Special Billing Policies
All services performed are the financial obligation of the patient or responsible party. Fees are expected at the time services are rendered. Special billing policies will apply to the following patients:
Medicare. We accept assignment on Part B Medicare patients. You will be expected to pay your deductible and a 20 percent co-payment.
Medicaid. If your coverage is active, we will file your claim. Please bring proof of coverage to each visit.
HMO/PPO/Managed Care. Our physicians have agreed to be specialty providers for many of the HMO/PPO plans. It is important for you to consult with your insurance company and our billing personnel prior to your visit to determine which services are covered.
If you belong to a pre-paid plan, HMO, or Point of Service contract, you have an obligation to provide us with a referral number. These rules are stated in your health plan information book. This referral number must be obtained from your primary care physician (PCP) prior to your visit. Even if another eye doctor refers you to our office, you must have a referral number from your PCP. If you have an established PCP, you may be able to handle this by telephone. If you have no PCP and have an urgent medical problem with your eyes, you may not be able to obtain a number without being seen by a plan PCP. In this situation you will be responsible for payment of services. For urgent and emergency problems, our office staff will try to help you. Your health plan has the final word on authorization of referral services.
Most prepaid health plans require you to make a co-payment with each visit. These cannot be billed to you, and payment is required prior to the medical consultation.
We require 100 percent prepayment prior to the scheduling of any elective surgery. If you wish, our office will be glad to process your insurance claim for surgical procedures. Please be sure that we have your correct insurance information. If your carrier requires pre-approval or special forms, please notify our staff before your surgery.
If we file your claim, we allow 45 days for the claim to be paid by the insurance company. Following that period, you will be asked to pay.
If you do not have insurance or the ability to pay, help through a state agency or program may be available. Our staff can provide details.
Itemization of Charges
At the time of your visit, you will be provided an itemization of your charges and payments. You will need to retain this form as a record of your visit. A monthly statement of your account will be sent to you for any unpaid balance after your insurance company issues their Explanation of Benefits for your visit.