NOTICE: The information on this page is meant to be used as a guideline only. Due to rapidly changing policies by insurance carriers, it is near impossible for our staff to obtain 100% accurate information from insurance carriers 100% of the time. We also recognize that issues relating to payment can be a major source of patient frustration following any visit, no matter the level of medical care delivered. Many patients do not understand their benefits or realize their employer may have chosen an alternate Vision Plan than their medical insurance. On a related note, many patients disregard patient balances that eventually may end up in Collections with an adverse effect on an individual's credit report. All of this can be avoided. We are happy to assist you in verifying your benefits provided we have your information prior to your visit. Many a time, we can only determine what benefits you have after examining your insurance card or cards. As such, if you have any questions, please contact your HR director or insurance carrier directly BEFORE your visit. Or feel free to contact us by phone or visit our location PRIOR to your exam date so that we can provide you the most up-to-date information after receving your information.
The policies on this page are subject to change at any time at our discretion.
Financial Information Policies
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.
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.
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.
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.
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.
Payment in full is expected at the time of delivery for all contact lenses, contact lens supplies and for glasses and optical accessories.
For your convenience, we accept Visa, MasterCard and American Express.
All charges not covered by insurance companies are due at the time of service and/or dispensing of goods.
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.
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.
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