Financial Policy

Financial Policy

Thank you for choosing Consulting Ophthalmologists, P.C. as your eye care provider. We are committed to building a successful physician-patient relationship with you. Your clear understanding of our Patient Financial Policy is important to our professional relationship. Your payment for services is a part of that relationship. Please ask if you have any questions about our fees, our policies, and your responsibilities. It is your responsibility to notify our office of any patient information changes (i.e. address, name, insurance information, etc.).

Insurance Claims

Please bring your insurance cards to every visit. In order to properly bill your insurance company, we require that you provide accurate and current insurance information including primary and secondary insurance. Failure to provide complete insurance information may result in patient responsibility for the entire bill. Although we may estimate what your insurance company may pay, it is the insurance company that makes the final determination of your eligibility and benefits. If your insurance company is not contracted with us, you agree to pay any portion of the charges not covered by insurance, including but not limited to those charges above the usual and customary allowance. It is your responsibility to check with your insurance company to be sure we participate with your plan. If we do not participate in your plan, you will be responsible for full payment.

Vision Plans

We participate with some Vision Plans. Please check with your plan to see if we are members of your particular Vision Plan. If we do not participate, services are payable at the time of service.

Co-pays

All co-payments are due at the time of your visit. We accept cash, check or credit cards.

Patients with no Insurance

Self-pay accounts are for patients without insurance coverage, patients covered by insurance plans in which the office does not participate, or patients without any insurance card on file with us. Liability cases will also be considered self-pay accounts. We do not accept attorney letters or contingency payments. It is always the patient’s responsibility to know if our office is participating in their plan. If you come for an office visit and we do not participate with your insurance company, we assume you decided to see us as an out-of-network provider.

Good Faith Estimate

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 (800) 985-3059.

Routine vs. Medical Exam

A Routine Vision Exam is a screening exam which is performed as a “healthy” visit. It is most frequently requested by patients to determine the need for corrective lenses. Not all insurances cover screening exams or offer a “vision” benefit. It is your responsibility to know if you have this benefit and how often it may be available. You will be responsible for payment if your vision exam is not covered. A Medical Exam is billed to your medical insurance with the symptom or condition which was examined on the day of the visit.

Refraction

Refraction is the process of determining the eye’s need for glasses or contact lenses. This is often done by checking your ability to see an eye chart using corrective lenses. Refraction also provides us with important information about the function of your eyes and may alert us to any problems that are related to a decrease in visual acuity. Our Refraction fee is $40.00 and generally not covered by insurance, including Medicare. It is billed to the patient in addition to the exam charge and is payable at the time of service.

Financing

Our office accepts Care Credit, a healthcare credit card that is used to pay out-of-pocket expenses. Click here to learn more.

Already a Care Credit cardholder? To pay your balances online with your Care Credit account, click here to use the “Pay My Provider” option.

Workers’ Compensation and Automobile Accidents

In the case of a workers’ compensation injury or automobile accident, you must obtain the claim number, phone number, contact person, and name and address of the insurance carrier prior to your visit. If this information is not provided, you will be asked to either reschedule your appointment or pay for your visit at the time of service.

Minors

The parent(s) or guardian(s) who accompanies the minor is responsible for full payment and will receive the billing statements.