Complaints

• Initial Complaint

  11/14/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My daughter, **** ****** DOB:********** was seen at Grene Vision by provider ******* ******** on 2/1/23. When checking in for the appointment and providing our medical insurance card and VSP vision insurance card we were never told the doctor she was scheduled with is out of network. Once receiving the statement from Grene Vision showing we owe the full amount and the provider is out of network, I have called the Grene Vision office countless times to discuss this issue and was not told that the provider is out of network. There actions do not follow the “No Surprise Act” as they did not notify the patient(or patients family) of the unexpected bill. If we would have known this provider is out of network, we would’ve cancelled this appointment. We have continued to call Grene Vision to discuss this statement/claim with no resolution. The representatives state it is out of there control and claim a manager will contact us to resolve the issue, but a year and half later we have yet to receive a call to resolve the issue. We would like this to be acknowledged and Grene Vision to follow the No Surprise Act in this circumstance. It should not be allowed(following this act) to bill us more than the in network rate through insurance when we were not notified of this surprise bill or that the provider our daughter was scheduled with was out of network.

  Customer response

  11/18/2024

  My daughter’s date of birth is **********. She is 5. Yes, I am on her bill. 

  Business response

  12/03/2024

  This is in response to the complaint by the parent of **** ******.  The No Suprise Act covers noninsured patients, the patient is insured, therefore not covered by the No Suprise Act.  The provider is in Network with the patient's medical insurance.  Of course, it is impossible for a doctor to know ahead of the exam what the diagnosis will be or if it will be covered by the patient's insurance.  The diagnosis of the exam that day was not covered by the medical plan.  We have spoken to this patient's parent many times trying to explain the circumstance.   Grene Vision Group did nothing incorrectly with the billing of this exam.  We will however adjust the balance of $135.00 off this one time as a courtesy.

  
  

• Initial Complaint

  10/03/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My eye specialist suggested I change eye injection medicine. I told her and the desk that I would only agree to new medicine if it was paid by my insurance. They asked me to sign many forms. My eyes had been tested and my vision was poor. I did not have my glasses available. Following the injection I received an invoice for $300. Today I received an invoice for over $600.

  Business response

  12/05/2023

  Patient did let us know that she did not want to have any treatment not covered by her insurance. We checked on her insurance and the drug was covered. However, we cannot know until we process the claim with some insurances what portion they are going to kick back t the patient. It looks like on her particular policy they cover the cost of the drug, but there is a co-insurance that kicks 20% back to patient responsibility. Again, we do try to verify everything we can for the patient, but some things are unknown to us until we submit the claim. We do work with patients that have a portion their insurance pushes back to their responsibility and will work out a payment arrangement. Going forward, knowing that her insurance does not cover the medication without a portion of that being patient responsibility, we can look at other treatment options if it is what the patient wants. We always try to work with and help our patients, however we cannot know everything about their individual insurance policy ahead of time. We verify that a drug is covered initially, that is the information we have to go off of.

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