The medical care itself was excellent. The exam was thorough, the staff were professional, and I was genuinely impressed by the advanced diagnostic technology and comprehensive approach to eye care. From a clinical perspective, this was one of the best eye care experiences I've had. Unfortunately, my experience with billing and prescription release left me extremely disappointed. As a fully dual eligible Medicare and Medicaid beneficiary with QMB protections, along with primary UMR coverage, I was charged additional copays and contact lens fitting fees that I did not believe I should be responsible for under my coverage. I was also informed that my eyeglass and contact lens prescriptions would not be released until those charges were paid. My understanding is that the FTC's Eyeglass Rule requires eyeglass prescriptions to be provided to patients following the exam, regardless of whether payment disputes or eyewear purchases remain outstanding. My understanding is also that providers participating in Medicaid generally may not bill QMB beneficiaries for prohibited Medicare cost-sharing amounts. Because of those protections, the experience felt unfair, financially burdensome, and inconsistent with both the quality of care I otherwise received and my understanding of the applicable rules surrounding dual eligible patients. I sincerely hope the office reviews these policies and practices, because the doctors, staff, and technology were otherwise outstanding and I would gladly return if these concerns were addressed.
