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    canyouhelp's Avatar
    canyouhelp Posts: 2, Reputation: 1
    New Member
     
    #1

    Jan 8, 2007, 03:43 PM
    Who do I file a complaint with against a doctor re insurance
    I took my children to have their eyes checked and to get new glasses if needed. My co pay is 5.00 for the exam and 10.00 for glasses. This eye doctor is in the insurance network.

    When I made the apoitment I verified that the co pays were in fact 5.00 for the exam and 10.00 for the glasses.

    We went to the apointment. I was then told the glasses would be an additional 40.00 because they would only give children glasses with special non shattering plastic. I was told a beach ball shattered a pair of regular plastic lenses and it was their policy not to use those type of lenses for children. Great except I have a 10.00 co pay for regular glasses and they are in the network. They have a contract with the insurance company and when people go their they jack the price up.

    I feel they are taking advantage of people actually stealing from people. When I said something I was met with rudeness. The eye doctor told me they only receive 35.00 from the insurance. OK... how is that my problem. If they don't like the deal with the insurance company than don't take the insurance.

    I took the RX somewhere else and got glasses for my 10.00 co-pay but I am MAD. How many other people do they do this to everyday?? Who besides the insurance company (I have already reported this to them) should and can I report this to?


    :confused: :mad:
    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,301, Reputation: 7692
    Expert
     
    #2

    Jan 8, 2007, 03:48 PM
    No I feel they did their job very properly, as children should have the shatter proof lense. And it was your option, to not buy them there and go somewhere else with your prescription if you had to have the cheaper glasses.

    And they have a broad plan normally that pays various amounts toward other options, my plan basic glasses even bi focals are free, but I get tinted and coated lenses which cost me 65 dollars.

    I wish more doctors would only issue children the shatter proof ones.

    There is no one you should report them to, they did nothing wrong, matter of fact you should call them and tell them you are sorry.
    froggy7's Avatar
    froggy7 Posts: 1,801, Reputation: 242
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    #3

    May 18, 2008, 02:53 PM
    I'm sorry, but they are covering themselves. If they had given you're the glasses you wanted for your kids, and something happened that caused the lens to shatter, causing irreparable damage to your kid's eye, the odds are really high that you would turn around and sue them for selling you the glasses when they knew that something like that could happen. Quite frankly, I'm a bit shocked that you would take that risk with your kids, but that's your choice.

    And they didn't violate their agreement with the insurance company. The insurance company allows them to charge more for items beyond the basics. They gave you the prescription, you got the glasses elsewhere, so there's really no reason for you to be upset.
    canyouhelp's Avatar
    canyouhelp Posts: 2, Reputation: 1
    New Member
     
    #4

    May 18, 2008, 03:14 PM
    What a load of rubbish. If this or any other doctor contracts with an insurance company for good and services to be rendered for a certain price that is in fact the price that can be charged. To then charge more is AGAINST the contract.

    Furthermore, In the year and a half that this occurred I have spoken with a couple other eye doctors. They agree with me. Since my child only wears these glasses sitting at a desk in a classroom and not for sports or recess it is highly unlikely that they will shatter and injure his eye.

    I am all for option but it is that my option. I also don't see anyone suing a doctor because glasses shattered that would be more the manufacturer if the lenses were defective.

    Anyway, I did report this to the insurance company and they were happy to taken my complaint. I also passed this along to other mothers that asked me about eye doctors.

    CHOW!
    Shanni4's Avatar
    Shanni4 Posts: 25, Reputation: 4
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    #5

    May 19, 2008, 05:22 AM
    Have you read the whole contract? I pay the extra $35 for the shatterproof.

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