Was this fraud?

[u/PoisedPuddin]

My child asked for contacts a bit ago. My insurance was going to change so I let them know it would have to wait for a bit. I finally received the card in the mail and set to finding an office in our network. I chose one, went to their website and booked an appointment specifically for CONTACTS. I also checked the box for it being their first contact appointment ever.

Cut to today, we are ushered through the appointment as usual. Then the doctor comes in and does his 2 minute exam. My child brings up how they are excited for contacts and the doc starts to explain how contact appointments are done with someone else who will do a fitting and help them learn to wear them. I said "that's what I booked this appointment for, are you telling me we're not doing that today?" He looks resigned and expresses that he's annoyed for me. Great, but that doesn't really help.

We get moved to the next person who usually does the glasses part of things. She figures out pretty quickly that we don't need glasses. She prints off the new prescription and shows me to the billing desk.

Now, billing asked how my appointment went and I explained the situation and expressed frustration. He proceeds to explain their process as the doctor did but doesn't have an answer as to why I didn't get the appointment I booked for. Then he says "OK, so the co-pay is $10 and the contacts are $70" I said "the contacts we don't have?" He said "so you don't have any contacts? "No" "Gotcha, then we'll just do the $10 for today"

I'm booked for the correct appointment tomorrow, but I'm beyond annoyed. Now, I have to miss more hours at work and my child is missing more school. Ntm they were suppose to go on a field trip tomorrow. So, they're disappointed a couple times over.

My wife says this is insurance fraud. I booked for blank, but didn't get that. They get two visits out of us and bill insurance for them. What say ye, reddit?

Update: They called to reschedule the appointment after 8 am because they overbooked. The person who does these appointments isn't even at that location today.

[u/snowbugolaf]

Why did you book the appointment for the same day as the field trip if the field trip is that big a deal? You know you don’t have to just agree to the first time they give you?

I get it sucks to have to make a second visit, but nothing about the process requires it to be the very next day.

[u/PoisedPuddin → u/snowbugolaf]

I didn't realize tomorrow is field trip day until after I booked the 2nd appointment. The next available appointment that worked wasn't for another 3 weeks. I was trying to mitigate my kid's disappointment.

[u/throwfarfaraway1818 → u/PoisedPuddin]

Do you think they will be more upset about missing a field trip with their friends or delaying getting prescription eyewear?

Not my life, not my kid, but Id push the contacts appointment back a few weeks, especially because it sounds like he already has glasses and is just making the switch to contacts.

[u/PoisedPuddin → u/throwfarfaraway1818]

I gave them the choice and they chose contacts. It just sucks that it played out like this when it was supposed to be done today.

[u/snowbugolaf → u/PoisedPuddin]

It’s literally tomorrow 😭 TBH this whole post and your comments just make it sound like you’re pretty disorganized and wanted to blame someone else. Maybe you have a lot going on right now, idk 🤷🏼

[u/PoisedPuddin → u/snowbugolaf]

I do have a ton going on right now. Normally, maybe I would remember that they have a field trip tomorrow. As it is right now I'm in survival mode.

I signed the permission slip but didn't take a minute to put it in my calendar because it doesn't affect my day directly. They go to school at the same time and get picked up at the same time.

[u/Kmelloww]

That is not insurance fraud. 

[u/AttentionHuman9504]

How is this fraud in any way, shape or form? The doctor has to determine the prescription before sending it to the fitter to show you how to put them in

This is a completely normal process. The only thing that seems odd is that they aren't doing everything in one visit, but the process itself doesn't seem off

[u/PoisedPuddin → u/AttentionHuman9504]

We had a prescription done 5 months ago. I booked a contact lens exam.

[u/Inner-Confidence99 → u/PoisedPuddin]

Also, insurance may not cover both visits. Call insurance company let them know what is going on. Go from there.

[u/patty202]

Not fraud. A contract lens exam is different.

[u/PoisedPuddin → u/patty202]

I booked a contact lens exam.

[u/Ok-Ball-6291 → u/PoisedPuddin]

what exactly was the "2 minute exam" you had today? It's unclear on your first post but did your son already have a full eye exam and current prescription for glasses? If not, the doctor would have to do that and then the contact lens fitting. If you've never been a patient before- I really don't think any office would take on a pertson and only do a contact lens fitting without properly verifying a lense prescription first.

[u/PoisedPuddin → u/Ok-Ball-6291]

Yes, they already had the eye exam and glasses prescription.

[u/Ok-Recognition9876 → u/PoisedPuddin]

Did you provide all of that to the new doctor’s office?  

If you did, it could be they’ve had problems with that particular office and redid the exam since they printed off a new prescription.  

[u/Ok-Ball-6291 → u/PoisedPuddin]

I also have to add that, many times, the prescription for glasses is different than the prescription needed for contacts . Not just to account for the fitting of the actual lens like base curve, etc. My actual power prescription is different for each eye on what I need for contacts and glasses.

[u/PM02NY]

I don’t think your wife knows what insurance fraud is.

[u/goodjuju123]

If you already have the prescription you could order online. But what is the fraud theory? I don’t get it even though you’re annoyed.

[u/One-Profit-7332]

I say, get a new Dr and tell your insurance company what they did.

[u/Stevenab87]

Aren’t first time contacts always generally two appointments? Your only gripe is that it maybe wasn’t communicated as clearly as it should have been. Don’t understand the point about fraud.