Elmhurst Clinic

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Billing? They don't care who pays.
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ELMHURST, ILLINOIS -- I'd have to say this medical visit was a mixture of good and bad experiences. I liked my doctor a lot and thought I got quality eye care, so at first I was happy with my choice. But then I got my bill and found out that my insurance wouldn't cover it. The reason? I only get covered for the exam, NOT the fitting or glasses/contacts themselves. So guess how they classified it. "Script & Fit Contact." And guess how willing they were to split up the charges. NOT AT ALL. They flat out refused. In fact, they wouldn't even take the charge for an eyeglass script and subtract out the difference! All they did was write a letter explaining it. Of course it didn't fly with the insurance company! What makes it worse is that my doctor kept saying "oh, don't worry, it's free." So, if you like PAYING TWICE for your medical care, then make sure you go here.
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User Replies:
Anonymous on 12/22/2006:
My insurance, Anthem, only covers eye exams.
Anonymous on 12/23/2006:
The same as JayD and emt most insutance only covers exams and mine doesn't even cover that.
awieber on 12/23/2006:
I wasn't surprised that I'd get charged for the fitting. What I was surprised about was that the clinic lumped the two together and refused to split up the charges so that the insurance could pay the portion they were responsible for. This time I don't blame the insurance company at all.
eyecandy on 08/22/2007:
I work for an optometrist and think I can explain why it seemed like you were being charged multiple times for the same service. Your eye doctor's office staff should have explained this to you- and they should have done so BEFORE your exam so you would have been able to make an informed decision about which services you wished to receive. For each routine eye exam that results in a contact lens prescription, there are actually at LEAST three billable procedures. There is the medical evaluation of the eyes for disease (pressure check for possible glaucoma, slit lamp evaluation for abnormalities, etc.), then there is the refraction, which is the portion of the exam during which the actual vision is tested ("Which is better, A or B?"). When a patient wants contact lenses, the doctor has to perform another evaluation- keratometry. This evaluation provides the base curve and diameter readings which are necessary for contact lens prescriptions.
The reason these services are divided out and charged separately is because insurance companies require very specific information about services provided and because every patient is different. Some patients do not need a refraction each time they come in for an eye exam. Many patients are not interested in contact lenses, so they never require keratometry.
You weren't charged three times for one exam. You were charged $X for the exam, $Y for the refraction (a.k.a. 'Script') and $Q for the contact lens fitting. If your insurance covers one ROUTINE VISION (not just medical treatment) exam per year, however, they SHOULD have paid for the refraction portion of the exam. In that case, your only out of pocket should have been the actual fitting fee and contact lenses.
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