Policy & Procedure

To our patients

We are here to provide you with the eye care you need. We have established fee and payment policies that enable us to have the quality staff and facilities that are necessary to provide the care you expect. This explanation of our payment policies has been prepared so that you can help us maintain quality services. Like you, we are very concerned about the cost of health care. Our payment policies are designed to enable us to reduce unnecessary collection cost which would otherwise increase the cost to our patients.

Your Responsibilities for Charges

You are ultimately responsible for the payment of charges for services you receive. We rely on accuracy of information you provide to determine if a third party will be responsible for payment. If you will be paying personally for services or if you are responsible for a deductible or copayment, we expect payment at the time service is rendered. We accept cash, personal checks, Visa, MasterCard, Discover and American Express.

If payment is to be made through an insurance company of medical plan and we have agreed to accept assignment from that plan, then you are responsible to complying with all procedures required by that plan to enable us to receive payment on your behalf. To assure that your insurance or medical plans will provide covered benefits, you must let us know at the time you schedule your appointment and when you check in.

You are responsible for payment of any non-covered services as well as finance charges for overdue payments and fees for return checks and collection agencies.

Medical vs. Vision Services

Insurance plans differentiate between “medical” and “vision” problems. Most medical insurance plans do not pay for “vision” services. Most vision plans do not pay for “medical” problems. While some medical problems are obvious, when you have an eye problem, it may be at most impossible for you to know if it is a “vision” or “medical” problem. If you have a medical eye problem, we can file a claim with your medical plan. If you simply need an eye exam, that is usually a vision service and would not be covered by a “medical” plan but would be covered if you have a “vision” rider or a separate “vision” plan such as VSP or Eyemed.

When you make your appointment, please let us know what plans you have we will help you determine which plans may be appropriate for your visit

Medicare and Supplemental Plans

We accept assignment for Medicare and will file supplemental claims for those plans that accept a claim directly from Medicare. Medicare has a deductible and coinsurance which is the patient responsibility to pay at the time of your visit. A refraction, which is normally part of an eye examination, is NOT a covered service under Medicare and payment is your responsibility.

Insurance Plans

Your insurance company determines what they will or will not pay for. We rely on what an insurance company representative tells us to make an initial determination of coverage. Subsequent decisions made by your insurance company are outside of our control. We will generally file insurance for you for covered services. We do expect you to make prompt payment for any portion the insurance will not be responsible.

Referrals

We participate with many of the HMO and POS plans and other managed care medical plans currently offered in this area. If a written referral is required by your plan, you must provide such referral before the service is provided. If you do not have a valid referral form at the time of your visit, it will be necessary for you to pay for services at the time of the visit or reschedule the visit.

Refraction Service and Fee

Refraction is the process of determining if there is a need for corrective eyeglasses or contact lenses. It is an essential part of an eye examination and necessary to write a prescription for glasses or contact lenses. It is NOT a covered service by Medicare or most “medical” insurance plans. These plans consider a refraction a “vision” service not a “medical” service. Our office fee for refraction is currently $30.00 and this fee is collected at the time of service in addition to any copayment your plan may require. We will not file the charge for refraction with an insurance plan unless we know that your plan pays for the refraction charge. Should your plan pay us for the refraction, we will reimburse you accordingly.