Sunday, July 3, 2016

EYE$ ON THE PRIZE - Breaking Exclusive!!


Temecula, CA - In the United States, larceny is a common law crime involving theft. Under that common law, larceny is the trespassory taking (caption) and carrying away (asportation, removal) of the tangible personal property of another with the intent to deprive him or her of its possession permanently. Today most jurisdictions have eliminated the crime of Larceny from the statutory codes, in favor of a general theft statute.

Larceny by trick was created to punish the taking of property with the owner's consent when that consent was obtained by Fraud or deceit. Before the courts created the offense of larceny by trick, defendants who had swindled their victims were able to argue that they had not committed larceny because the victims had willfully given them property.

Because the Temecula Calendar stands for what we believe in delivering just the facts, like Dragnet we present to you, dear reader, a report alleging local larceny complete with redacted exhibits, pulled right from AARP's headlines of Medicare Fraud. A call to my Medicare mole in Denver got this reply when questioned on the topic. “Medicare fraud is rampant!” [$60,000,000,000 per year - AARP].

This allegation concerns not some recent tenant to the valley, but a long time resident. As you read of a proposed Temecula sales tax ramp-up for revenue, please remember this report from someone who reached out to us to release the facts. After the jump, the local alleged larceny licensed[?] by Lobue Laser & Eye Medical Centers.

Our eye witness:

'I needed new eye glasses and my primary physician referred me to a Dr. Kim, at the Temecula branch of Lobue Laser & Eye Medical Centers. I arrived on time, filled out the necessary paperwork and waited a few minutes to be called. There were no other patients waiting, it seemed. I can't be more sure as my glasses had become unusable by my appointment time and the world at any distance was a blur.

Dr. Kim then gave me his exam which probably lasted a half hour max, including having my eyes dilated. He handed me my prescription to give to the optician in the same office area across the aisle way in the general office area. I handed her my prescription slip and she typed in my info.

This took several minutes which seemed strange since the prescription wasn't complicated. The amount of typing could have been text communications. After this, she said that they could fix me up with frames and lens for $552. The lens were to be single vision, not bifocal. I inquired if this amount included my $100 deductible [since they had my insurance info], and she said 'Yes'. All this was done and I hadn't been shown a single pair of frames. I paused for about a minute, and then asked for my prescription back. There had been conversation to the possibility of paying half now on this visit and the other half in the following month. I said, 'No, I'll just take my prescription. Having not even been shown frames but quoted a total price of $652 seemed like putting the cart before the horse. I didn't get a good feeling for this method of business and never recalled ever been given a final price without seeing a single set of frames first to chose from.

She handed me back the prescription the doctor had given me. The doctor mentioned wanting me to return for some glaucoma tests and I half-nodded, but I knew I was never coming back there, ever! I asked what the charge was for the prescription. He said, “No charge.” I walked out and got my trip home.

I found an online deal for $185 after picking out the frames I wanted and getting the lens style also, but there was one more snag. The doctor's prescription was only 2/3s complete. Missing was my PD. I was later able to get this measurement then convert it to millimeters. I was able to get this measurement and complete the order. My new glasses arrived before the month of May was over.

On Monday, June 20th, I received an explanation of benefits claim #88930125767. The acct # was dated 6-17-2016. The service code and reason code shows that I am responsible for the itemized $85 charge. On Tuesday, June 21st, I received another explanation of benefits claim #88930125766. The acct # was also dated 6-17-2016. The service code and reason code this time shows Humana responsible for the itemized $475 charge, minus a $40 [paid amt.?], leaving Humana on the hook for $435, and me for $85, grand total $520, two dollars shy of the doctor's optician's original quote.

A call to the eye professional network didn't seem to generate what I thought should be a proper response for outright fraudulent charges. Written complaints have been filed.' Patient X

Further patient investigation revealed these conclusions.
  1. The two different services, split for billing purposes, are considered all part of the same exam.
  2. The general market cost for this exam is $89, and that includes all 3 measurements. This would be covered by my vision portion of my insurance carrier.
  3. The prescription was written on forms addressed from a different LoBue branch, and the doctor is also listed at that same branch, neither of which are Temecula.
  4. The LoBue website does not list or show any of the personnel encountered during my visit, though the site drag down category lists Doctors & Staff.
  5. The Temecula branch office has had the same location [not sure of the staff] for at least 15 years so it is not a new start-up.
  6. The yelp reviews are telling in that they are fives or ones, with one about bogus charges also.
  7. This report was filed after two days of attempts to reach the LoBue billing department, to no avail [billing at lunch 11:20 to 4:00, overlapping shift, home emergency]. Leaving a name and phone number wasn't an option the patient wanted as there is a time limit to file a complaint.

Given the recent talk of a city sales tax spreading like a new trend, it's time to look at ways to stop the blatant established way the middle class are being robbed by those in positions of trust, not to take more from the working and retired classes.

First of our July 4th looks at America past all the flag waving and fireworks. “In the days of Noah...”

(Filed while listening to Stand For What You Believe - Poison)

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