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Precision Maintenance Reviews (2)

Initial Business Response / [redacted] (1000, 5, 2016/02/19) */ Third Party payors (Insurance companies) have decided years ago to differentiate Vision problems as separate from Medical conditionsVision testing or exams include testing or prescribing for glasses or contact lensesMedical testing includes evaluation for red eyes, cataracts, diabets, glaucoma etc For years, NEOES chose to include refractive testing in the medical eye exams as a courtesy to our patientsTherefore, we "refracted" or checked patients' vision during the medical eye examsHowever, the true 3rd Party Payors' definition of medical eye exams do not include "vision coverage." 3rd Party Payors have now penalized providers (Drs) for not following guidelines for the different exam definitionsTherefore, providers have been fined for "underbilling" as much as "overbilling." Medicare and other 3rd party payors will financially penalize providers if they not separate vision from medical eye examsInterestingly, doctors need to test for vision conditions in order to fully evaluate a patient's complete eye health With the threat from 3rd party payors of penalties and with reimbursement declining, NEOES chose to follow specific insurance guidelines and separate the medical portion of the eye exam from the vision (refractive) portion of the examNEOES changed the policy to bill refractions (92015) separate and not include this test in the medical exam (99xxx)NEOES changed the policy years ago (2012) NEOES is not fraudulently billing the consumer/patient for testing we did not performWe are billing the patient for testing we performedWe are just following the recommended 3rd Party Payor guidelines under Current Procedural Terminology (CPT) created by CMS (Centers for Medicare and Medicaid Services)We did NOT create the system; we are only following the recommended policies and defintion of the current Medical Ins system We recognize the confusion people may have with medical billingWe empathize that the system is confusingWe have tried to inform patients that medical billing is different than vision billing While we recognize that 3rd Party Payor system is confusing and frustrating for providers and patients, we did choose to write off this specific patients $refraction feeHowever, we contend that we were only following Ins guidelines, and the patient needs to complain to his insurance company who set the guidelines in motionSince this patient has medical coverage, but not vision coverage, the patient's insurance allowed the refraction fee to billed as a "non-covered" itemIf the insurance would not allow this test, we would have received a note (EOB) that stated the refraction was a "non-allowed" serviceHowever, the Ins ALLOWED the service, but just stated the service was "allowed non-covered"Therefore, the service is the patient's responsibility We have apologized for any perception of misleading the patientWe have removed the disputed charge from the patient's account We hope the issue is resolved Initial Consumer Rebuttal / [redacted] (2000, 7, 2016/02/24) */ (The consumer indicated he/she ACCEPTED the response from the business.) Thank you My main complaint is in the change in billing practice resulting in a necessary part of the exam to be billed and charged to the patientI have been getting this exam including the refraction for the last years with no issuesIt appears that this I need to voice a strong objection to my insurer aboutHowever, NEOES was aware of the impact this would have on my coverage and should have clearly indicated this to me so that I could have it pre-approvedAnother good argument for a single payer system Again Thank you

Initial Business Response /* (1000, 5, 2016/02/19) */
Third Party payors (Insurance companies) have decided years ago to differentiate Vision problems as separate from Medical conditions. Vision testing or exams include testing or prescribing for glasses or contact lenses. Medical testing...

includes evaluation for red eyes, cataracts, diabets, glaucoma etc.
For years, NEOES chose to include refractive testing in the medical eye exams as a courtesy to our patients. Therefore, we "refracted" or checked patients' vision during the medical eye exams. However, the true 3rd Party Payors' definition of medical eye exams do not include "vision coverage."
3rd Party Payors have now penalized providers (Drs) for not following guidelines for the different exam definitions. Therefore, providers have been fined for "underbilling" as much as "overbilling." Medicare and other 3rd party payors will financially penalize providers if they not separate vision from medical eye exams. Interestingly, doctors need to test for vision conditions in order to fully evaluate a patient's complete eye health.
With the threat from 3rd party payors of penalties and with reimbursement declining, NEOES chose to follow specific insurance guidelines and separate the medical portion of the eye exam from the vision (refractive) portion of the exam. NEOES changed the policy to bill refractions (92015) separate and not include this test in the medical exam (99xxx). NEOES changed the policy 4 years ago (2012).
NEOES is not fraudulently billing the consumer/patient for testing we did not perform. We are billing the patient for testing we performed. We are just following the recommended 3rd Party Payor guidelines under Current Procedural Terminology (CPT) created by CMS (Centers for Medicare and Medicaid Services). We did NOT create the system; we are only following the recommended policies and defintion of the current Medical Ins system.
We recognize the confusion people may have with medical billing. We empathize that the system is confusing. We have tried to inform patients that medical billing is different than vision billing.
While we recognize that 3rd Party Payor system is confusing and frustrating for providers and patients, we did choose to write off this specific patients $38 refraction fee. However, we contend that we were only following Ins guidelines, and the patient needs to complain to his insurance company who set the guidelines in motion. Since this patient has medical coverage, but not vision coverage, the patient's insurance allowed the refraction fee to billed as a "non-covered" item. If the insurance would not allow this test, we would have received a note (EOB) that stated the refraction was a "non-allowed" service. However, the Ins ALLOWED the service, but just stated the service was "allowed non-covered". Therefore, the service is the patient's responsibility.
We have apologized for any perception of misleading the patient. We have removed the disputed charge from the patient's account.
We hope the issue is resolved
Initial Consumer Rebuttal /* (2000, 7, 2016/02/24) */
(The consumer indicated he/she ACCEPTED the response from the business.)
Thank you.
My main complaint is in the change in billing practice resulting in a necessary part of the exam to be billed and charged to the patient. I have been getting this exam including the refraction for the last 10 years with no issues. It appears that this I need to voice a strong objection to my insurer about. However, NEOES was aware of the impact this would have on my coverage and should have clearly indicated this to me so that I could have it pre-approved. Another good argument for a single payer system.
Again Thank you

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