Our office deals with several contracted payors, including Medicare and most HMO and PPO insurances. We also accept all major credit cards, checks, and cash. Because many insurance companies do not give out fees until after the treatment is completed, it is sometimes difficult for our office to accurately estimate our patient’s co-payment. As a courtesy, we ask that you keep us informed of any change to your insurance. It is also important that all information about you is current.
*WE ACCEPT ALL MAJOR CREDIT CARDS, CHECKS, AND CASH*
Co-Payments: All co-payments are payable when you check-in at the front desk.
HMO Patients: If a patient comes to us with a problem that they expect to be covered by medical insurance, (biopsies, tumors, infections, deformities) they must have a referral from their physician. Obtaining a medical referral is the patient’s responsibility. We cannot obtain the referral for you, and the referral cannot be obtained retroactively. If you do not have a referral, we will be happy to see you on a cash basis, but your medical insurance company will not pay for your treatment.
Medicare Patients: Generally, Medicare pays us directly for your care. You are responsible for any deductible and co-insurance. If Medicare denies your procedure, you are responsible for the charges.
Private and Group Insurance: As a courtesy, we will file your insurance claims for you. Upon receipt of an insurance payment, any balance due will be billed to you. If you have deposited an excessive co-payment, it will be refunded to you.
Insurance & Insurance Collection
Please understand that insurance reimbursement can be a long and difficult process for our office. In fact, insurers will routinely stall, deny, and reduce payments. Our billing staff has undergone extensive training to maximize your insurance reimbursement, while reducing the time by which they pay. Thank you.
Non-Contracted Indemnity Insurance Plans
We will bill your insurance company as a courtesy. Our office, as a convenience and a service to you, we will absorb the costs incurred for billing. We require you to pay in full at the time of service. Your insurance company will send payment directly to you.
Plans In Which We Are Participating Providers
HMO PLANS All co-pays must be satisfied each and every visit. There can be no exceptions due to contracting and uniform compliance rules. You are responsible for getting proper referral information and authorizations in advance of your appointment. You will be responsible for payment for services denied by your HMO for lack of referral and/or pre-authorization.
PPO PLANS We have agreed to accept the discounted rate from your plan, however, all co-insurance is your responsibility. We will estimate balances to the best of our ability.
Self-Insured/Union Plans
This office has been thoroughly trained on how to get reimbursed by your employer; however, in the event there is a problem, you must provide us with the name of your human resources director and/or benefits manager. We may also require your authorization to file complaint letters to the Department of Labor and your administrator if necessary.
Medicare
As a participating provider, we will bill your Medicare carrier. You are responsible for your annual deductible and 20% co-insurance and we must collect it. We will be happy to bill your secondary payer as well. If a balance remains after we bill Medicare and your secondary insurance carrier, we will bill you for the balance, which is payable by you upon receipt of our statement.
Secondary Insurers
Having more than one insurer DOES NOT necessarily mean that your services are covered 100%. Secondary insurers will pay as a function of what your primary carrier pays. We may bill your secondary carrier as a courtesy. You are responsible for any balances after your insurance(s) has cleared.
Co-payments, co-insurance and patient deductibles
All co-payments, deductibles, share of costs and coinsurances are due at the time of service.
Services Not Covered By Your Insurance
Services not covered by your insurance are payable in full prior to or at the time-of-service. We will provide prior notification if you are going to receive a service that we know is not or may not be covered by your insurance. Some of these services may include refractions, refractive surgery, and premium intraocular lenses with cataract surgery.
Missed Appointments
There is a $35 missed appointment fee if you cancel or reschedule a clinic visit appointment with less than 24 hours advance notice or if you fail to arrive for your appointment.
Minor Patients
The adult accompanying a minor and the parents (or guardians) of the minor are responsible for full payment. For unaccompanied minors, non-emergency treatment will be denied unless charges have been pre-authorized to an approved credit plan, Visa/MasterCard, or payment by cash or check at the time of service has been verified.
