Visionary Eye Care Professionals
Understanding your Insurance, and your Agreement with our Office
VISION INSURANCE: We participate in VSP and Eyemed and will bill your plan for all available services as necessary. If we do not participate with your vision plan, payment in full is required at the time of service, unless other arrangements have been made in advance. Knowing your insurance benefit; eligibility for services, covered service and material benefits and applicable copays for exams and materials are your responsibility. Please contact customer services at your insurance company for questions you may have regarding your coverage. You are responsible for any charges not covered or denied by your plan. Traditionally, vision coverage is secondary to a medical insurance plan and serves to cover routine eye exams, glasses and/or contacts.
MEDICAL INSURANCE: We participate in many managed care plans and will bill your insurance plan as may be necessary. If we do not participate with your managed care plan, payment in full is required at the time of service, unless other arrangements have been made in advance. Knowing your insurance benefits – including eligibility, covered benefits, and medically necessary procedures is your responsibility; please contact customer services at your insurance company for questions you may have regarding your coverage. You are responsible for any charges not covered by your plan. Traditionally, medical insurance does not cover routine eye exams or materials although some exceptions do apply. Visionary can bill your medical insurance when providing medically focused eye care outside of your routine annual exam.
Medicare & Secondary Coverage: Please present both your medicare and secondary forms of coverage at the time of service. You are responsible for informing medicare of your secondary coverage to insure that claims are forwarded and paid correctly. Any amount not covered by Medicare or your secondary insurance is your responsibility and will be billed to you directly.
Proof of Insurance: All patients must complete and/or update our Patient Information Form at each office visit. You must furnish valid and up-to-date proof of insurance coverage and a copy of your driver’s license. If you provide false or expired insurance information or neglect to verify your insurance information upon the request of our office you will be responsible for the balance of the claim. Please notify us of any changes in insurance coverage at least 24 hours prior to time of service. Insurance denials for termination of coverage will be automatically billed to you.
Co-payments, outstanding balances and deductibles:. All co-payments and outstanding balances must be paid at the time of service. By contractual law your insurance company requires us to charge for, and requires you to pay for, all applicable co-payments, coinsurances, deductible and non-covered services. Any services applied to your deductible are your responsibility and you will be billed accordingly.
Claim submission. We will submit your in-network insurance claims and assist you in any way reasonable to help get your claim paid. Your insurance company may need you to supply information directly to them. It is your responsibility to comply with their request in a timely manner. Please be aware that the balance of your claim is your responsibility to pay whether or not your insurance company has paid. We are not a party to your insurance contract.
Referrals. If your managed care plan requires approval or authorization for referrals to a specialist, radiological imaging, medical facility care, etc., it is your responsibility to inform our office of this requirement prior to referral. We require 72 hours notice to facilitate a referral request and cannot issue retroactive referrals.
OUT-OF-NETWORK CARE: Please be aware that you have an option to seek care from Physicians even though they are not participating in your network. We are happy to provide you with any information necessary to aid you in self-submitting for reimbursement from your insurance company.
By signing the financial agreement and office policies acknowledgement on the intake form provided by staff, I understand that I am agreeing to the above for the term of my engagement with Visionary Eye Care Professionals, or upon such time that there is a change of policies, at which time I will be informed and asked to renew my agreement.