ComplaintsforEyes of New Mexico Family Optometry

• Initial Complaint

  12/07/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  My son had an eye exam and received glasses from the Eyes of New Mexico in September 2021. At the time of the appointment we waited over an hour for insurance to be verified and proof to be sent over. About a month after reviving his glasses, they got horribly scratched. When we came in to get the lenses replaced he was blamed for the scratches even though he has had glasses since Kindergarten and have never had an issue. We dropped off the glasses to be fixed and several weeks later we were contacted saying his lenses were there and for us to drop off his glasses. We had already dropped off the glasses and were told over text that was not true. I asked for security footage to be pulled to prove we dropped off his glasses. After no communication for a couple more weeks we received a text saying his glasses were found and were ready for pickup. No apology. A few weeks later his lenses were super scratched again. This time for fear of another mess up we took his lenses to a different eye doctor and had his lenses replaced. After they replaced his lenses, which we had to pay full price out of pocket since his insurance was already used for the year. Since then he has had zero issues with scratches. Over nine months after we receive a full bill for his eye exam and glasses. They did not submit it to our insurance. They are now out of network with our insurance and cannot submit it. I contacted them and they told me our insurance denied the claim. I contacted my insurance to verify this info and was told an insurance claim for my son from this establishment was never submitted.

  Business response

  02/28/2023

  Patient was seen on 09//22/2021 for a routine eye exam where a pair of glasses were purchased.  The patient had a discount plan for eyewear through their insurance provider and all discounts were applied to the eyeglass order, see attached invoices.  Discount Plans are not submitted to insurance due to the fact that they are discount plans and discounts are applied as per insurance providers guidelines.  On 12/02/2021 the patient returned eyeglasses for a warranty on the lenses from the 09/22/2021 order.  The lenses were remade at no charge to the patient and dispensed on 01/03/2022 for the father. All of our lenses have a scratch protection warranty.  That does not mean lenses will not get scratched and we will always honor the scratch protection warranty on any lenses ordered through us, as we did for this patient. 

  On 12/07/2021 the patient was notified that their medical insurance denied the claim for the routine eye exam due to the provider being out of network with their insurance, and  a courtesy discount was applied to the patient's invoice.  Insurance providers do not guarentee payment and if denied, it is the patients responsibility for what is denied. If the responsible party would have reached out to our office this would have been explained.  

  We strive to give excellent care to all of our patients and pride ourselves in the services that we provide.  At no time have recieved any communication from the patient regarding the outstanding bill for the routine eye exam until now.  I have adjusted the outstanding balance of $140.25 off as a courtesy and act of good faith in the services we provide to our patients.

   

  Customer response

  03/03/2023

  Complaint: ********
  
  I am rejecting this response because:
  This does not address the bad service we received from the company nor faulty glasses. We received the glasses on 9/22/2021 and on 12/02021 had to return them because they were so scratched my son could not see through them even though they were supposed to have scratch resistant coating.  My son has never had this issue before and has had glasses for 5 years.  At the time his glasses were lost, we were blamed for them being lost and they were not found or returned to us until 1/3/2022, a whole month he had to go without his glasses.  We were not even issued an apology for us being blamed for them being lost for how long it took for them to be found and returned to us.  

  
  

  In March 2022 his glasses were severely scratched again.  I was not going back to the business because 1. why would I go back after we were treated so poorly 2. after two pairs of defective glasses I wasn't going back for a third pair.  We went and had his lenses replaced by Walmart vision, receipt attached and did not have any issues with scratches after that or with any other pairs of glasses since then.  We have since switched to ****** ****** *** and have had no issues.  

  
  

  When I spoke to the insurance about the claim, they said it was not submitted and the problem might be the provider waited too long and is no longer in network with them.  We were in network at the time of service that is how I found the provider AND we waited for over an hour for insurance to be verified before we were seen.  This was a very stressful experience and as a two working family it is expensive to have to pay for glasses to be fixed when insurance is not honored.  
  
  
  Regards,
  
  ********* ******* 

   

  [To assist us in bringing this matter to a close, the consumer must give a reason why they are rejecting the response. If the consumer does not provide a reason the complaint will be closed Answered]

  Business response

  03/03/2023

  The patient's eyeglasses were made correctly with a scratch protection warranty.  The scratch protection does not make lenses scratch proof, but adds another layer of protection to the material.  We stress to our patient's that lenses will scratch if not properly taken care of and/or dropped, etc.   Extreme heat and cold will craz a lens, often appearing like tiny scratches on the lens.  The lenses were replaced at no charge according to our policy.

  To address the treatment the patient/parents during this process, I was not made aware of any of the patient/parent concerns until this correspondence.  I can assure you that we pride ourselves in our patient care and strive to acheive this with every patient, and every circumstance.  I apologize for any lack of communication and behavior that is less than our standard of care and will use this information for further train our staff as it is an ongoing process.  

  As for the insurance, the discounts for the eyeglass order was applied properly and no claim can be filed on a discount plan, which was the type of plan the patient had, and all discouns were applied in accordance to the patient's plan guidelines.  As for the exam, the claim was filed in a timely manner by our biller's on 09/27/2021.  On 05/02/2022 the biller's notated that the claim was denied.

  The consumer/patient/parent asked how they would like this resolved, as a courtesy we have absorbed the outstanding balance on the patients account, as they requested, and yet this did not satisfy them.  We remade they eyeglasses in question at no charge and delivered them accordingly.

   

   

  Customer response

  03/03/2023

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau®:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me with the business clarifying they absorbed the remaining balance due.  The last invoice attached still showed a balance due of $140 which caused my confusion.  
  
  Regards,
  ********* *******

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