Ophthalmologist billed wrong insurance and refuses to fix it
Hello everyone, I had an eye exam done and I type 2 diabetic. This is the first time I have ever received a surprise bill from an ophthalmologist and also the first time I have been to this company. I do not have any diabetic related damage to my eyes and received a diabetic eye exam which as far as I know is the same as a standard eye exam except they also check for diabetic retinopathy. The diabetes has not affected my eyes at all and I did not receive any further treatment aside from the eye exam.
My problem is that the ophthalmologist billed my medical insurance instead of my vision insurance. They told me that it does not matter, simply because I have diabetes they have to bill my exam to medical. I even contacted my vision insurance and they said that I was covered but that the copay for my diabetic exam would be $39 rather than $10.
The ophthalmologist refuses to fix their error even though I told them what my vision insurance said and told me I was responsible for the $190 bill. I even searched it online and found an article that stated the following:
"When deciding whether to code vision or medical insurance, think about what brought the patient to your office. For example, if the patient has diabetes that is not affecting their vision, and came to your office for a vision exam, then you would bill vision insurance and then have the patient back for follow-up visits to monitor the impact of diabetes on their eye health. However, if the patient came to you due to fluctuating vision, you would first address the diabetes-related fluctuating vision as a medical visit, billing the patient’s medical insurance."
Do I really know more about medical billing than this company from a quick google search or am I missing something here?
submitted by /u/Supernewb01
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