Billing & Insurance

Thank you for choosing Clarity Advanced Eyecare for all of your eyecare needs. Below, you will find information on our office policies and how insurance is billed. If you have questions regarding your eligibility and benefits, please do not hesitate to ask.

We ask that you please bring your insurance card to your appointment. In order to properly bill your insurance, please make sure you provide us with accurate and updated information on primary and secondary coverage, as well as any updates on your name and address. Please be advised that we are mandated to follow the guidelines set forth by your managed care plan when billing for services.


Insurance Plans – What is the difference between Medical and Vision Insurance?

Most supplemental vision plans are designed to include a routine vision examination. This will typically cover a basic refraction (vision check) and eye health screening. This type of exam is best suited for patients without any ocular conditions, symptoms, or findings. Vision insurance coverage for glasses and contact lenses varies from plan to plan and can often become confusing for all involved, but our staff will help you sort through it and make sure you are maximizing your benefits. Do be advised that certain insurance plans will sometimes dictate where your glasses will be made. This may or may not be a lab that we would generally recommend. If this happens, it makes it difficult for us to guarantee the quality standards we strive for.

Vision plans do not cover medical diagnoses. Medical insurance will be billed when a medical diagnosis is the outcome of a patient exam. Medical diagnosis can range from blurred vision to eye infections or ocular manifestations of systemic conditions and include everything in between. Medical insurance will also cover any follow-up care for progressive, chronic, or isolated emergent conditions.

It is also possible that your vision insurance can be billed for your routine examination and you can return to the office at a later date to address any medical diagnosis. Your medical insurance would then be billed for your follow-up care.


Insurance Plans – Our Policy

When a patient sees our doctors for an office visit or comprehensive eye exam related to a medical eye problem or has existing medical conditions that require routine monitoring of eye health, Clarity will bill the patient’s charges to Medical Insurance as the primary payer and then to Vision Insurance as the secondary payer (if applicable and coordination of benefits is allowed). Co-pays and refraction fees will be collected at the time of professional service. It is also possible that your vision insurance can be billed for your routine examination and you can return to the office at a later date to address any medical diagnosis. Your medical insurance would then be billed for your follow-up care.

We will bill the insurance, but please be reminded that our insurance coordinator may not know whether certain deductibles have been met or not. Ultimately, your insurance company will determine reimbursement amounts based on eligibility and benefits. Any charges that are not covered by insurance will become the responsibility of the patient. Please do not hesitate to ask if you have any questions regarding our policy.


Insurance Plans – FAQs

  • Do I need to purchase a separate vision plan if I have medical insurance that can be billed for my eyecare?
    • Each case is different, but the answer is often “No.”  Factoring in premiums and ocular health, it may not make sense for some patients to have both medical and vision coverage.
  • What if I do not have vision insurance?
    • If you do not have vision insurance, your medical insurance will be billed for any medical diagnosis or you will be responsible for payment in full on the day of service.
  • How is out of insurance network care handled?
    • You can still take advantage of the premium eyecare provided by Clarity. We can provide you with an itemized statement that you can submit to your insurance for reimbursement.
  • I have a High Deductible Medical plan.  How will this affect me?
    • High deductible medical plans are gaining popularity because the initial cost is lower. These plans result in a much higher out-of-pocket cost to the patient until the deductible is met. Typically, the high deductible is offset with a Flexible Spending Account (FSA). Increased deductibles can interfere with continuity of care by causing added financial anxiety if further ancillary testing is required. We will do our best to work with you, but please remember that anything our doctors recommend and/or prescribe is being done because it is in the best interest of your eye health and maintenance.
  • Do you offer payment plans?

Payments

Clarity Advanced Eyecare has products and pricing to accommodate all budgets for your eye care and eyewear needs.  All insurance copays and costs incurred beyond insurance benefits coverage are due in full at the time of service and when ordering products from our optical.  Our practice accepts the following methods of payment:

  • Cash
  • Check
  • All Major Credit and Debit cards (American Express, Discover, Visa, MasterCard)
  • Flexible Spending Accounts (FSA)
  • Health Savings Accounts (HSA)
  • Medical Savings Accounts (MSA)
  • CareCredit
    • CareCredit is a credit card exclusive to healthcare services. With CareCredit, you can get a No Interest (restrictions apply) payment plan if paid in full within 6, 12, 18, or 24 months of purchases with your CareCredit card. Interest will be charged to your account from the purchase date if the promotional balance, including optional charges, is not paid in full within 6, 12, 18, or 24 months or if you make a late payment. Minimum monthly payments are required. To apply or get more information, visit www.carecredit.com

If your copay is overdue, a fee will be added to the invoice. Returned checks will incur a $20.00 fee, which will be applied to your account along with the insufficient funds amount. We reserve the right to place patients with returned checks on a cash only basis going forward.

All minors are to be accompanied by a parent or guardian. The parent(s) or guardian(s) who accompany the minor will receive billing statements and are responsible for payment due.

All outstanding balances must be resolved prior to non-emergent services being rendered. If your account becomes delinquent, it may be turned over to a collections agency.