Southern Title

To Whom It May Concern:I would like to respond to the complaint that your office received from a patient that was seen on  Oct. 30, 2017.  The patient called in with questions concerning her bill.  The patient's insurance was billed for a medical condition not routine exam. ...

She is a glaucoma suspect.  We also had scheduled her at our [redacted]. for more testing to rule out glaucoma. The patient did not understand why we had to bill her medical and not routine and we explained that she came in for a routine exam but when the doctor saw her and she was diagnosed glaucoma suspect that we had to bill medical.  I explained the importance of her follow up visit  but she cancelled that appointment also. I even sent the patient in the mail a brochure on glaucoma and asked her to please follow up with someone.  I feel we were very professional and understanding with this patient.  I just don't think she is taking the situation serious. Sincerely, [redacted]Office Manager/Optician

In response to the complaint made by Mr. [redacted], I have attempted to reach out to him numerous times. We have called him with the number we have on file with no response from Mr. [redacted].  When patients come in to the office they are not always aware of their insurance. Some policies have...

deductibles, coinsurance , and copay’s. We filed Mr. [redacted]’s insurance after he made us aware that he had insurance coverage for us to file. As a result of filing his insurance he has coinsurance of $30.00 that is due for the date of service 09/25/2015. We have no control over what type of coverage the patient has. We try to help the patient out to the best of our ability filing their insurance for them and trying to keep the cost down as well. In regards to the glasses Mr. [redacted] purchased when he came into the office he did not present insurance again. He called back to let us know he in fact had coverage for his glasses. Mr. [redacted] had already paid $ 105.00 for the Spectacle package.  We checked on his vision benefits with [redacted]. His benefits indicated he has a discount plan. With the plan he would have received a discount on his frame and lense. He would have paid $50.00 on the lense, $21.00 on the frame, and $40.00 for the standard polycarbonate which would total $111.00. We spoke to Mr, [redacted] to let him know that the discount plan would have cost him more money, and he was actually saving $6.00 by purchasing the Spectacle package. We have spoke with Mr. [redacted] on numerous occasions to help him understand the insurance coverage and the discount plan. The coinsurance is $30.00 per his medical insurance plan. If there is anything else we can help you with please let us know. Sincerely,Dr. Andrew C Kartesz

I have reviewed the response offer made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Regards,
[redacted]