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La Quinta Optometrist says VA needs to pay

Optix of La Quinta says the Department of Veterans Affairs is giving them the run around for five months and owes the optometrist office more than $2000 for glasses and frames made for local veterans.

“Every time I send the claims they send them back,” say Jay Rein manger of Optix of La Quinta.

“Four times I sent the claims in, every time they sent them back telling me I need to do something different. The first time is ‘we can’t accept it if it’s hand written’, the second time is ‘we can’t accept it because it has to be original’. The next time ‘we cant take it because it’s on a black and white form and we need it on a red and white form’,” says Rein.

Eight months ago Optix of La Quinta joined a program with the VA where they would provide low cost eye exams and glasses for veterans.

Originally they were billing TriWest Healthcare for the exams and glasses, but a few months in, TruWest told the optometrist office they would only be paying for the exams, not the glasses and frames. Optix of La Quinta would need to bill the VA and pay back TriWest for the glasses they had already paid for. In total, it’s a cost of around $2000.

For the past five months Optix of La Quinta has been trying to get paid from the VA.

“It’s sort of like bait and switch,” says Dr. Bill Kiernan, owner of Optix of La Quinta, “it’s just one more headache fighting with the government and were supposed to be doing something good and it’s turning into egg on our face.”

Dr. Kiernan is a Navy veteran who served during the Vietnam War.

The Department of Veterans Affairs gave Optix of La Quinta options to get their bill submitted online.

“They gave me a website that I can bill the VA,” says Rein. “The problem with billing on the VA website is I have to purchase their software which is $150 and I have to pay a $125 maintenance fee for six months to accept for them. So I’m going to have to spend a $1000 to bill 10 claims,” says Rein.

“I had people forewarn me and say once you start dealing with the good old government there’s going to be a lot of red tape, but I was thinking how bad can this be,” says Kiernan.

Optix of La Quinta says they never had a problem getting paid for TriWest Healthcare. “TriWest says that the scanned all my forms into the system,” says Rein. “They can read my claims no problem the VA tells me that they can’t read them, they didn’t even try to scan them into the system they just refused,” say Rein.

News Channel 3/CBS Local 2 reached out to Congressman (D) Raul Ruiz’s office who contacted the VA. Shortly after, the VA contacted Optix of La Quinta and offered to streamline the process to get the bill paid.

“They are going to send me a form to be a vendor,” says Rein. “Then I can send the black and white typed form and they’ll pay the bill.”

Optix of La Quinta asked to be removed from the program and does not anticipate rejoining after the bill is paid.

KESQ News Team


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