Insurance companies usually categorize visits to your eye doctor as either “routine” or “medical.” The type of eye exam you have is determined by your visit or your chief complaint, as well as your diagnosis. Most medical insurance plans do not pay for “vision” services. Most vision plans do not pay for “medical” problems. When you schedule your appointment, please let us know the reason for your visit, what insurance plans you have, and we will help you determine which plans may be appropriate for your visit.
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 eyeglasses prescription and to dilate your eyes. If you are coming to see a retina specialist, the examination may well be longer due to frequent additional testing.
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.
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.
Everybody’s eyes will react different to the dilating drops. On average, we say that your eyes will remain dilated for 8-12 hours after your appointment, but some patients may stay dilated longer. Please bring your sunglasses with you to the office.
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 the 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 a 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: