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blow off steam/ eyeglass help??
- Thread starter annr
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annr
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As you can see from my first post I had a bad experience with a D.O. and some glasses this summer. Well, I found out that things are worse than they appeared and I'm debating whether to take action or not:
At the time of the visit the doctor said that my insurance company only covered the medical part of the visit and not the eye exam. I would need to pay him my co-pay plus the charge of the eye exam, $145. I did.
This month, while scrolling through my medical claims on line I noticed that he had been paid for both the eye exam and the "medical" aspect for a combined total of $143 and change.
I contacted the insurance company; they called him and he admitted that he owed me a refund of $125. In about 3 days I had the refund.
I don't think that this was an accident or an oversight. I'm debating writing a letter to the consumer affairs department at the insurance company. Is this a no-brainer?
At the time of the visit the doctor said that my insurance company only covered the medical part of the visit and not the eye exam. I would need to pay him my co-pay plus the charge of the eye exam, $145. I did.
This month, while scrolling through my medical claims on line I noticed that he had been paid for both the eye exam and the "medical" aspect for a combined total of $143 and change.
I contacted the insurance company; they called him and he admitted that he owed me a refund of $125. In about 3 days I had the refund.
I don't think that this was an accident or an oversight. I'm debating writing a letter to the consumer affairs department at the insurance company. Is this a no-brainer?
I have been thinking on this a while. You had a pair of lenses that worked for you. The quack changed the optical center on purpose, knowingly gave you something very different, and told you to get used to it. When it did not work, he has no explanation....
Yes, i use the word quack with intentional meaning. This just makes me madder the longer i think about it.
My family has gotten over half a dozen pair of glasses from Zenni so far. Had to get replacement ear pieces for one pair and they are still worth far more than we paid.
annr
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grommit,
Thanks for sharing some of my sense of outrage-frustration.
Obviously I can't cover all of the nuances in a forum, but there is another very strange facet to the whole puzzle:
The D.O. told me that I suffer from prism, the eyes not working well together. I asked how ( in his opinion) at my age (37 years in glasses, 30 in contacts) I could develop such a problem. I had been using the same Rx for at least 20 years, done massive amounts of reading in school............. and how is it that he is the first person to recognize this?
I tried to fill 2 of his Rx's for this condition and was told twice that I should get my eyes rechecked that the scrip just didn't add up. I called the G.P. and am going to see a neuro-opthamologist. This may be overkill, but if there is something wrong, well let's fix it, if not, I don't want to waste more time and $ on glasses, etc.
Zenni may be just the place for me after I try to get some answers.
Thanks for sharing some of my sense of outrage-frustration.
Obviously I can't cover all of the nuances in a forum, but there is another very strange facet to the whole puzzle:
The D.O. told me that I suffer from prism, the eyes not working well together. I asked how ( in his opinion) at my age (37 years in glasses, 30 in contacts) I could develop such a problem. I had been using the same Rx for at least 20 years, done massive amounts of reading in school............. and how is it that he is the first person to recognize this?
I tried to fill 2 of his Rx's for this condition and was told twice that I should get my eyes rechecked that the scrip just didn't add up. I called the G.P. and am going to see a neuro-opthamologist. This may be overkill, but if there is something wrong, well let's fix it, if not, I don't want to waste more time and $ on glasses, etc.
Zenni may be just the place for me after I try to get some answers.
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Ann, I feel your pain, sorry you are having so much trouble. I know somewhat of what you feel, just because of some Dr. and Rx problems I had last year. It is frustrating. I hope you get to the bottom of this problem and get it resolved.
BTW, you are not too old, my Mom had eye surgery at 90 and did just fine.
Have a good day and know folks care.
Jim
BTW, you are not too old, my Mom had eye surgery at 90 and did just fine.
Have a good day and know folks care.
Jim
annr
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Jim,
Thanks, I thought of you and your suggestion when I read this article the other day in the WSJ, 'Reach for the Stars, Now That You Can See Them' by Jacob Goldstein 9-21-07.
Summary:
Military studies of vision correction with laser. It may now be possible for people to become astronauts who would formerly be disqualified on vision grounds. Pros and cons of the various therapies and their progression. Seems the big concern is that peoples' eyes who have had laser correction will not withstand the pressure encountered in space travel. Here is the link if you can get it online:
http://blogs.wsj.com/health/2007/09/21/reach-for-the-stars-now-that-you-can-see-them/
I'll email you just in case you don't subscribe.
BTW would you make a complaint about this person (D.O.) on the grounds that he is collecting twice (once from the patient and once from the insurance Co.) and ask that he be scrutinized? I don't want him to get away with repeat offenses if that be the case.
Thanks, I thought of you and your suggestion when I read this article the other day in the WSJ, 'Reach for the Stars, Now That You Can See Them' by Jacob Goldstein 9-21-07.
Summary:
Military studies of vision correction with laser. It may now be possible for people to become astronauts who would formerly be disqualified on vision grounds. Pros and cons of the various therapies and their progression. Seems the big concern is that peoples' eyes who have had laser correction will not withstand the pressure encountered in space travel. Here is the link if you can get it online:
http://blogs.wsj.com/health/2007/09/21/reach-for-the-stars-now-that-you-can-see-them/
I'll email you just in case you don't subscribe.
BTW would you make a complaint about this person (D.O.) on the grounds that he is collecting twice (once from the patient and once from the insurance Co.) and ask that he be scrutinized? I don't want him to get away with repeat offenses if that be the case.
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Our state has fraud abuse hotlines for most every insurance carrier, I would also report him to his certification board and to Medicare Fraud. The point is: If he did it to you, NOT LIKELY you are the only one. Drs that bill twice for services rendered run up everyone's cost. Most are not caught, because most do not turn them in.:grumpy:
So be a good citizen and report the guy or gal.:thumbup:
Jim
Cougar Allen
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No need to get into your feelings, just report the facts of what happened. No one can blame you for that.
annr
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Interesting, Jim. I tend to think the same way, Where there's smoke there's fire, but when I called the (unnamed HMO) today I felt that I was all but discouraged from pursing a complaint, thereby sheltering the provider. That bothered me because I am the one paying the premium and not the provider. This is why I thought I would turn to the collective wisdom of bladeforum.
The next thing that occurred to me is: how does one know if he did the tests he was supposed to do? did he bill for ONLY the tests that he did do? You get my drift. Fx. was he supposed to dilate eyes? (He did not.) Did he bill for this service? or file for this or some other test that never happened? According to the HMO rep. there is no way for me to find this out. His claims pass muster at the HMO. His only 'mistake' was that he charged me , not that he sent them a duplicate bill or that they paid him.
Feeling I was getting nowhere, I asked if I should call the AG or the Insurance commissioner ... that's when I was given the in-house address to send my complaint. Your ideas sound more reasonable-that an outside government agency would look into things.
Cougar Allen,
Good advice.
The next thing that occurred to me is: how does one know if he did the tests he was supposed to do? did he bill for ONLY the tests that he did do? You get my drift. Fx. was he supposed to dilate eyes? (He did not.) Did he bill for this service? or file for this or some other test that never happened? According to the HMO rep. there is no way for me to find this out. His claims pass muster at the HMO. His only 'mistake' was that he charged me , not that he sent them a duplicate bill or that they paid him.
Feeling I was getting nowhere, I asked if I should call the AG or the Insurance commissioner ... that's when I was given the in-house address to send my complaint. Your ideas sound more reasonable-that an outside government agency would look into things.
Cougar Allen,
Good advice.
I'm myopic - I can see about 11 inches uncorrected - and need 2.5 bifocals to see corrected inside my arms length.
One caveat - I've been wearing contacts about 40 years. At work, I have to wear safety glasses, and they are available in bifocal for less than $20, if you like the sporty wraparounds that make me appear a demented weasel. I don't care there, I can see(if the plant had decent lighting, but that's another problem.)
The very small PD is a problem for me, too, and large wide lenses don't help at all in the looks department. You can see the back of my head through the lenses. So small lenses and minimal frames are better there.
Off days I wear lineless bifocals with guaranteed scratchproof lenses - and yeah, they will, but I get free replacements as needed in the same Rx (no changing!) These are not safety rated, so I mimimize their use at work. They have been the best I ever have worn (since I was 6.)
Radio frequency keratotomy is coming online - and no cutting of the outer tissue is required. I would definitely go that route if 1) I had the money 2) I was under 40. At 54 it's hard to justify the expense on a limited cash flow when all the other expenses and hobbies in life come first. So look into that as a more permanent solution - nobody seems to regret it when it's done right (ahem) - and it does have some application to reducing the need for bifocals. That's a big plus.
If not, at least try the bifocals. The do take getting used to, walking down stairs or tilting your head up for long periods has it's drawbacks, but the tradeoff can be worth it.
One caveat - I've been wearing contacts about 40 years. At work, I have to wear safety glasses, and they are available in bifocal for less than $20, if you like the sporty wraparounds that make me appear a demented weasel. I don't care there, I can see(if the plant had decent lighting, but that's another problem.)
The very small PD is a problem for me, too, and large wide lenses don't help at all in the looks department. You can see the back of my head through the lenses. So small lenses and minimal frames are better there.
Off days I wear lineless bifocals with guaranteed scratchproof lenses - and yeah, they will, but I get free replacements as needed in the same Rx (no changing!) These are not safety rated, so I mimimize their use at work. They have been the best I ever have worn (since I was 6.)
Radio frequency keratotomy is coming online - and no cutting of the outer tissue is required. I would definitely go that route if 1) I had the money 2) I was under 40. At 54 it's hard to justify the expense on a limited cash flow when all the other expenses and hobbies in life come first. So look into that as a more permanent solution - nobody seems to regret it when it's done right (ahem) - and it does have some application to reducing the need for bifocals. That's a big plus.
If not, at least try the bifocals. The do take getting used to, walking down stairs or tilting your head up for long periods has it's drawbacks, but the tradeoff can be worth it.
annr
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Jim,
Thought you'd want to know that I checked out OK with the "neuro-eye" MD. Nothing to correct in that regard. So it would seem the fellow I saw this summer was not only an unscrupulous business man but he mis-diagnosed and mis-treated this patient!
(With this ammo I can start filing complaints.)The remaining option of course is to get a third opinion; this is allowed when the two don't agree.
Otherwise, I'll be gettting some bifocals.
; since I'm still chicken.
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I am glad you sought another opinion, I hope the 3rd gives you some definitive answers that have eluded you to this point. But don't be a chicken if the eye surgery can be done to fix it up. My daughter did just fine and so did some friends in our church that were much older.
Of course, I am not the one staring down a scapel with eyes open and awake.
Just my thoughts,
Jim
Of course, I am not the one staring down a scapel with eyes open and awake.
Just my thoughts,
Jim