In order to make your financial obligations to our office and keep the necessary insurance paperwork as simple as possible, we ask that you observe the following policies.

Private Insurance Carriers

Payment is expected at the time of service for all procedures unless prior arrangements are made. Upon request, copies of our fee bill are provided for your convenience in filing claims to your insurance carrier.

Medicare

We will file all claims to Medicare with a valid signature on file. We will also file with your secondary insurance. Routine eye exams and refractions are not covered by Medicare and payment is requested at the time of service.

Health Care Plans

All claims will be filed to your insurance carrier. Co-payments are due at the time of service. Contact lens evaluations and contact lenses are usually not covered by most Health Care Plans. Please check with your carrier for information about this.

Manage Care Plans/ PPO

A valid authorization is required for all services performed. All claims will be filed for you to your insurance carrier. Co-payments are due at the time of service. Please check your insurance handbook or check with your insurance company before scheduling an appointment to be sure you will be seeing a participating provider. Failure to obtain a valid referral will result in the patient being financially responsible for all charges incurred.

Workers Compensation

We will file your claim with Workers Comp when we receive your claim number. Please notify our office with your claim number as soon as you receive it.

Please bring all health insurance information with you. We will need to copy any insurance cards for our records.

Feel free to contact our office if you have any billing or insurance questions. Our staff will be happy to assist you. While we are happy to assist you, given the time and presented with the correct information, it is ultimately the responsibility of each patient to verify their own insurance benefits. Our offices cannot be responsible for incorrect information relayed to us by the insurance carrier or when provided incorrect insurance data.

The best medical care can be provided only on the basis of mutual understanding. We encourage you to discuss any questions you may have regarding our policies with our billing staff.

Eye Exam

If you pay cash at the time of service and we do not have to bill you or your insurance we offer a cash discount from our normal comprehensive eye exam fee. In some cases when a medical problem is found, we may be able to bill your medical insurance. New Medicare guidelines ask us to break your visit into a medical portion, which we can bill to your insurance company, and a glasses prescribing (refractive) portion for which you are responsible.

Medical Service

Services covered by an insurance company with which we have an agreement will be billed. Services not covered will be due at the time of service.

Optical Goods

Payment in full is expected at the time of delivery for all contact lenses, contact lens supplies and for glasses and optical accessories.

Credit Cards

For your convenience, we accept Visa, MasterCard and American Express.

Billing

All charges not covered by insurance companies are due at the time of service and/or dispensing of goods.

Insurance

We participate in a variety of insurance plans and will directly bill your insurance under these plans. In this circumstance you are responsible only for applicable copayments before the visit. If you have hot met your deductible, payment is due at the time or your visit. We cannot accept responsibility for negotiating claims with insurance companies. You are responsible for payment of your medical care within a reasonable time, regardless of status of a claim. Services not covered by your insurance are your responsibility.

Copayments

When your insurance specifies a copayment (usually indicated on the identification card), this payment must be made at check-in, prior to your exam.

We Participate in Medicare

We are participation providers under Medicare. This means we accept the fees set by Medicare for medical services covered by the Medicare program, including surgery. Medicare patients will be responsible only for copayments, deductibles and non-covered services, such as refractions and routine eye exams.

Medicare Refraction Policy

Refraction is a measurement of the lens power necessary to prescribe glasses or other corrective lenses. Most medical insurance plans, including Medicare, do not cover routine refractions or routine eye examinations (when no medical eye problem is known or suspected). Medicare allows that we charge separately for that portion of the examination, since it is not a covered service. If you have a separate vision plan that covers routine or annual eye examinations and/or glasses, please let us know. Your vision plan may assist you with your eye care needs that are not covered by your medical plan. .

If you have any questions regarding Medicare and insurance policies and procedures, please do not hesitate to ask. We will do our best to assist you.

Prior Authorization and Vision Care Forms

Some health maintenance organization (HMO) plans require you to obtain authorization for services from your primary care provider (internist, family practitioner, pediatrician, etc.). It is your responsibility to obtain authorization from your primary care provider. This is required by your insurance before you visit our office, even when the visit is for an urgent problem. Contact your insurer if you have questions, or contact the office of your primary care provider.

Claim Form Preparation (where we do not bill your insurance)

We provide an invoice (sometimes called a physician portion of the claim form). Our patient accounting office will be happy to assist you with instructions for completing your claim form. Most insurance companies will accept this statement with no additional forms needed.