I AGREE WITH MANY OTHERS' COMPLAINTS ABOUT "SURPRISE BILLING," COLLECTION THREATS, ETC. SUMMARIZED HERE:
https://www.google.com/search?q=richens+eye+center+reviews+billing+problems&oq=richen&aqs=chrome.1.69i57j69i59l3j0i457i512j0i131i433i512j46i175i199i512i654j0i512j46i175i199i512i654j0i10i512.6005j0j7&sourceid=chrome&ie=UTF-8
And as you'll see from my experience, THERE IS NOTHING YOU CAN DO IN ADVANCE TO PREVENT THEM FROM CHARGING YOU FOR MORE THAN YOU SPECIFIED TO BE SEEN FOR. I TRIED.
Richen's on Sunset is "IN NETWORK" for my MEDICARE ADVANTAGE plan. I COULDN'T HAVE MADE IT MORE CLEAR TO THEM THAT ALL I NEEDED WAS THE ANNUAL "ROUTINE EYE EXAM" which shows "$0 COPAY" IN MY "EVIDENCE OF COVERAGE," and that is exactly how it has been billed with 4 other eye care providers in my 11 years in Medicare Advantage.
I made this clear...
1) on the phone when I made the appointment,
2) also when I arrived, and identified myself, and
3) again after the exam when I left. All was OK. Nothing due.
I didn't notice anything different or unusual about this exam, and wasn't told it was any different than a "routine exam." BUT STILL... RICHEN'S "UP-CODED" ME AFTER THE FACT, for a COMPLETELY DIFFERENT, MORE EXPENSIVE EXAM - one I WAS NEVER INFORMED OF, AND WAS GIVEN NO OPPORTUNITY TO DECLINE - even though they had three opportunities (listed above) to warn me and get my consent. This would be a huge problem on its own - NO CONSENT.
So then, I get a $375 bill, and had to call billing. I was initially told they never even submitted it to my insurance, saying, "gee, we're only human." Well, $375 is MUCH, MUCH MORE than they ended up getting from my insurance. "Human" nature to try for more, I guess.
But even when they submitted it, they billed as though it was for a MEDICAL SPECIALIST (code 99204), which IS SIGNIFICANTLY MORE MONEY FOR THEM, AND has a copay FOR ME. This was INSTEAD OF the "routine VISION exam" I scheduled with them, I and came for. This was supposed to have billing code 92004 or S0620, and $0 copay, as billed by my 4 previous optometrists. I had to investigate and uncover all of this myself.
When I called billing again, they tried to justify the higher charge by characterizing my ROUTINE exam as being a "SPECIALIST" exam (NOT TRUE), performed in an OPHTHAMOLOGY office (NOT TRUE) by an OPHTHAMOLOGIST (NOT TRUE). Dr. JEDEDIAH B. LISTER (an OPTOMETRIST) is the only Doc in Richens Sunset office.
In summary, Dr Lister either:
1. Didn't do anything outside a "routine" exam, yet up-coded it as though it was a medical exam,
2. Or, he performed an exam I did not ask for, was not told about, and did not approve.
Which is it?
He noticed I had mild cataracts. (No treatment, or advice). So what? A routine exam is for the purpose of noticing many things including cataracts. My previous 4 eye doctors, over 11 years, noticed the same cataracts, but NONE of them tried to charge me extra for just noticing it.
The billing dept. refused to correct this bill, and as others have said, threatened collection plus 33% if I didn't pay up. This rolled off her tongue as though it were a script she recites every day, and in fact, she admitted that they BILL THIS WAY EVERY DAY, which tells me this is NOT an honest mistake.
She also claimed that my Medicare Advantage always has a co-pay for vision exams (COMPLETELY FALSE). But if that were true, then they should have warned me in advance the exam would not be $0 copay, as I specified to them.
She also told me to go ahead and post bad reviews and complaints, which sounds like this is not at all unusual for Richen's. When I asked to speak to the office manager, I was told this is the office manager's last day. I wonder why. read more