One of the most challenging issues in an ophthalmology office is explaining the difference of "Vision" or "Medical" insurance. If there is no medical discovery, (a medical diagnosis), the visit is considered routine and your medical plan will not cover. We do not submit claims to "Vision" plans. We provide comprehensive medical eye examinations and participate with most major insurance companies.
Vision plans provide coverage for routine exams, glasses, and contact lenses. We ask our patients to pay at the time for these services. We will be happy to supply a copy of the fee ticket for the patient to submit to their vision plan for reimbursement.
Medical Plans we participate with include:
- Arkansas Medicaid
- Arkansas Blue Cross Blue Shield
- Care Improvement
- Coventry Health
- PremierCare NWA
- Today's Option
- United Healthcare
We have found that within each of these plans are some that fall outside of the normal plans. With so many variations of plans for our patients to choose it is very difficult for us to be experts on all plans. Therefore, we strongly encourage our patients to be familiar with their individual insurance plan, its benefits, co-pays and deductibles.
A refraction is the part of the exam where the doctor determines the prescription for glasses. During a medical exam, a refraction is not necessarily done. Medical insurance companies separate the components of the eye exam; the comprehensive exam and the refraction. Medical policies typically cover the exam only and the patient is responsible for the refraction fee.
Many procedures performed by our doctors may be covered by insurance if the doctor agrees the procedure is "medically or professionally necessary". However, even when a procedure is "covered" by your health insurance if there may be a deductible that needs to be met or a coinsurance. Financial responsibility for the full cost of the procedure may shift to the patient.
If you have any questions concerning your coverage, again, we encourage our patients to contact their individual insurance plan.