Helping you receive your maximum allowable benefits and avoid any financial misunderstandings in the future is our goal. For us to achieve this goal, it is your responsibility to understand your insurance coverage and our payment policies. As you are responsible for charges not covered by your insurance plan, we suggest that you verify your eligibility for services prior to your visit.
Fees and Payment Policies
We accept cash, checks, debit cards and all major credit cards including MasterCard, Visa and Discover.
• Full payment for our services is due at the time the services are rendered. We “Accept Assignment” from the insurance plans in which we participate. “Accept Assignment” still requires you to pay all co-payments, coinsurances, deductibles and non-covered services.
• Refraction (the determination of your eyeglass prescription) may not be a covered service. Many insurance carriers including Medicare select not to cover this procedure. A refraction is a test that measures your best possible vision. During the test, lenses are placed in front of your eyes and the patient is asked, “which is better—one or two?” A refraction is a separate procedure that measures your ability to see and determine if you need new glasses or if you need a change in your current glasses. It will also determine if you need bifocals. It is typically performed during both a routine exam as well as part of an evaluation and monitoring of a medical condition such as diabetes, cataracts, glaucoma, dry eye or macular degeneration.
• Contact lens fitting and/or evaluation are not part of a routine examination. Your insurance may not pay for this service. There may be a separate fee depending upon your individual insurance coverage.
• If your managed care plan requires a referral, that referral must be obtained prior to services being rendered. Otherwise, you will be responsible for payment. We request that you provide us with your complete insurance information at the time of your initial visit.
• Returned checks are subject to a $20 fee. Balances owed after 90 days may incur a billing fee as well as an administrative fee until balances are paid in full. If your account goes into collection you are responsible for the original charges and any expenses this office or the collection agency incurs collecting them.
• A 50% deposit is required on all materials including eyeglasses, contact lenses and low vision devices.
• Your company may offer a medical spending account, which allows you to set aside pre-tax dollars to pay for your medical expenses. Please contact your employer for more details.
Frequently Asked Questions
What is the difference between routine eye examinations and a visit for medical care?
Your visit for routine eye care allows your eye doctor to evaluate your visual needs. The doctor can determine if there is a need to prescribe or change your prescription for vision correction. It also allows him/her to evaluate your eye health, to rule out the most common eye diseases and to determine if there is a need for further evaluation and procedures.
What is vision Insurance and how does it differ from medical insurance?
Vision insurance is usually a separate insurance covered by your employer or insurance company that covers routine eye care and may or may not include payments towards eyeglasses or contact lenses. It cannot be used to treat medical problems.
Medical eye care involves visits and procedures your doctor performs to diagnose and to treat eye disease such as glaucoma, dry eye, conjunctivitis and cataracts. It may or may not include determination of your eyeglass prescription.
Does my medical insurance cover routine eye care?
Typically, your major medical insurance or managed care plan pays for procedures needed to diagnose and treat eye disease. While the examination may provide you with a new eyeglass prescription, medical insurance rarely pays for routine care and refractions.
Does insurance cover refractions?
Many of the examinations and tests performed at SUNY College of Optometry evaluate your eyes for possible disease. Once a disease is found, examinations and tests allow us to manage your eyes appropriately. There is however, one test called a refraction that is typically not covered by insurance that needs to performed at least once a year. It is not an optional test, but essential to fully evaluate your eyes appropriately.
Federal guidelines state that the office visit and the refraction are to be reported as two separate charges when submitting your services to Medicare and other insurances. Most medical insurance carriers do not cover charges for the refraction and there is a separate charge for this service. The payment for the refraction must be made at the time of service along with your copay and any deductible amounts for the covered charges for your visit.
Contact Lens Warning
Contact lenses are medical devices. Improper use may endanger your eyes. Your eyes may change with time and contact lenses that were initially fitting properly may no longer be appropriate. Visit your eye doctor periodically to ensure correct fitting of your lenses. Remember to discontinue lens wear and call your doctor if you experience any signs of complications including pain, redness, irritation or loss of vision.