Arrival
Please arrive approximately 10 minutes prior to your scheduled appointment to allow time for the registration process.
Duration of Appointment
We make every effort to see patients in a timely and courteous manner. However, individual patient needs and circumstances do impact the time a doctor must spend with each patient ultimately impacting the day’s overall schedule. As a general rule, a routine eye examination will take approximately one hour. Appointments for medical follow-ups, surgical evaluations and pre-ops will generally take approximately one to two hours.
Routine vs Medical Eye Examinations
The reason for your visit to our office and the diagnosis found by your doctor during the examination will determine whether your examination is considered to be for Routine care or Medical care.
A Routine Comprehensive Eye Examination is usually performed when the patient’s complaint is blurry or poor vision which is determined by the doctor to be the result of a refractive error such as near-sightedness, far-sightedness or astigmatism. Such refractive conditions are usually addressed with traditional eyeglasses or contact lenses. Most traditional medical insurance plans do not provide coverage for a Routine Comprehensive Eye Examination. However, some patients do have a separate Vision Plan which will provide limited coverage and benefits for a Routine Comprehensive Eye Examination.
A Medical Comprehensive Eye Examination or other Medical care follow-up examination is performed when the patient has a new vision complaint or ongoing medical condition impacting eye health or vision which is not solely a refractive condition. Such condition are usually covered by medical insurance. If you doctor determines that the primary diagnosis for the complaint or condition presented is a medical diagnosis, your medical insurance will be the primary for any fees associated with the examination, tests or procedures performed related complaint or condition. We cannot and will not file an insurance claim for Medical care provided under a routine vision care or Vision Plan coverage or benefit.
Refraction
A Refraction is diagnostic test performed to determine the eyeglass lens prescription needed to allow the patient to achieve the best possible vision. Most patients know this test as the one where the doctor or technician place an instrument in front of the patient’s eyes and begin asking “Which is Better, One or Two” as different lens powers are rotated before the eyes as the patient reads letters on an eye chart. The “Refraction” is done to determine the best possible vision correct for the patient – and established a prescription for eyeglasses.
Because the Refraction is a separate diagnostic test and is used primarily to assess a refractive error (i.e. near-sightedness, far-farsightedness and/or astigmatism) this test is never covered by Medicare and rarely covered by medical insurance. Therefor, the patient is responsible for the profession fee associated with this test in addition to any fees for eye examination, other tests or services performed.
Annual Contact Lens Fee
For most patients already wearing contact lenses, we recommend an annual Comprehensive Eye Examination to confirm continued eye health and best possible vision while wearing contact lenses. Since contact lenses are appliances which have direct contact with the eye, it is important to regularly check the fit, prescription and proper use and care of such to protect your vision. Since the confirmation or adjustment of any contact lens fit and prescription for are additional services outside the scope a regular eye examination, there is a nominal additional Annual Contact Lens Fee assessed for this service.
Vision Plans
We participate with most major Vision Plans. Such plans are typically available as separate coverage from a patient’s regular medical insurance. It is the patient’s responsibility to know and present proper evidence of coverage with any insurance plan providing coverage for a service. Such information (i.e. Insurance Card or other written authorization) must be presented prior the receipt of services as prior authorization is typically required by most Vision Plans. Without prior authorization, most Vision Plans will not provide coverage or benefits for services provided even if the patient is determined to be eligible for such coverage and benefits after such was provide by our doctors or staff.
Insurance and Billing
As a service to our patients, our doctors participate with most major insurance plans and we gladly accept Medicare assignment. If you are enrolled with an insurance plan that we accept, we will gladly file a claim on your behalf with your insurance plan. You remain responsible for all deductibles, copays, co-insurance, non-covered services or other amounts not paid by your insurance plan. We ask your cooperation in this process by respecting our billing and payment policies.
Please understand:
1. Payment is due at the time services are provided.For your convenience, we accept cash, checks, debit and credit card payments.
2. We accept Medicare Assignment and participate with most major insurance plans.
3. To process an insurance claim on your behalf, you must present a valid insurance card or other form of insurance coverage documentation at the time services are provided.
4. You are responsible for securing all required referrals or authorizations from your primary care provider, insurance or other third party required by your insurance plan.
5. You must notify us prior to receiving services if you have a vision plan providing coverage and benefits for your examination, contact lenses or eyeglasses.Such plans generally require you to get authorization for coverage and benefits prior to your examination or before ordering contact lenses or eyeglasses.
6. Once your insurance plan has processed your claim and paid any benefits available, you may receive a final bill from us for any remaining balance due on your account.We request final payment from you within 30 days of this bill.
7. Payment in full is required prior to dispensing contact lenses or eyeglasses.
8. We offer third-party financing options for most major services including cosmetic and refractive care and treatments.
9. We also offer patient-assistance programs for patients with demonstrated financial difficulty accessing needed services.
10. For more information regarding our billing and payment policies, please contact our insurance and billing department at (828) 433-1000.A team member will be happy to assist you.
Note Regarding Insurance Coverage:
Please understand that your insurance plan coverage is a private contract between you and your insurance plan. We do not control the services covered by your insurance nor the level or amount of benefit that will be provided for such services. Therefore, it is very important that you take time to learn and understand the coverage and benefits available to you under your insurance plan. It is your responsibility to contact your insurance plan provider when you believe they have paid or processed your claim incorrectly. We are happy to assist in this process by filing an inquiry or an appeal on your behalf. However, you remain responsible for any amounts due for services provided and not otherwise covered or paid by your insurance plan.
