Help! Doctor submitted Inaccurate Claim and I lost all benefits/coverage. How to resolve asap?

Hi, Please help me. I had an eye exam, and the optometrist apparently did a contact lense fitting as well. However, I called beforehand and spoke with the receptionist that I ONLY want eyeglasses, not contacts. This is because with glasses, frames and lenses are covered (150 for frames, 125 for lenses/exam). For contacts, is only 125 split between lenses, the exam, and the contact lenses fitting. The receptionist printed everything before the appointment, i had full benefits. After the appointment, and when I selected my frames, suddenly all benefits were gone aside from $70, the remainder of the $125. Apparently, the eye doctor ignored my appointment info, gave me the incorrect exam, immediately sent in the claim, and I am now out my entire $150 frame coverage. I am pissed. I spent what felt like hours trying to get this corrected to no success. The Eye Doctor told ME to call the insurance company, and have them cancel the claim?! I knew I wouldn’t have authority to do that, but still called and was told exactly that, the DOCTOR needs to cancel and rebill. However, I truly don’t think she cares to do this, ab my coverage is over at the end of the month.

Do I have any other options beside calling the optometrists office every day and leaving a message? Should I contact the eye insurance and report it as deceptive practice, possibly fraud? I need these glasses and cannot get them After I lose coverage.

TLDR: Deceptive eye doctor performed incorrect eye exam, billed insurance for the performed, yet incorrect exam (I specified glasses, Dr did exam for contacts), which resulted in my insurance not covering my glasses, effectively costing me ~$250 In benefits. (I still haven’t bought the glasses, because now they aren’t covered) How can I get this resolved ASAP if doctor is not cooperating?

submitted by /u/isitloveorjustsex
[link] [comments]
Hi, Please help me. I had an eye exam, and the optometrist apparently did a contact lense fitting as well. However, I called beforehand and spoke with the receptionist that I ONLY want eyeglasses, not contacts. This is because with glasses, frames and lenses are covered (150 for frames, 125 for lenses/exam). For contacts, is only 125 split between lenses, the exam, and the contact lenses fitting. The receptionist printed everything before the appointment, i had full benefits. After the appointment, and when I selected my frames, suddenly all benefits were gone aside from $70, the remainder of the $125. Apparently, the eye doctor ignored my appointment info, gave me the incorrect exam, immediately sent in the claim, and I am now out my entire $150 frame coverage. I am pissed. I spent what felt like hours trying to get this corrected to no success. The Eye Doctor told ME to call the insurance company, and have them cancel the claim?! I knew I wouldn’t have authority to do that, but still called and was told exactly that, the DOCTOR needs to cancel and rebill. However, I truly don’t think she cares to do this, ab my coverage is over at the end of the month. Do I have any other options beside calling the optometrists office every day and leaving a message? Should I contact the eye insurance and report it as deceptive practice, possibly fraud? I need these glasses and cannot get them After I lose coverage. TLDR: Deceptive eye doctor performed incorrect eye exam, billed insurance for the performed, yet incorrect exam (I specified glasses, Dr did exam for contacts), which resulted in my insurance not covering my glasses, effectively costing me ~$250 In benefits. (I still haven’t bought the glasses, because now they aren’t covered) How can I get this resolved ASAP if doctor is not cooperating?
submitted by /u/isitloveorjustsex [link] [comments]Read Morer/HealthInsurance

Leave a Reply

Your email address will not be published.