Ophthalmological Services, Inc

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear belowRegards,
*** ***
At no time did Dr*** or anyone else in the office inform me of the cost of the prismI live off of social security disability if I had been informed of the cost of the prism I would have denied the prism. I was just told the prism could help my visual field loss and naturally I was willing to try itHowever, I could never get used to wearing the prism and can see just as good without the prism as I can with the prismI have cancelled all remaining appointments with Dr*** and have mailed the prism back to the address on the business card. I do believe that Dr*** or someone else in the office should inform patients of all cost they will or could be billed for.%

I keep getting bills in the mail from Ophthalmological Services, Inc. stating that I have an account balance of $20.59 and a statement balance of $30 but does not indicate what the charges are for. Account number on the bill is [redacted]. I had an appointment with a Dr. [redacted] at the address stated on the bill on May 27, 2014 and as I always do, I submitted my insurance information which at that time was Medicare and Wellcare of Kentucky. Dr. [redacted]'s office did bill Medicare for $255.00 of which Medicare approved $214.31 and paid $168.02. The remaining amount should be billed to Wellcare of Kentucky. Dr. [redacted] added something to one lens of my glasses and said it should help my visual field loss. Dr. [redacted] told me to wear it home and see if it helped me. Dr. [redacted] told me if it helped me I could keep it and if it didn't help me I could return it. I returned the item within a week because it did not help me.
       
Desired Settlement:
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Desired Outcome:
If the money I am suppose to owe is due to the office visit, Wellcare of Kentucky should be billed after Medicare. If the money I am suppose to owe is due to what Dr. [redacted] added to the lens of my glasses, I wore the item home and tried it out as I was told to do by Dr. [redacted] then I returned the item to Dr. [redacted] and should not be billed.

Business Response to a Complaint
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Complaint ID#:
[redacted]
Company Name:
Ophthalmological Services, Inc.
Company Contact:
[redacted]
Company Phone:
###-###-####
Company Email:
[redacted]
Person Who Sent the Complaint:
[redacted]
Staff Member:
Response:
The patient was prescribed a Fresnel prism to aid in visual field awareness. This treatment option was discussed in detail but the cost of the prism and insurance coverage was not explicitly discussed with the patient by me, the prescribing doctor. The patient was provided with a written statement at check-in that advised him of the following: "Medical insurance does not typically cover the cost of a low vision refraction, low vision devices, or eyeglasses. We accept most major credit cards and some individuals may be eligible for financial assistance. Fees for services not covered by Medicare or other insurance plans are due at the time of service." The patient signed and dated the form acknowledging the following statement: "I have read and understand the above information and agree to the terms sent forth in this agreement. I also acknowledge that I have had all of my questions answered." Not all services are covered by all insurance contracts. It is a patient's responsibility to understand their benefits and the patient can be held personally responsible for payment of charges not covered by their plan. It was determined by our billing office that this charge would not be covered under the patient's insurance plan, and thus was billed to the patient. We are happy to submit these charges to the patient's primary and secondary insurances, but they will likely be denied. This patient made no attempt to contact our office regarding questions about his services or these charges. He also no-showed this week to a follow-up appointment with our Occupational Therapist whom he was referred to for additional treatment.
Sent on: 6/12