- Most medical insurance plans do not pay for “vision” services.
- Most vision plans do not pay for “medical” problems.
Appointment times vary depending on the type of appointment. A full exam can take 1-2 hours. This includes the time needed to check your glasses prescription and to dilate your eyes.
A 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 insurance plans. These plans consider a refraction a “vision” service, not a “medical” service. If your insurance does not pay for refractions, you will be notified.
Yes, please bring all recent glasses (reading and distance) with you to your exam.
Your ophthalmologist will determine whether your eyes need to be dilated. A thorough, dilated exam allows your doctor to have a better view of the back of your eye to detect and diagnose common eye diseases and conditions at their earliest stages including diabetes, high blood pressure, macular degeneration, retinal detachment, glaucoma, and more.
It is the responsibility of the patient to know his/her benefits. Your insurance company determines what they will or will not pay for. We rely on the accuracy of information you provide and information from your insurance company representative to make an initial determination of coverage. Subsequent decisions made by your insurance company are outside of our control. We will generally file insurance on your behalf for covered services. We do expect you to make prompt payment for any portion which the insurance company will not be responsible.
We participate with many of the HMO and POS plans and other managed care 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 to reschedule the visit.
Please bring the following on the day of your visit to our office:
Current insurance cards
Current medication list
All recent glasses and contact lenses (both distance and near)
An insurance referral if your plan requires one
If you are a new patient, please register online at MyPatientVisit prior to your appointment. New patient forms can also be found here. Please print your completed forms and bring them to your appointment.
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 707.252.2020.