Insurance & Billing

Helping you navigate the billing process

It is important to understand what medical services are covered by your insurance policy. We encourage patients to confirm with their insurance provider to ensure we are in network and that Advanced Eye Physicians services are covered by their policies, and how much of their bill they will be responsible for. Advanced Eye Physicians requires that payment be made at the time of service for any amount not covered by insurance. Co-payments are due at the time of service.

Advanced Eye Physicians makes every effort to simplify the billing process. If you have questions about your bill, please contact us at 203.235.2511

INSURANCES

We accept MOST insurances, including United Healthcare Medical plans, VSP, and Access Network EyeMed plans. (Unfortunately we do not currently accept Spectra Vision or Davis Vision.)

The past few years we have seen many changes in insurance coverage. It is important that you understand your coverage; not just for when you come to see our physicians; but for all your medical needs. We suggest that you contact your insurance carrier or employer if you have questions on your coverage. Below is a simple guideline to help you become more aware of your potential responsibilities through your insurance carrier.

We hope you find the information below helpful.

Co-payment or Co-pay

This is a payment that is made at the time of services. Most insurance companies require co-payments and the amounts are usually written on the front of your card. Our physicians are specialists. (Specialists are physicians you see outside of your primary care physician.) Your insurance may require a different amount of co-payment for specialists.

Deductible

Your deductible amount is not written on your insurance card and something that you need to be aware of. You may have a specific amount of monies that you are required to pay out of pocket prior to your insurance company paying for your services. This amount varies for carrier to carrier and we have no way of knowing this information until your claim has been submitted for payment. We suggest you contact your insurance company and obtain detailed information concerning your coverage if you do not have this information.

Co-Insurance

Not all insurance carriers have co-insurance. Co-insurance is the amount of money left on your claims (outside of co-payments and deductible amounts) that the insurance company tells us to bill you. For example: Medicare normally pays 80% of your claim leaving the remaining 20% to be billed to your secondary insurance or billed to you.

**Our receptionist will ask for your insurance card at every appointment.

REFERRALS

This is the biggest change of insurance coverage we have seen. Some insurance companies have changed their policies stating that patients must obtain a referral from their primary care physicians prior to being seen by a specialists. We are discovering that some insurance carriers did not educate their customers on this change. If you need a referral is should be noted on the back of your card. This is another aspect of your insurance coverage you need to be aware of. If you do not obtain a referral from your primary care physician prior to seeing a specialist your insurance company will deny your claim. Therefore, if you do not obtain a referral prior to your appointment, and if we have not received the referral, your appointment will need to be rescheduled.

**If your insurance requires a referral; please ensure that it is obtained prior to your appointment. (Not all insurances or insurance products require referrals. It should state this on your insurance card.)

 

We are not happy about these changes either.