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Sep 19, 2015
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#41
Looking at the photo of the place, and reading that the glasses are paid for by Medicaid, this looks like a really bad choice as far as optical stores. It looks like a "welfare mill". "Transitions" is not a coating applied at a store, but a brand-name for a lens that changes colors. Other companies also make similar lenses, and like someone said, it is like "Kleenex" used generically and improperly. So I googled "eclipse" in the context of color-changing lenses, and there is no such company. Going by the column it is listed in on the receipt, and also going by the narrative that they went in the back of the store to make them darker, I believe this is simply the store's name for their coating - which does not adapt to light, but is a fixed color. That is a lot of money to be charged for a color coating, and the word "scam" is probably appropriate. Contacting Essilor would be a huge waste of time. A chargeback on the credit card would be one option. Complaining to Medicaid would be another option - probably the best choice.
I am not sure complaining to Medicare would help. Medicare was not billed for the “Transitions”
the OP was. Medicare only is concerned when they are defrauded.
 
May 15, 2016
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#42
First of all, Medicare and Medicaid are not interchangeable. This is Medicaid. Medicare does not cover glasses (except for certain circumstances after cataract surgery). Secondly, Medicaid credentials this center. They did pay for the glasses portion of this bill. They have a vested interest in their clients being treated honestly. Insurance companies take a HUGE interest in this kind of problem; unfortunately Medicaid maybe somewhat less than other insurance companies.
 
Sep 19, 2015
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#43
First of all, Medicare and Medicaid are not interchangeable. This is Medicaid. Medicare does not cover glasses (except for certain circumstances after cataract surgery). Secondly, Medicaid credentials this center. They did pay for the glasses portion of this bill. They have a vested interest in their clients being treated honestly. Insurance companies take a HUGE interest in this kind of problem; unfortunately Medicaid maybe somewhat less than other insurance companies.
You must have different experience with insurance companies from me. I could not get my private insurance to look at an overbilling of an appointment -- billed for comprehensive visit when it should have been brief.

I suspect Medicaid will look at this as a bad upselling of a product that they do not even cover. Will they questions the credentialing over this? I think it is doubtful, as there are so few places that accept the Medicaid restrictions.

I remember how hard it was to get a wheelchair from a provider that took Medicare -- medically necessary but almost impossible to find one quickly -- the supply stores stopped dealing with Medicare because of all the paperwork.

And to be blunt, this is New York City. There are people defrauding Medicaid through false billings where the amounts are in the millions of dollars. That is where the enforcement actions are concentrated.
 
May 15, 2016
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#44
We all bring different experiences to the forum. Yours are valid. I am surprised to hear that a private insurance company was not concerned about overbilling for complexity - that is fraud. As far as supplies - it is unreal how high medical equipment is reimbursed - and I have never seen a supplier who did not take Medicare readily - unless they were suspended from the program. Paperwork is just part of what they do. Now Medicaid is different- many suppliers do not deal with that.
 
Sep 19, 2015
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#45
We all bring different experiences to the forum. Yours are valid. I am surprised to hear that a private insurance company was not concerned about overbilling for complexity - that is fraud. As far as supplies - it is unreal how high medical equipment is reimbursed - and I have never seen a supplier who did not take Medicare readily - unless they were suspended from the program. Paperwork is just part of what they do. Now Medicaid is different- many suppliers do not deal with that.
Thank you and your observations are equally valid. I have just found that in NYC (where I live) the resources are focused on the major frauds as there as so many.

And yes I was really annoyed about my private insurance and the dr -- complained to the office of said doctor, never returned to that doctor, and complained to the doctor that referred me. Even though it did not cost me any more money, I was unhappy -- and knew this was not a place I wanted to return. Of course I only found out after the fact when I received the EOB.

I would not discourage the OP from complaining but suspect the complaint would be overwhelmed in a sea of other cases of more serious fraud with Medicaid.

As for the Medicare wheelchair, the medical equipment people basically said it is not worth the hassle for us (ie people pay out of pocket so why bother) .... the other medical supplies providers were much further away (close to an hour by car) -- so we went to a not for profit that has a store, people donate slightly used equipment and the proceeds support people with MS. That seemed far more beneficial to everyone.

I do want the OP to have a proper resolution and do agree that she has not been treated well and that this has been a highly dubious transaction. I cannot remember what I paid for my Transition lenses at the optician in NYC -- but as I do not have vision insurance so my choices of providers was not as limited. In no way do I believe that the OP was treated properly from those photographs.
 
Jun 9, 2019
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#46
https://www.transitions.com/en-us/coa-registration/Transitions
Carol, use this to request contact information. Our research guru may be able to find the CEO:

https://www.elliott.org/research/
Hi. Christina. Just this morning I recieved a call from GVS Head Quarters(Teresa) saying they are sending me a label so can send them the glasses to be fixed. I asked what about the $100. fee and was told they would take care of it. I don't know whether to trust them. Do they want the glasses to hide evidence, or could they send the glasses out to a reputable eye glass store that does transitions? I wrote and called Transitions.com, waiting on a reply. I also contacted Essilor and waiting on response. Whats thoughts on this matter? Carol
 

Neil Maley

Moderator
Staff Member
Advocate
Dec 27, 2014
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www.promalvacations.com
#47
I would ask her what they are going to
“Fix”. Are you getting transition lenses or are they just going to tint them darker? I’d ask why the receipt you have says nothing about these being “transition” lenses and what they are doing to them as well as how long it will take. I’d also ask why they can’t be corrected in the store that sold them to you.

If I had satisfactory answers, I’d send them back and get them fixed. And make sure you send with proof of delivery.
 
Jun 9, 2019
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#48
Carol, use this to request contact information. Our research guru may be able to find the CEO:

https://www.elliott.org/research/
Just this morning I recieved a call from GVS Head Quarters(Teresa) saying they are sending me a label so can send them the glasses to be fixed. I asked what about the $100. fee and was told they would take care of it. I don't know whether to trust them. Do they want the glasses to hide evidence, or could they send the glasses out to a reputable eye glass store that does transitions? I wrote and called Transitions.com, waiting on a reply. I also contacted Essilor and waiting on response. Whats thoughts on this matter? Today I will contact Consumer Affairs, Medicaid and The Attorney General. I ve been in contact with Krisseye and Christina H. Before I print out this label I'd like all thoughts. and then call H.Q. Teresa and ask some questions. Thanks so much. Carol
 
May 15, 2016
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#49
As for the Medicare wheelchair, the medical equipment people basically said it is not worth the hassle for us (ie people pay out of pocket so why bother) .... the other medical supplies providers were much further away (close to an hour by car) -- .
? I went to medicare.gov, did a search, put in a Manhattan zipcode, and put in "wheelchair-manual" and there are 178 Medicare suppliers within 10 miles. There has to be more to your issue. I can assure you that is not normally a problem for a Medicare covered patient to get DME (durable medical equipment) in a no-hassle manner.
 
Jun 9, 2019
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#50
I would ask her what they are going to
“Fix”. Are you getting transition lenses or are they just going to tint them darker? I’d ask why the receipt you have says nothing about these being “transition” lenses and what they are doing to them as well as how long it will take. I’d also ask why they can’t be corrected in the store that sold them to you.

If I had satisfactory answers, I’d send them back and get them fixed. And make sure you send with proof of delivery.
I was told by
I would ask her what they are going to
“Fix”. Are you getting transition lenses or are they just going to tint them darker? I’d ask why the receipt you have says nothing about these being “transition” lenses and what they are doing to them as well as how long it will take. I’d also ask why they can’t be corrected in the store that sold them to you.

If I had satisfactory answers, I’d send them back and get them fixed. And make sure you send with proof of delivery.
 
Sep 19, 2015
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#53
? I went to medicare.gov, did a search, put in a Manhattan zipcode, and put in "wheelchair-manual" and there are 178 Medicare suppliers within 10 miles. There has to be more to your issue. I can assure you that is not normally a problem for a Medicare covered patient to get DME (durable medical equipment) in a no-hassle manner.
This was not in Manhattan.... WA state for a relative.
 

Neil Maley

Moderator
Staff Member
Advocate
Dec 27, 2014
18,939
17,165
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New York
www.promalvacations.com
#54
The store can't fix them Krisseye looked them up at Transition.com and they are listed as a place that does transition glasses.
But did you actually get transition lenses? There is no indication on the receipt. And the picture you showed of the glasses on you don't look like transitions.

I would verify from the woman that called you that are you going to be receiving are transitions.
 
Likes: xoqtox1960
Jun 9, 2019
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#56
But did you actually get transition lenses? There is no indication on the receipt. And the picture you showed of the glasses on you don't look like transitions.

I would verify from the woman that called you that are you going to be receiving are transitions.
Question even though GVS called to fix the glasses should i still contact Attorney General?
 
Jun 9, 2019
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#58
I, too, am concerned that this is an instance of saying a brand name and meaning something similar but different. Of even greater concern to me is the runaround, alter the documents, and charge more to fix. I would create a paper trail by writing a bullet-point list of events ordered by date. Include the list in the body of a short letter to the store manager. Make an appointment with the manager and hand deliver the letter to him/her. If the store manager has not corrected your issue within a week or so, then send your copies of the letter and list to the state attorney general consumer affairs department. Good luck.
Hi, I got a call out of the blue from GVS HQ Teresa, telling me she sent a label for me to sent them back to fix. GVS is not on the Translation list. Translation .com, so how are they going to fix them?
 
Jun 9, 2019
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#60
I, too, am concerned that this is an instance of saying a brand name and meaning something similar but different. Of even greater concern to me is the runaround, alter the documents, and charge more to fix. I would create a paper trail by writing a bullet-point list of events ordered by date. Include the list in the body of a short letter to the store manager. Make an appointment with the manager and hand deliver the letter to him/her. If the store manager has not corrected your issue within a week or so, then send your copies of the letter and list to the state attorney general consumer affairs department. Good luck.
Hi, I got a call out of the blue from GVS HQ Teresa, telling me she sent a label for me to sent them back to fix. GVS is not on the Translation list. Translation .com, so how are they going to fix them?
Hi, I got a call out of the blue from GVS HQ Teresa, telling me she sent a label for me to sent them back to fix. GVS is not on the Translation list. Translation .com, so how are they going to fix them?
I already contacted the VP of Gvs and spoke to Head Quarters and the manager. If they are not allowed to do transitions, hoe will they fix them?