Our office has been working with your insurance companies to ensure we are following the regulations they have set forth. With this, you may notice changes to the way we must bill your visits to our office:
Understanding Your Vision and Medical Insurance:
There are two types of health insurance that will help pay for your eye care services and products. You may have both and our practice accepts both: Vision care plans (such as VSP and EyeMed) and Medical insurance (such as Blue Cross/Blue Shield and Medicare). Vision and medical insurance are very different in terms of what is covered, and it is important for our patients to understand the difference. As an optometrist, I am required to abide by the rules set forth by your insurance company.
Vision care plans only cover routine vision exams along with eyeglasses and contact lenses. Vision plans only cover a basic screening for eye disease. They do not cover diagnosis, management or treatment of eye diseases or medical eye conditions.
Medical insurance must be used if you have any eye health problem or systemic health problem (such as diabetes, hypertensive eye changes, or dry eye that has ocular complications). During your exam, your doctor will determine if these conditions apply to you.
If you have both types of insurance plans, it may be necessary for us to bill some services to one plan and other services to the other. We will use coordination of benefits to do this and to minimize your out-of-pocket expense. Each of your insurance plans has deductibles and copays which we are required to collect in your agreement with them.
We are an intermediary between you and your insurance. We will bill your insurance plan for services if we are a participating provider for that plan. We will attempt to obtain advanced authorization of your insurance benefits, so we can tell you what is covered. We encourage you to contact your insurance company as well. It is important to know, insurance does not guarantee the information they are giving us is correct. If some fees are not paid by your plan, the remaining charges will become your responsibility. We will bill you for any unpaid deductibles, co-pays or non-covered services as instructed by your insurance contract. If your insurance covers a portion we have collected from you, we will refund you the difference.