

  06/23/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Date of Service: Friday June 3 Reason for Service: Annual Eye Exam Place of service: Cascade Eye and Skin in ********** ****************************************************************************** I am writing as VSP insurance lists Cascade Eye and Skin as a Premiere partner for annual eye exams. I scheuduled an eye exam with this company and arrived and paid a copay of $10 with my vision insurance. ***************** never received a claim.)Since leaving the office I have been sent a **** for $220 as they want to charge my medical insurance to make more money from the visit. I was sceen by an office worker, who was unsanitary and touching my face and eyes, for most of my 1 hour and 45 minute appointment then sent to another room to eventually see the eye doctor for a 5 minute.appointment. I was not informed there would be two bills for the two different people I saw. I was not informed they would not be doing a full exam, no retinal scan or dialation was conducted.Friday June 17 at 3:39 PM I spoke with Cascade and informed to throw away the **** and I would not be charged this additional amount.Wednesday June 22 I recived a voicemail they want my medical insurance to **** and why I am writing you for help here. I was also told this isn't "America's Best" on the phone and I saw a doctor. Yes, I should see a doctor for an annual eye exam. This appears to be fradulant billing for an annual eye exam covered by VSP to make a bigger profit through a medical insurance company and we should protect consumers. Many of us pay for vision plans to be used for annual eye exams.

  Business response

  06/29/2022

  Patient was initially seen by a Certified Ophthalmic Assistant who is trained in diagnostic testing.  This is a common and customary patient flow process in an Ophthalmology medical practice.  The patient presented a complaint that is medical in nature, above and beyond a contractual routine exam.   

   

  When a patient is seen for both a routine exam and a medical complaint which is not covered by the routine exam, medical insurance is required by VSP before being billed to VSP.  As we were not able to obtain patients medical insurance, VSP has not been billed, and therefore Cascade Eye & Skin is following up with patient to obtain medical insurance.

   

  Physician did discuss with patient their chief medical complaint. 

   

  Regarding a retinal scan, our organization does not perform this procedure unless it is medically warranted.   This is normally done in optometry practices.  CESC chooses to utilize dilation which is our ophthalmologist preferred diagnostic test.   Unfortunately, patient declined dilation as documented in chart notes. 

   

  All of our patients have access to their current chart notes via our patient portal.  An invitation to the portal is sent to our patients if they have provided an email address at check in.

   

  Cascade Eye & Skin Centers will recategorize the visit as routine and remove the medical component from the claim.  This will allow CESC to **** VSP and settle the account.   Should patient choose to follow up with CESC regarding their primary medical complaint, verification of medical insurance is required.  

   

  Patient will not be contacted again regarding this matter unless **** is denied by VSP.

   

  cc: *************************

   

   

  **************************************

  Chief Financial Officer

  ******************************************************************

  O: *******************

  D: ************

  C: ************

  LinkedIn

   

  

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