My question involves insurance law for the state of: New York



Hi, I recently went to an Optometrist for an eye exam so that I can get a new prescription for glasses. I made sure she was in my network, and called to confirm that she accepted my insurance. I went in for an appointment and she checked my insurance again while I waited. I had my eye exam and got my prescription then she suggested that I come in the next week for a test to make sure I don't have glaucoma. Did the test and thought everything was settled.



Here is the problem: I did not fully understand my insurance process which I discovered to be an HMO. So I need a referral from my doctor to see a specialist. This I should have looked up. I did not find out however until the optometrist's assistant called a month later and told me that she (the assistant) had made a mistake [img]images/styles/el-evo/smilies/wallbang.gif[/img] and that I need the referral because it will not be covered completely.



So instead of checking my insurance properly and telling me when it occurred that I would be paying out of pocket, she called me up a month later and just said oops, my boss is mad at me, sorry but you have to pay yourself now. Am I responsible for her assistant's mistake? I tried talking to them, but they are just saying sorry and to pay the amount due. Can this be sent to collections or can anything bad happen to me? I was willing to make payments, etc. because I cannot afford it due to being a full-time student but they just want their lump sum. Thank you for reading. I hope I can get some advice here.