Complaints

• Initial Complaint

  01/24/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I took my daughter to Best Chance Optical on *** ****** ** ******* ** **** ** **** ***** Let’s just say it’s the best chance to get ripped off!!! They had a special on 2 pair of glasses. She got an eye exam, 2 pair of glasses and a 6 months supply of contacts. I left my insurance card at home so I paid out of pocket and called when I got home to give the owner my insurance info so that he could file my claim as we had discussed and agreed upon at the visit. When I called him he told me to have her come back in and get a pair of sunglasses off her choice any pair regardless of price and he would make it work. Which was a ploy to keep the $704 I paid him and file the sunglasses on my insurance. We never returned for the sunglasses . Months went by and I hadn’t received my refund so I called the insurance company in November and they told me that no claim had been filed. I reached back out to the owner who told me that he didn’t file the claim because she didn’t come back for sunglasses and that he didn’t have to file the claim because I paid cash. I explained to him that there’s a reason that I have medical insurance and I prefer to use it. He then told me that he didn’t know which frames she got because I paid cash and he doesn’t keep a record of cash customers in the charts and it would take some time to figure it out. Well he submitted the claim, but he submitted it with the contacts at the top so that the insurance would pay for the contacts and not the glasses. The insurance company told me to ask him to cancel the claim and resubmit it with the eye glasses on top to maximize my coverage. He said that’s why he put the contacts on top so they would pay for them which was another ploy to keep the bulk of my $704 because contacts are cheap!!! I called him again to rectify the matter and he agreed to write me a check at the end of November. It’s now the end of December and he has yet to resubmit my claim!!! However, he finally figured that she chose 2 pair of high end glasses I don’t know how he came up with that if he doesn’t keep a record… I sent my daughter to his office to pick the check up because my work schedule has not allowed me to get out in time to go to his office. She calls me and said that the check was for $94. He doesn’t want to honor the special that was running any longer. I asked her to return it to him because he obviously feels that needs my money more than I do.

  Business response

  01/30/2023

  Good morning I would like to provide my side of this situation and offer a response to the complaint. On ********** our office rendered services for the complintants daughter as she requested. All fees for services rendered where clearly expressed and several discounts where applied to reduce the cost for these services. At the time services where rendered the patients insurance was not provided. With this I reduced all fees according to our very reduced "in house" fees. The parent of the patient agreed at the time without hesitation that this was a fair price and paid. No obligation is "forced or demanded" The patient did provide her insurance information after the date of service and our office did fail to file her claim immediatly. For this I apologized and offered an alternative option based on the doctors recommendations and the patient said they would consider it. This was not a ploy or scheme to keep the balance over what the insurance would have paid it was for the benefit of the patient. I have been a health care provider for over 25 years and never have I been looked at or put down by a patient as with this situation. I made several attempts to resolve the concern and even went as far as offering the customer a full refund for one of the pairs of eyewear. The compalintant continuesly called me a fraud and stated I stole from her, she stated she would go on social media and express her dislike in us and report us to the BBB and insurance commisioner. Our office commited no fraud and has reached out to the patients vision insurance carrier to request that they change the way they discuss the patients benefits. This patient was advised they recieve one pair of eyeglasses for "free" but when the patient has a sever refractive error and opts for better lenses and treatments other fees are warranted. In the patients Member Bill of Rights it clarifies the patients responsibility in understanding their particular plan. I will under normal circumstances clarify this with the patient at the time of service, but due to the plan not being avaliable we did not get this that day. I asked the patient to return to the office and allow me to break down the plan for her and this did not happen. I am unable to show over the phone a physical breakdown of the insurance benefits. I pleaded with the comlaintent to allow me to resolve this before it went down this dark path but I was told "it was to late". The day after the patients last call to advise me of her plans, she again called just to advise me she was taking me to court in the new year. I do take responsibility for not following up on the insurance claim filing on the patients time table but as mentioned other options where being offered before finalizing a claim. In regards to oour in house specials and the insurance it is clarified by insurances that "specials" and insurance can not be combined. When insurance is billed the retail fees are claimed and  the conracted rate is paid by the insurance plan. This is not part of any conversation an insurance company has with its patients. I will always make every effort to resolve issues but in this case the resolution was not acceptable to the complaintant. I again apologize for the un-timely claim filing but again our office did not commit any type of deception or "scam" Our pricing was clarified and the cost of all services where voluntarily paid for at the time with no complaint or concern. We ask that the BBB not look poorly on our office as we did attempt to resolve this concern on multiple occasions to no avail. Our office was publicly humiliated via social media by this complaintant and I am atleast content that the BBB allows us to dispute this claim. Our Google reviews and Facebook reviews show the clear picture of who we are and how we conduct business. Our patients always come first and every effort is always made to save our patients and their families money. Thank you for your time.

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