Business Profile

Vision Insurance

Davis Vision Inc

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Complaints

This profile includes complaints for Davis Vision Inc's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

46 total complaints in the last 3 years.
11 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

Initial Complaint
Date:05/10/2024
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
12/12/23 I took my son to an eye exam by an in-network provider that we've been going to for years. The provider has been unable to file a claim with Davis vision due to a glitch in their system. Our vision plan with Davis Vision is through our main health insurance provider, ************ **** *****. I have confirmed through HR via my husband's employer that my son is covered currently and has been on the vision plan even on the date of the visit. I have also called Independence **** ***** and Davis Vision to confirm coverage. Despite that, the provider is not able to submit a claim through Davis Vision and has tried multiple times calling Davis Vision for assistance. Each time, they receive a different answer. The provider has also tried calling Independence **** *****, per Davis Vision, only to be directed to call Davis Vision again. The provider has finally received an answer from David Vision that there is a glitch in their system preventing the provider from filing a claim but could not offer a solution as of yet. Because of this, the provider has tried billing me because since they cannot file a claim with insurance, my son is considered "not covered". I need Davis Vision to fix their "glitch" and allow my provider to submit the claim correctly.
Business Response
Date: 05/22/2024
We appreciate your assistance in bringing this matter to our attention. The complaint has been reviewed and it has been found there is a claim on file for the date of service 12/12/2023 for an eye exam for one of the dependents. I am unsure if its for the dependent in question due to more information being needed to investigate this issue. Please send your complaint to RTQA@versanthealth,com for further investigation. Please ensure to include the dependent name in question, the member id number as well as the provider information, the date of service and the services being requested. I do apologize for any inconvenience this may have caused you.
Initial Complaint
Date:03/11/2024
Type:Customer Service Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am trying since Dec 2023 to get Explanation of Benefits/EOB for my son's vison exam from 9/25/2023. I have called Davis Vision 5 times requesting it. The customer service representatives indicated that I would get the EOB within 10 days from each call. I still have not received it. The last call was on 02/20/24. By not having the EOB, Davis Vision is preventing me from getting the benefits of the second insurance I have,
Business Response
Date: 03/22/2024
Davis Vision has outreached with the complainant directly via email on March 22, 2024. Davis
Vision will submit a copy of the EOB statement to the complainant via the email
address that was provided. Davis
Vision takes customer service seriously and aims to address member concerns in
a diligent manner. We apologize for any inconvenience this issue may have
caused.
Customer Answer
Date: 03/25/2024
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.

Regards,

***** *******
Initial Complaint
Date:02/27/2024
Type:Product Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am trying to claim contact lens money for my son and me.

It's 120 + 120 = 240$.
So far, I called 6 to 7 times from December 2023 beginning till now.
They did not have the claim form on the website.
When I ask the customer rep, they say we send by USPS mail. But they never did.
They won't send the form also through email.

I am tired and wasted lot of time waiting for the customer service and getting the same lie.
Business Response
Date: 02/28/2024
Good Afternoon Mr. ***********,My name is Phil L** and I am a Quality Analyst with ******* Health, Bringing you Davis Vision and Superior Vision. I received the
complaint from the New York State Better Business Bureau that you had filed
earlier today concerning a request to receive a refund for 2 pairs of contact
lenses which you stated you had purchased. In order to investigate this
matter and come up with an equitable solution, I will need to receive
additional information from you, which was not included in the original
complaint.Please provide the following information:The name of the
provider/provider’s office that you purchased the contact lenses from; if
the provider was a chain provider (i.e., *******, ********* **** ******** * *********** ******* etc.), then please provide the address for the
location in question.A copy of the billing
receipt showing that the contact lenses were purchased from the provider.The date of service in
which you purchased the contact lenses.The phone number that
you contacted regarding your request to receive an out-of-network claim
form.The above information can be submitted via secure email or
secure fax using the following modes:Secure Email:
Please send the above requested information to **********************.
Please put ATTN: Phil L** RE Complaint ID # ******** in the subject line.Secure Fax: Please
forward the above information via fax to ###-###-####. Please put
ATTN: Phil Lee RE Complaint ID # ******** in the subject line.Upon receipt of the above information, I will be able to
complete the investigation and will respond to your complaint in a timely
manner.Thank You,
Business Response
Date: 03/21/2024
Claims Submission Process:
- A copy of the claim reimbursement form was emailed to Mr. *********** on 03/18/2024 with instructions on how to complete it.
- Mr. *********** has been advised that the itemized receipt that is to be included with his form must reflect a date of service between 01/01/2023 and 11/16/2023 because his plan was terminated effective 11/16/2023; Any services outside of this timeframe cannot be processed for reimbursement.
- Mr. *********** has been advised that the claim reimbursement form must be submitted no later than 365 days from the date of service as outlined by his out-of-network benefits.
Reimbursement:
- Per the guidelines associated with his plan, Mr. *********** can expect to receive 2 reimbursement payments (1 for him and 1 for his son) each in the amount of $120.00. This assumes that the claims he is seeking reimbursement form have dates of service between 01/01/2023 and 11/16/2023, as well as that a completed claim reimbursement form and an itemized billing receipt have been submitted to Davis Vision.
- Mr. *********** has been advised that he can submit the claim form and the itemized billing receipt either by secure email or fax.
I have attached a copy of the email that was sent to Mr. *********** on 03/18/2024 to this email for reference purposes. Please advise if you have any additional questions concerning this matter.
Initial Complaint
Date:01/17/2024
Type:Customer Service Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I submitted a claim to Davis Vision via mail months ago. They have not contacted me to inform me of the processing of my claim, NOR have I received any money from this claim. I no longer have Davis Vision for my insurance, and without my Member ID I cannot get in touch with anyone on the phone. I have submitted messages on their online portal and still, nobody is reaching out to me. I'm about to move and worried that if they eventually send a check, I won't receive it. I desperately need someone from the company to contact me, because I paid $300 out-of-pocket for a visit and need the money I am owed.
Business Response
Date: 01/19/2024
Issue:
****** ******* alleges that she went to
an out-of-network provider on August 8th, 2023 to receive
services. She stated that she paid $300.00
for the services and completed the out-of-network claim form; however she has
not received her reimbursement for the services.
Requested Resolution
****** ******* is requesting to receive
a reimbursement payment of $300.00
Benefits Review:
Analyst **** *** conducted a benefits
review on ****** *******’s plan on January 18th, 2024. The following determinations were made based
on the review:
****** *******’s plan operated on a 12-month cadence based on the previous years’ service date.
****** *******’s plan allows for her to receive 1 routine eye examination, and either 1 pair of eyeglasses or one pair of plan or non-plan contact lenses.
****** *******’s plan allows her to see either an in-network or an out-of-network provider.
If ****** ******* receives services from an out-of-network provider, she would be entitled to reimbursements in the following amounts based on the services provided:
Routine Eye Examination- $45.00
Frame: $45.00
Single Vision lenses: $52.00
Bifocal Vision lenses: $82.00
Trifocal Vision lenses: 101.00
Lenticular lenses: $181
Contact lenses (Specialty, disposable, gas permeable, sclere, and dispostable: $97.00
Medically Necessary Contact Lenses: $285.00

Claims Review:
Analyst Phil L** conducted a claims
review on ****** ******* on January 18th, 2024. The following determinations were made based
on the review:
****** ******* had a claim processed from an out-of-network provider on August 8th, 2023 for the following services:
1 routine eye examination
A pair of contact lenses

Davis Vision approved claims and processed the payment on October 30th, 2023
Davis Vision mailed a check (Check # *******) to ****** ******* on October 31st, 2023.
The total amount of the reimbursement was $142.00 based on ****** *******’s plan set up for out-of-network claims.
Analysis of Findings:
Based upon the investigation, the following determinations have
been made:
Davis Vision submitted a payment to ****** ******* on October 31st, 2023 via Check # *******.
Actions Taken:
****** ******* will need to review her checking account to confirm that she has not received the payment.
If she confirms that she has not received the payment, she can contact the Versant Health customer service unit at ***** ******** to request a replacement check payment and a check investigation for Check # *******
Note the check investigation will take 30-days from the date of request to complete. Additionally, as part of the investigation, Versant Health will engage in a recoupment action on Check # ******* to recoup the funds from any account that they were deposited into.
Sincerely
Yours,
Phil L**
Quality Analyst
Customer Answer
Date: 01/23/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
Regards,

****** *******

Customer Answer
Date: 01/24/2024
Hello! I understand that Davis Vision said they sent me a check - I never received it. I am unable to call their customer service line, because it requires a Member ID to be connected to a customer service agent. I no longer have my Member ID, as I have new vision insurance now. Being unable to call the number as well as not having any of my emails or website submissions answered, I am genuinely unable to contact them in any way. I am hoping that they can establish a line of communication with me so I can provide an address for my check.
If I was able to call the customer service number and connect to someone, I could resolve this on my own. But again, I don't have a Member ID to enter when prompted, so I am unable to connect.
Business Response
Date: 01/31/2024
Issue:
****** ******* alleges that she went to an out-of-network provider on August 8th, 2023 to receive services. She stated that she paid $300.00 for the services and completed the out-of-network claim form; however, she has not received her reimbursement for the services.
Requested Resolution
****** ******* is requesting to receive a reimbursement payment of $300.00
Benefits Review:
Analyst **** *** conducted a benefits review on ****** *******’s plan on January 18th, 2024. The following determinations were made based on the review:
•****** *******’s plan operated on a 12-month cadence based on the previous years’ service date.
•****** *******’s plan allows for her to receive 1 routine eye examination, and either 1 pair of eyeglasses or one pair of plan or non-plan contact lenses.
•****** *******’s plan allows her to see either an in-network or an out-of-network provider.
?If ****** ******* receives services from an out-of-network provider, she would be entitled to reimbursements in the following amounts based on the services provided:
oRoutine Eye Examination- $45.00
oFrame: $45.00
oSingle Vision lenses: $52.00
oBifocal Vision lenses: $82.00
oTrifocal Vision lenses: 101.00
oLenticular lenses: $181
oContact lenses (Specialty, disposable, gas permeable, scleral, and disposable: $97.00
oMedically Necessary Contact Lenses: $285.00
Analysis of Findings:
Based upon the investigation, the following determinations have been made:
•Davis Vision submitted a payment to ****** ******* on October 31st, 2023 via Check # ********
Actions Taken:
•****** ******* will need to review her checking account to confirm that she has not received the payment.
?If she confirms that she has not received the payment, she can contact the Versant Health customer service unit at ***** ******** to request a replacement check payment and a check investigation for Check # *******
?Note the check investigation will take 30-days from the date of request to complete. Additionally, as part of the investigation, Versant Health will engage in a recoupment action on Check # ******* to recoup the funds from any account into which they were deposited.
Update Action:
•Analyst **** *** outreached to client billing on January 29th, 2025 to put a stop payment on Check * ******* and recoup the funds that were paid out; the process will take between 30-60 days to complete.
•Analyst **** *** submitted a request to have a replacement check in the amount of $142.00 sent out to ****** *******. The amount of $142.00 is reflective of the out-of-network reimbursement that ***** ******* would be entitled to based on her plan benefits. ****** ******* can expect to receive the replacement reimbursement check within 30 days.
Sincerely Yours,
**** ***
Quality Analyst
Initial Complaint
Date:01/13/2024
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Cannot get ahold of anyone in the company to submit an out of network reimbursement claim. When you call you have to enter a member ID, which I do not have. Their site gives an error when I try to login even after multiple password resets. Have emailed the company multiple times over the last month trying to get ahold of someone to give me the needed information with no response. My union switched to Davis for vision a couple years ago and it has been a headache dealing with them ever since. The resolution I am seeking is the ability to talk to a human so that I can submit my claim, but that has turned out to be impossible.
Business Response
Date: 01/18/2024
Issue:
***** ****** alleges that he has made multiple
requests to Davis Vision to be sent an out-of-network claims form so that he
can receive a reimbursement for his order; however, he further alleges that to
date he has been unable to receive one.

Requested Resolution
***** ****** would like assistance in
receiving an out-of-network claim form and in having it processed.

Benefits Review:
Analyst Phil L** conducted a benefit
review of ***** ******’s benefits on January 17th, 2024. The following determinations were made based
on the review:
***** ******’s benefits with Davis Vision were terminated effective December 31st, 2023.

In calendar year 2023, ***** ******’s plan consisted of the following benefits:
Beginning January 1st of each year, ***** ****** had 1 routine eye examination and 1 contact lens evaluation, fitting and follow-up.

Beginning January 1st, of each year, ***** ****** had an allowance of $350.00 to go t***** the cost of any plan or non-plan eyeglasses; the allowance would go t***** the cost of frames, spectacle lenses, lens options (i.e. anti-reflective coating), or non-plan contact lenses with an in-network provider.
***** ****** would be responsible for any out-of-pocket charges that exceeded the $350.00 allowance.

If ***** ****** submitted an out-of-network claim, he would submit an out-of-network form, which would provide him to receive $40.00 for a routine eye examination and a total of $175.00 for the materials.

***** ******’s plan also included a secondary benefit which could be used to purchase a pair of safety glasses.
The safety glasses benefit could only be used with an in-network provider; the secondary benefit did not include out-of-network benefits.

Claims Review:
Analyst Phil L** conducted a claims
review on ***** ******’s plan on January 17th, 2024. The following determinations were made based
on the review:
***** ****** did not file any claims (approved, pended or denied) in Calendar Year 2023.

Member Contacts:
Analyst Phil L** conducted a review of the contacts that Davis
Vision received from ***** ******. The
following determinations were made based on the review:
Davis Vision did not receive an outreach call from ***** ****** during Calendar Year 2023
The most recent call received from ***** ****** was dated March 23, 2022

Actions Taken:
Analyst Phil *** has mailed out an out-of-network claims form to ***** ****** on January 17th, 2024; additionally, an out-of-network claims form has been attached to this write up.
***** ****** will need to complete and submit the reimbursement form within 365 days from the date of service with the following items:
A copy of the billing receipt from the provider; the receipt must clearly show that the services were paid for.
Note-
the claim must have had a service date in Calendar Year 2023; any service date
prior to 2023 or in 2024 cannot be approved
Customer Answer
Date: 01/30/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.

The person responding is claiming I requested full reimbursement of $300. I do not know where they came up with this claim or this number. I never once requested full reimbursement of $300. They also provided a phone number to their customer service line which I have repeatedly stated is unusable due to my member ID being inactive because of the service date ending on December 31. This is the entire reason this complaint was filed. The representative I spoke with is Named Hollis H***** and she thankfully was finally able to resolve the matter for me and my claim for myself and my 3 dependents was paid out. This matter is now closed through my own means of finding assistance. I wish for this complaint to stay active on the BBB page so that others are able to use it before a making a decision about an insurance provider. The only thing I was requesting was a serviceable contact for customer service. This is something the company needs to address if they are not intentionally trying to prevent people from having access.

Regards,

***** ******
Customer Answer
Date: 02/02/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.

The company reply was blank. I'm assuming they have nothing left to say in their defense and are unwilling to make any changes to their system. If this case can be closed with an unsatisfactory reply go ahead and close it. I will not accept their response as satisfactory however.

Regards,

***** ******
Initial Complaint
Date:12/31/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On 12/31/23 I had an eye exam and I was told that Davis vision refused to pay for contrast drops a $35 value to help image the back of my eyes. Davis vision refused to pay for a service my doctor deemed medically necessary. They choose to pay for an old and outdated service and that is unprofessional and exploitative of me because I pay my premiums in full.
Business Response
Date: 01/04/2024
Good Morning Mr. Mossel, I received the complaint that you had filed with the New York State Better Business Bureau on December 31st, 2023. In order to fully investigate the issue presented, I will need to receive additional information that was not provided in your initial complaint. Please provide the following information:The name of the provider/provider office that you went to on December 31st, 2023A copy of the paid receipt showing that you had to pay out-of-pocket monies for the service.A claim number on the date of service; per your claims history, Davis Vision has not received any claims from a provider with a date of service of December 31st, 2023.The above information can be submitted using the following modes:Email: Please submit the above information via email to **********************- ATTN **** *** ** * *******Fax: Please fax the above information to ***** ******** - ATTN **** *** ** # *******Once this information has been received, I can begin the investigation process and provide a final resolution to the referenced complaint.
Initial Complaint
Date:11/16/2023
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
They are refusing to repair the glasses which were only purchased within the past 4 months. They claimed that it was an act of god that caused the damages and refused to repair or replace them
Business Response
Date: 11/20/2023
Member: ***** *****
Member ID #: XXXXXXX681
Provider: **** ******* *** **** *********** ***.
Provider ID #: *****
Plan: Davis Vision
Dates of Service: August 4th, 2023
Complaint ID# ********

Issue:
***** ***** purchased a pair of
eyeglasses from **** ******* *** **** **********, Inc. on August 4th,
2023. At some point after the purchase
(the date was not specified in the complaint), ***** ***** broke his eyeglasses
and took them back to **** ******* *** **** **********, Inc. to utilize the
repair-replace benefit. ***** ***** was
advised that **** ******* *** **** **********, Inc. could not complete the
repair-replace benefit because the repair-replace benefit does not include “Act
of God” provision.

Requested Resolution
***** ***** would like his eyeglasses
repaired.

Contact History:
Analyst Phil L** reviewed the contact
history betw**n Versant Health and **** ******* *** **** **********, Inc, and
Versant Health and ***** ***** on November 17th, 2023. The following determinations were made based
on the review.
**** ******* *** **** **********, Inc. contacted Versant Health on November 7th, 2023 to determine whether ***** *****’s plan had a repair-replace benefit.
The CSR who took the call advised **** ******* *** **** ********** that ***** ***** did not have a repair-replace benefit.

Benefit Review:
Analyst Phil L** conducted a review of
the ***** *****’s’ benefits and available warranties on November 17th,
2023. The following determinations were
made based on the review.
***** ***** purchased a pair of eyeglasses which included a Versant Health frame on August 4th, 2023.
The benefit includes a breakage warranty, which lasts 1 year from the original date of dispensing of the eyeglasses; this original dispensing date is d**med to be 10 days after the date the order is shipped from the lab- in this case the dispensing date is August 14th, 2023.

Outreach to Provider:
Analyst Phil L** outreached to **** ******* *** **** **********, Inc. on November 17th, 2023; he spoke
with Office Representative- Judy.
Per Office Representative-Judy, she did not confirm that the “Act of God” response was made, but she apologized in case that it was.

Office Representative- Judy further stated that the practice was having issues with entering orders and processing on the provider portal; she further suggested that Versant Health provide a copy of the frames, and that **** ******* *** **** **********, Inc. will install the lenses into them.

Analysis of Findings:
Based on the analysis of ***** *****’s plan and the totality of
the circumstances, the following determinations have b**n made:

**** ******* *** **** **********, Inc. received incorrect information from the Versant Health CSR; specifically, the CSR did not reference the 1 year breakage warranty that is associated with Versant Health plan supplied frames.

**** ******* *** **** **********, Inc. placed was unable to place the remake order for ***** *****’s eyeglasses due to a system error in their provider portal.

Actions Taken:
Analyst Phil L** took the following actions on November 17th,
2023.
Analyst Phil L** reviewed the **** ******* *** **** **********, Inc.’s portal to determine the issue.
**** ******* *** **** **********, Inc. processed the claim on the Versant Health legacy portal instead of the Versant Health Eyewear Dispensing Portal

Analyst Phil L** outreached to the Versant Health Lab Services and requested assistance in processing the repair-replace order.
Versant Health lab services remade the eyeglasses order on November 17th, 2023; Analyst Phil L** was advised that the order will ship out on November 20th, 2023 because the order included an anti-reflective coating which requires a day to finalize.

Analyst Phil L** outreached to the Versant Health Provider Relations team on November 17th, 2023 to request that they outreach **** ******* *** **** **********, Inc. to provide the following actions.
To assist **** ******* *** **** **********, Inc. in using the Versant Health Eyewear Dispensing Program portal.
To provide an education session to **** ******* *** **** **********, Inc. on the repair-replace warranty.

We
apologize for the inconvenience that has b**n caused to Mr. ***** *****.
Initial Complaint
Date:10/27/2023
Type:Order Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Glassed returned and refunded, but the insurance eligibility not reinstated.

9/18/2023, I bought a pair of glasses from ***** ******, which is an in-network provider, billing directly to my insurance. Then I returned it for the wrong frame size.
10/2/2023, ***** ****** emailed me that the return has been accepted and the refund has been issued.
However, the insurance eligibility is not reinstated.
10/5/2023, I called Davis Vision, the representative helped file the request to reinstate the eligibility. Not worked.
10/11, 10/17, 10/19, 10/25, I called again and again, never worked.

They took my glasses, but never give my money back. If it passes this year, then this year's eligibility will be over due. Is this how they planed?
Business Response
Date: 10/31/2023
Issue: ****** ** went to ***** ****** on
September 18th, 2023 to purchase a pair of eyeglasses. ****** ** returned the eyeglasses on October
2nd, 2023 because she alleged that the frames were the incorrect
size. ***** ****** advised ****** **
that they would retract the claim so that she could use her benefits, however
the claim was not retracted. Requested Resolution ****** ** would like to have her benefits
reinstated. Benefit Review: Analyst Phil L** reviewed the provider
panels for each provider on October 30th, 2023. The following determinations were made as a
result of the review. ****** ** has a claim on file (Claim # APG-********) with a date of service of September 18th, 2023; the claim was active as of October 30th, 2023. Provider Outreach: Analyst P. L** outreached to ***** ******
on October 30th, 2023; He spoke with patient representative
******. The following determinations
were made from the interaction. Per patient representative ******, ****** ** did place an order for a pair of eyeglasses on September 18th, 2023, and subsequently returned them on October 2nd, 2023. Per Patient Representative ******, ***** ****** retracted the claim after the eyeglasses were returned. Analysis of Findings: Based on the information, the following determinations have been
made: Claim # APG-********* was processed by ***** ******, however the claim was not retracted. Actions Taken: Analyst Phil L** submitted a ticket to the Claims Team on October 30th, 2023 to retract Claim # APG-********. The claim was retracted on October 30th, 2023. As of October 31st, 2023, ****** ** is able to use her material benefits to purchase eyewear. We
apologize for any inconvenience that this has caused to ****** **.
Customer Answer
Date: 10/31/2023
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Regards,

****** **
Initial Complaint
Date:10/23/2023
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
In July 2023 I called Davis Vision to inquire about when I could go to my eye doctor to have an exam and new glasses. At first they said I'm eligible every 2 years, so would not be eligible until July 2024. Then the man who took my call noticed I was signed up under 2 different policies. Since I turned 61 in May 2023,I was now eligible for yearly exams and glasses, so I made my appointment. In September 2023 I received a call from my eye doctor, saying my insurance won't cover me until July 2024. I then called Davis Vision to try and get this straightened out. They said that since I had the exam in July 2022, while on the every 2 years plan, I would not be eligible until 2024. But, according to them, I am now on a yearly plan, but have to wait another year to get services?
Business Response
Date: 11/08/2023
Issue:****** ***** alleges that she was given
misinformation pertaining to her plan.
She stated that she contacted the ******* Health Contact Center in July
2023 and was advised by the Customer Service Representative (CSR)
stating that she is eligible for benefits every 2 years and that she would not
be eligible for a new pair of eyeglasses or contact lenses until July
2024. She states that up until she
turned 61 years old, she was able to use her benefits on a yearly basis.Proposed Solution:****** ***** would like clear information
as to what the timeframe for her benefits is.Interaction with Contact CenterAnalyst Phil L** conducted a review of ****** *****’s interaction with the ******* Health Contact Center. The following determinations were made based
on the analysis.****** ***** contacted the ******* Health Contact Center on July 19th, 2023 at 9:45am CST****** ***** was advised by the CSR that she had two plans open at that time through the Massachusetts Public Employee Fund. The first plan (referred to a MP -300) has a benefit cycle for routine eye examinations and material benefits every 24 months from dates of service.The second plan (referred to as MP-301) had a benefit cycle for routine eye examinations and material benefits of every 12 months from dates of service.; the plan was specific to members over the age of 61 years of age.****** ***** was advised at this time that she would receive coverage for MP-301 at that time which would allow her to receive benefits every 12 months. ****** ***** contacted the ******* Health Contact Center on September 7th, 2023 at 11:06am CST.****** ***** was advised that this time, that she her benefits had a cadence of 24 months; ****** ***** was advised that the MP-301 plan was discontinued by the State of Massachusetts in August 2023.****** ***** was further advised by the CSR that she would be able to receive a second pair of eyeglasses at a discounted out-of-pocket rate, however she would be responsible for the out-of-pocket cost for the routine eye examination until July 7th, 2024.****** ***** was advised that she would receive the pair of eyeglasses with bifocal lenses for $93.40, with additional charges for other services (i.e., anti-reflective coating).Benefit Review:Analyst Phil L** conducted a review of ****** *****’s benefits on
November 8th, 2023. The
following determinations were made based upon the analysis.- ****** *****’s benefits have the following benefit cadences assigned to her plan:- Eligible enrollees up to age 15 have a benefit cadence of 12-months from date of service.- Eligible enroll**s from age 15 through age 61 have a benefit cadence of every 24-months from date of service.Claims Review:Analyst Phil L** conducted a review of ****** *****’s claims
history on November 8th, 2023.
The following determinations were made based upon the analysis.- ****** ***** previously used her routine examination benefit on July 6th, 2022- ****** ***** previously used her material benefits on July 7th, 2022- ****** ***** last used her benefits prior to July of 2022 on July 30th, 2019.Analysis of Findings:Based on the review of the ****** *****’s benefits, claims history
and interactions with the ******* Health Contact Center, the following
determinations have been made:- ****** *****’s benefits have a 24-month from date of service cadence; She currently will not be able to use her routine eye examination and primary material benefits until July 6th 2024 and July 7th, 2024 respectively.We
apologize for any inconvenience that this has caused ****** *****.Sincerely
Yours, Phil L**Quality Analyst175 East Houston
St San Antonio, TX
78203O: 210-245-2113******* HealthBringing you Davis Vision and Superior
Vision*******health.com
Initial Complaint
Date:09/24/2023
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
November 2022: I visited Visionworks for annual exam and eyeglasses that included a free frame from Visionworks. I always call to check my plan and a Davis Vision rep confirmed that I got a free frame benefit and that if I wanted to pay $70, I could purchase another free frame benefit for the year.

December 2022: I returned to Visionworks under their 100-day satisfaction guarantee to change the frames. I picked out new frames on the shelves, a pair of Versace glasses. I called Davis Vision from the store to confirm that my frames were covered. At the t**e, the plan read any frame in the store "except Maui J**." A DV rep SPOKE TO the Visionworks rep who said she needed an authorization code because I had already received my annual benefit. The Visionworks associate said she would work on this and call me. She returned the glasses that I had purchased under my 2022 plan year.

First week of January 2023: I spoke to several Davis Vision reps who confirmed that I did get the free frame benefit except Maui J**.

Somewhere around second week of January 2023: Visionworks associate called me and told me that she "wasn't getting anywhere" with Davis Vision and asked me to call. When I did, a rep informed me that Davis Vision changed its plan to read "except Maui J** and Luxury Brands."

This resulted in many months of phone calls and two appeals. The last of which was denied because the plan says the free frame benefit does not include luxury brands.

AT THE T**E I MADE MY ORIGINAL PURCHASE AND ATTEMPTED TO DO A RETURN, THE PLAN ONLY EXCLUDED MAUI J**; THEREFORE, DAVIS VISION NEEDS TO HONOR THE PLAN TERMS.

In fact, in March 2023, I visited the plan website and the plan benefit only excluded Maui J**.

Today, September 24, 2023, the Davis Vision website STILL says that my plan benefit only excludes Maui J**. There is NO MENTION of luxury brands. I have attached a plan PDF and screenshot with date & t**e stamp.

Resolution: Voucher for any eyeglass frame at Visionworks
Business Response
Date: 10/12/2023
10/12/2023
Member: ****** ********
Member ID #: XXXXXXX861
Provider: Visionworks
Provider ID #: 30288
Plan: Davis Vision
Dates of Service: November 23rd, 2022
Complaint ID# ********

Issue:
****** ******** went to VisionWorks on
November 23rd, 2022 for an routine examination and a pair of
eyeglasses. She states that her benefit
allows for her to receive a free frame along with her routine eye examination
and material benefits. Between November
23rd, 2022 and December 31st, 2022, VisionWorks acquired
a “Luxury Collection of eyeglass frames.
This collection includes high-end brands such as Burberry and Versace. ****** ******** went to the VisionWorks on
December 29th, 2022 to request a style change on her eyeglasses; specifically,
she wanted to change the eyeglasses she purchased on November 23rd,
2022 to a pair which includes Versace frames.
VisionWorks attempted to place the order but received a notice from ****** ********** plan (FedEx) which stated that their members were not permitted to
purchase any of the Luxury Collection frames and that there would be a $300 cap
on all frame purchases going forward.
****** ******** states that she was unaware of this change and that she
had documentation that contradicts this new directive.

Requested Resolution
****** ******** would like to have her
order re-processed to include the Versace frames in her order.

Benefit Review:
Analyst Phil Lee conducted a review on
the ****** ********’s benefits on October 12th, 2023. The following determinations were made from
the review:

****** ********’s benefit operates on a 12-month cycle; she is able to receive a routine eye examination and either a pair of plan eyeglasses or a pair of plan contact-lenses after 12 months from the last date in which she used the benefit.

****** ********’s benefit provides her with a $120.00 allowance that is applied toward the usual and customary (U&C) cost of provider-supplied frames or provider-supplied contact lenses; ****** ******** benefits provides that she would be responsible for 80% of the of the overage amount for the provider supplied frame and 85% of the overage amount for the provider supplied contact lenses.
The allowance must be used in one purchase of a pair of eyeglasses; it does not allow for a member to spread the allowance out to purchase multiple pairs of eyeglasses frames, nor does it allow for a member to receive the balance of the allowance if it is not exhausted after the purchase of the eyeglasses.

****** ********’s benefit does not include a free pair of eyeglasses frames on top of the routine eye examination and plan pair of eyeglasses or contact lenses. Additionally, the benefit does not allow for a member to purchase a pair of frames from Maui J** or any frames that are a part of the Luxury Collection (i.e., Versace, Burberry, Gucci & Prada)

****** ********’s benefit includes a style warranty on her eyeglasses with the following conditions:
For a period of 30 calendar days from the original date of dispensing, the patient may return any pair of Davis Vision Exclusive Collection Frames and/or lenses to the eye care professional for changes. The dispensing date is assumed to be 10 days after the date that the eyeglasses are shipped from the laboratory.

VisionWorks is considered a doctor doing own lab work provider (DDOL); Providers with this designation do not carry the Versant Health collection of frames.

****** ********’s documentation references that the member is entitled to a frame from VisionWorks that is from the VisionWorks Free Collection without having to pay any out-of-pocket expense.
The documentation that was provided by the ****** ******** references this being a 2014 benefit

****** ********s benefit does not rollover year-to-year; this means that if the benefit is not used before December 31st of each year, it is not carried over into the next year for usage.

Cla**s Review:
Analyst Phil Lee conducted a review of
****** ********’s cla**s history on October 12th, 2023. The following determinations were made from the
review:
****** ******** purchased a pair of eyeglasses from VisionWorks on November 23, 2022.

****** ******** returned to the VisionWorks on December 29th, 2022 to request a style change on the frame, however VisionWorks was unable to accommodate this request because the Luxury Collection offered by VisionWorks was not included in the benefit plan.

Visionworks processed a re**bursement for ****** ******** on the order that she processed, which was effected in January 2023

Analysis of Findings:
Based on the findings, the following determinations have been
made:
****** ******** is not entitled to style change warranty for the following reason(s):

The benefits document that ****** ******** supplied in her evidence references that the benefits were from 2014 and not 2022.
At the t**e that ****** ******** purchased her original pair of eyeglasses in November 2022, the benefit excluded any frames that were a part of VisionWorks Luxury Collection and any frame from Maui J**

The style warranty does not apply in this particular case because the warranty is specific to Davis Vision Collection Frames, and not provider supplied frames.

****** ******** elected to receive a full re**bursement on her order on December 29th, 2022, which included any out-of-pocket charges that she was responsible for. Since she did not use the 2022 benefit before the end of year 2022, she is unable to use it in 2023.

We
apologize for any inconvenience that this has caused to ****** ********.
Sincerely
Yours,
Phil Lee
Quality Analyst
175 East Houston
Street
San Antonio, TX
78203
O: 210-245-2113

Versant Health
Bringing you Davis Vision and Superior
Vision
Versanthealth.com
Business Response
Date: 11/15/2023
Member: ****** ********
Member ID #: XXXXXXX861
Provider: VisionWorks
Provider ID #: 30288
Plan: Davis Vision
Dates of Service: November 23rd, 2022
Complaint ID# 20650040

Issue:
****** ******** went to VisionWorks on November
23rd, 2022 for a routine examination and a pair of eyeglasses. She states that her benefit allows for her to
receive a free frame along with her routine eye examination and material
benefits. Between November 23rd,
2022 and December 31st, 2022, VisionWorks acquired a “Luxury
Collection of eyeglass frames. This
collection includes high-end brands such as Burberry and Versace. ****** ******** went to the VisionWorks on
December 29th, 2022 to request a style change on her eyeglasses; specifically,
she wanted to change the eyeglasses she purchased on November 23rd,
2022 to a pair which includes Versace frames.
VisionWorks attempted to place the order but received a notice from
****** ********’s plan (FedEx) which stated that their members were not
permitted to purchase any of the Luxury Collection frames and that there would
be a $300 cap on all frame purchases going forward. ****** ******** states that she was unaware
of this change and that she had documentation that contradicts this new
directive.

Requested Resolution
****** ******** would like to have her
order re-processed to include the Versace frames in her order.

Benefit Review:
Analyst Phil Lee conducted a meeting
with Client Management on November 14th, 2023 to determine what the benefit
of ****** ********’s based on the contact with her group (FedEx). The following determinations have been made:

As of 2019, this specific plan allows for members to receive a free frame from VisionWorks locations every 24 months.
As of 2019, the free frame provision of the plan excludes J** Maui frames, which contain a $120.00 allowance plus a 20% change on the overage.

****** ******** contacted Versant Health on December 29th, 2022 to request assistance in retracting the cla** so that she could have her eyeglasses restyled with Gucci frames.
The material benefits for 2022 were reinstated at that t**e.

Analysis of Findings:
Based on the findings, the following determinations have been
made:
****** ******** was permitted to change her frames in her original order to a Gucci pair of frames without having to pay any out-of-pocket charge.

Actions to be taken:
****** ******** will need to complete the attached in-network cla**s form and provide a copy of the billing receipt showing that she had paid for the frame that she requested in question.
The receipt must be an original or a copy of the billing receipt that she received from VisionWorks at the t**e she placed the order.

The above documents can be submitted via the following modes:
Secure Email to [email protected] ATTN: Phil Lee RT # 4845408
Fax: Submit documents to (888) 343-3475 ATTN: Phil Lee RT # 4845408

Upon receipt of the completed in-network cla**s form and billing receipt from VisionWorks, the Cla**s Team will reprocess the order retroactive to November 23, 2022.

As of November 23, 2022, the order consisted of frames, premium progressive lenses and polycarbonate materials; no additional materials can be added to the order.

The copay that ****** ******** paid for the original order ($10.00 for the spectacle lenses) will be included in the reprocessing.

Once the cla** is reprocessed, the material benefit cadence will resume based on the FedEx plan contract guidelines.

We
apologize for the inconvenience that has been caused to Ms. ****** ********.
Customer Answer
Date: 11/21/2023
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********.
Based on the response, it seems that I can pay for the frames and lenses and then receive re**bursement from Davis upon submission of the receipt and cla** form they provided. The lenses must be the exact same as my November 2023 order.
It is unclear how the re**bursement will happen and the length of t**e that it will take. I am guessing it will be a check that is mailed? Please advise.
Upon clarification of those two questions, I accept the resolution.

Regards,

****** ********

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