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Business Profile

Optician

Amarillo Eye Associates P.A. Bal4eyes Inc.

This business is NOT BBB Accredited.

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Complaints

Customer Complaints Summary

  • 1 complaint in the last 3 years.
  • 1 complaint 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.

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  • Initial Complaint

    Date:12/06/2024

    Type:Billing Issues
    Status:
    Answered
    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 scheduled a preventive annual eye exam for 11-4-24. When I scheduled the exam one of the employees said that they did not show that my insurance would cover it. I assured them that my medical insurance would cover the preventive exam at 100 percent and even had a BCBS Health Advocate call them and assure of the same before my exam. They said they would just have to bill it and see what they paid but I was not concerned because had already confirmed it would. After the appointment they billed BCBSTX for a Medical Diagnostic Visit and said the diagnosis was dry eyes. Obviously this business gets an advantage for a diagnosis and I am left owing for the entire visit since it was not billed as preventive. Evidently there is no way possible for me to get a preventive visit from this provider which is a big deal since I do not have vision coverage and only have the 100 percent preventive coverage and they will not commit to what services you will be billed until after the visit. I am not sure what the advantage is to them but this almost seems like fraud to me especially for a simple dry eyes diagnosis. I have never done anything for dry eyes and it never bothers me so this is really suspect.

    Business Response

    Date: 12/23/2024

    11/23/2024
    Attn: Complaint ID:******** (********)
    Dear **** ******,

    Thank you for reaching out to share your concerns regarding your recent visit to our office. We take all feedback seriously and appreciate the opportunity to address your concerns.

    We understand the importance of wellness exams and your expectation of receiving a free wellness check during your appointment. However, upon reviewing your visit, we identified medical issues that required attention and went beyond the scope of a standard wellness exam. When a medical condition necessitates diagnostic care or treatment during the visit, the nature of the appointment transitions from a preventive wellness service to a medical consultation, which must be billed differently based on insurance policies and rules.

    We understand how this may have caused confusion, and we sincerely apologize if the explanation at the time of your visit was not clear. It is always our goal to provide transparency regarding billing and services, and we regret if there was any misunderstanding.

    There is no mechanism for us to check if a well eye exam pays us more or less than the medical focused exam and I doubt there’s much, if any difference. What drives the direction of the billing is BCBS’s policies and rules that we are contracted to follow.

    Sincerely,
    James *****, OD


    Customer Answer

    Date: 12/28/2024

    I am rejecting this response because: I am not seeing how dry eyes qualifies as Medical Diagnosis since that is the same thing that I have been told for the last couple of years. This is really frustrating since I went to extreme measures up front to make sure this was covered including having BCBS call and visit with the local office. Now I understand why the office would not commit to it being coded as preventative. Evidently this is a common practice for your business that is definitely not in the best interest of the consumer.

Amarillo Eye Associates P.A. Bal4eyes Inc. is NOT a BBB Accredited Business.

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