Patient resources
Insurance & fees
We file your medical insurance for you as a courtesy. There is one thing worth knowing before you book, so we've put it first rather than in the small print.
We are a medical practice, not a vision plan provider
We do not participate with vision plans — the kind of coverage that pays for a routine glasses check and a frame allowance. We bill medical insurance, which is what covers eye health: cataracts, glaucoma, diabetic eye exams, dry eye, injuries and everything else we treat.
If your only eye coverage is a vision plan, you are still very welcome — you would simply be paying out of pocket, or billing your medical insurance if the visit turns out to be a medical one. It is worth a call to us beforehand so nobody is surprised.
Medical insurance we accept
We accept most government and commercial medical insurance, including but not limited to Medicare, Medicaid, BCBS, Aetna, Cigna, United and Tricare. Our staff will file your claim for you as a courtesy.
Insurance changes constantly, and most carriers run several plans — we may participate in some and not others under the same name. Please call your insurer before your visit to confirm we are in network for your specific plan. We will bill exactly what you tell us, so the information you give at check-in is what determines how the claim goes out. If a claim comes back denied as out of network, we will bill you for the balance.
The refraction charge
A refraction is the "better one, or better two?" test that determines your exact glasses or contact lens prescription. It is a genuinely useful part of a comprehensive eye exam — but Medicare and most medical plans do not cover it, because they treat it as a vision benefit rather than a medical one.
It is therefore billed separately and is payable on the day. We mention it here because it is the single most common billing surprise in eye care, and we would rather you heard it from us in advance than from an invoice afterwards. Ask our front desk for the current charge when you book.
What you pay on the day
- Copays are collected at your visit, so please come prepared
- Refraction, where performed
- Deductibles not covered by your primary or secondary insurance
- Self-pay fees where you have no applicable coverage
- Premium lens upgrades for cataract surgery, which insurance does not cover
- Over-the-counter products such as drops
We accept cash, personal check, Visa, MasterCard and Discover.
Surgery costs
Cataract surgery involves three separate charges — the surgeon's fee, the surgical facility fee, and the anaesthesia fee. Standard cataract surgery with a monofocal lens is typically covered by Medicare and most commercial plans. You will be given a written estimate before you commit to anything.
Questions about a bill
Please call and ask. Our billing staff deal with hundreds of claims a day and can usually explain quickly what happened and why. They are the people best placed to help you, and they will.
Ultimately, if a claim is not honoured for any reason, responsibility for payment rests with you as the patient — but we will have made every reasonable effort first.