San Diego

Getting the Runaround On a Medical Refund

NBC 7 Responds clears things up for Scripps Ranch woman who was seeing red over an eye procedure.

More than 191 million people in the United States wear prescription glasses, contacts, or uses some type of vision correction, according to the research group The Vision Council. [LINK:]

But for Athletic Trainer Holly Stroschine, wearing glasses and contacts wasn’t enough and often got in the way of her training.

Two years ago, eye doctors diagnosed Stroschine with Keratoconus, an eye disease that affects the corneas. Shortly after the diagnosis, Stroschine says the FDA approved a new procedure called cross-linking, aimed at curing the disease.

“There aren’t very many doctors who do it in the area,” said Stroschine. “I finally managed to find two or three in San Diego.”

Stroschine decided on having the procedure done at La Jolla Lasik. During her consultation, Stroschine requested that staff make sure that her insurance would cover the procedure.

“She said yes it was approved by the FDA and so, therefore, it should be covered by my insurance companies,” Stroschine said.

Staff at the clinic scheduled the surgery and told Stroschine that she would have to pay $7,000 up front for the procedure and she would be reimbursed by the clinic once the insurance company paid them. She agreed and moved forward.

But two weeks later, during a follow-up appointment, she asked the doctor whether her claim had been submitted to her insurance company. Stroschine said the doctor told her the claim had not yet been submitted.

“I've gone to so many doctors in my life you know for all sorts of injuries,” added Stroschine. It’s always the same, they send a claim to your insurance company and usually, you get your money back within a month or two. But, of course, this turned out nothing like expected.”

Weeks turned into months. And Stroschine said she never received the check.

After the fourth month, she decided to take action. She filed a claim directly to her insurance but the company rejected it because it did not have an itemized receipt with it.

“Six months went by, then seven months, eight months. I was concerned because I know that a claim has to be filed within one year or the insurance company is not responsible,” said Stroschine.

Not long after Stroschine was watching the Olympics and something caught her eye.

“During the Olympics, I saw an ad for NBC 7 Responds,” said Stroschine. “I thought, ‘Hey maybe this will work,’ Nothing else was, so I contacted you.”

Producers got to work and a few weeks later Stroschine finally got her check.

“I don't know what NBC 7 Responds said but as soon as you called we got some response about that claim. Thanks for making such a difference.”

NBC 7 Responds reached out to La Jolla Lasik. They were unable to comment citing doctor/patient confidentiality.

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