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FINANCIAL POLICY

At The Eye Institute we are committed to providing you with the best possible surgical care. We know you have many questions concerning your care as well as your financial responsibilities. We have several billing specialists who are available to discuss your financial responsibilities with you. Our financial policy is as follows:

Financial Responsibilities

Due to the many types of insurance available to patients today, payment requirements must be determined on an individual basis. Payment for services is due at the time services are rendered. We accept cash, personal checks, MasterCard, Visa, American Express, and Discover. Returned checks are subject to a service charge of $20.00 or 5% of the face value of the check.

Medicare Coverage

• If you are covered under Medicare Part B, we accept Medicare assignment. The term Medicare assignment is confusing. This does not mean that Medicare pays the entire bill, but rather, that the physician or facility accepts the Medicare approved amount as payment for services. Medicare pays 80% of the approved amount. The approved amount is always substantially less than our standard fee.
• If you are a Traditional Medicare recipient and have a supplemental policy designed to work with Medicare Part B, and you have satisfied your annual $110.00 deductible there should be no out of pocket expense for our services.
• If you are a Medicare Part B recipient with no supplemental policy, you will be asked to meet the 20% co-payment and your annual $110.00 deductible (if not yet satisfied) at the time of service.

Commercial Insurance / HMO

• If you are a Commercial Insurance participant, we will contact your insurance company to determine what their obligation is under your plan, you will be asked to meet the percentage not covered by your insurance plan and any deductible and/or co-payment.

Worker’s Compensation

• Prior to your appointment, your Worker’s Compensation insurance carrier must call us to authorize your appointment. We will then file your claims to that carrier. In the event that you fail to prosecute the claim for Worker’s Compensation for this illness or condition; or it is determined by the Worker’s Compensation board that the illness or condition is not a result of a Worker’s Compensation case, you agree to pay the usual and customary fees for services rendered to you in this case.

Private Pay

• If you are a private pay patient, you will be responsible for the entire fee at the time services are rendered.

FINANCIAL AGREEMENT

We will gladly discuss your proposed treatment and do our best to answer any questions relating to your insurance. You must realize however, that:

1. Your insurance is a contract between you, your employer, and the insurance company. We are not a party to the contract.
2. Not all services are a covered benefit in all contracts. Some insurance companies decline services not covered by your plan.
3. For your convenience, we will file your claim electronically with your insurance company and/or Medicare. If payment is due, please be prepared to satisfy this obligation at the time of service.
4. Please remember that insurance is considered a method of reimbursing the patient for fees paid to the doctor and is not a substitute for payment. Some companies pay fixed allowances for certain procedures, and others pay a percentage of the charge. It is your responsibility to pay any deductible amount, co-insurance, or any other balance not paid for by insurance or third payer within a reasonable period of time not to exceed 60 days.
5. Should it become necessary to collect payment through a collection agency, you the patient are responsible for all fees related to this collection, including attorney’s fee and interest on unpaid balances.