I asked the my eye doctor’s billing department why I was charged $95 for an eye exam when I was only required to pay a $10 copay. The response I got was
“The Doctor indicated you had Dry Eyes which is a medical condition people have and that is why it was sent to your medical insurance because it is not considered as a standard exam and the amount out to you is your deductible with your insurance plan.”
Is there any way I can dispute this?
I got charged $100 at the eye doctor for saying I had dry eyes. Can I dispute this?
byu/TheTerribleTortilla inpersonalfinance
Posted by TheTerribleTortilla
21 Comments
What type of appointment did you schedule? A regular vision exam, or a visit because you were having a problem.
No
Yes. And I would. Start with the eye dr and see if you get anywhere. If you do not go to your insurance company. With enough push back you could get out of this bill.
I have the same issue that I was pre diabetic. I’m not now but he’s looking signs now… They charge me as a medical not eye exam.
I had a doctor do the exact the same thing. They did it to my wife and I during our annual eye exams.
I think it’s a scam they figured out to make more money.
I called the doctor directly and disputed. They quickly reversed the charges and claimed it was a “mistake”.
I’m in the market for a new eye doctor.
Start pleading the 5th Amendment with the doctors now.
…do you have dry eyes?
Yearly covers nothing but routine examination. Same with healthcare. I went for basic labs and preventative visit and brought up another issue which changes the nature of the appointment.
This happened with me this year. It wasn’t even something I said. The doctor saw something and noted it. Something harmless and cosmetic but is a medical condition. So now it’s a medical insurance claim. Nothing I can do since he made a medical diagnosis. Called insurance and they agreed with his billing.
Check the member handbook for your insurance. When something abnormal is found during the visit the diagnosis changes, and this changes the test from routine to diagnostic, which means different cost share applies. It happens a lot with colonoscopies.
Source: years of work in health insurance customer care.
I would change doctors and let them know why you are leaving their practice. And post on Yelp etc. about your experience. That might help others if not you.
This is probably violating balance billing rules of your insurance company – some places prevent this. Call your insurance company.
They are hoping the insurance pays and when they don’t most places will remove it from the bill
Dentist did something similar, so now I don’t tell them anything. They bill extra if they know something hurts.
Did you see an optometrist (glasses and contacts) or an ophthalmologist (medical doctor)? My bet is optometrist with that copay.
Either way they can’t charge vision and medical same day.
Everyone has dry eyes just some people complain about it and others don’t. Ophthalmologists are considered specialists and would be under whatever your specialist copay would be. Change doctors for sure
Source: I’m a Certified Tech for over ten years
Reminds me of the first time my family and I got tested for COVID. Very early days. We went to an in-network urgent care clinic, I verified everything, including that the cost was fully covered by our insurance, both before we arrived, and at the front desk when we arrived. We went into the little room, nurse came in, asked about symptoms, told us she would be back shortly with the tests. While we were waiting on her, a guy in scrubs popped into the room, asked how we were doing. We said we were fine, just needed COVID tests. He said cool, made a little small-talk and then left. Nurse comes back, gives us all tests and we go.
A couple weeks later I get five bills for $2500 each (one bill per person in the family). Urgent care had billed insurance/us for a sick visit, including a consultation with the doctor for each of us (guy in scrubs was apparently a doctor), and had sent our COVID tests to an out-of-network lab. We had a high-deductible health plan that we hadn’t used at all so we were basically having to pay full cost for everything. Obviously wasn’t having any of that. It took a lot of calls between me, the insurance company, and the urgent care for it to get fixed (eventually someone at the insurance company stayed on the phone while I called the urgent care and basically made them change the billing codes, drop the doctor visit, and accept the normal insurance payment for the COVID test) but I was able to get it straightened out and didn’t have to pay anything.
Huge hassle. They will take you for everything they can get if you let them. Don’t let them.
Change Doctors. That is the actual POINT of the exam, to find stuff that might be wrong. Even people who don’t need glasses or contacts should get an eye exam regularly to make sure everything is ok. They screen for various eye diseases or anything else that might be a factor in your eye/vision health.
My eye doctor mentioned I had dry eyes during my last visit, I didn’t even know. She told me what to go get OTC. No extra charges, it was basically a 3 minute chat during the exam. She also mentioned things I can expect as I age, things to look out for and something she noticed that she is going to track that may or may not be anything to worry about in the future.
Your eye doctor sucks.
It is common for any medical appointment. In preventive exam app covered by insurance , never mention any problem otherwise all the preventative exams will be billed to you. My dentist asks me a hundred times like any issue? any pain? during annual exam. As long as I said sth, they can charge me.
Isn’t the number 1 rule of dealing with medical billing as a patient to never say or express a concern about something at any annual or standard appointment unless it was specifically scheduled and planned to be about said concern? Ie don’t bring up an unrelated concern at a yearly physical, make a separate appointment for your concern that isn’t your physical
Good luck OP-years ago I went for my annual medical exam with a primary care doctor. It was the first time I was seeing them and she wanted to know my medical history. I mentioned I experienced migraines and boom just like that the billing changed from a free annual exam to a medical exam because I mentioned an ailment I had. They refused to change it. And I didn’t receive any medications or imaging orders for the migraines. I was so mad! And I changed doctors.
Hold. You go to the doctor and mad he charged you? What you expect him to work for free?