Questions About Your Bill
I have insurance. Are they ultimately responsible to pay?
Your insurance company is responsible to you to pay according to your contract with them. Patients (or parents of patients they are legally responsible for), though, are ultimately responsible to pay us, regardless of whether or not the insurance company meets its obligations.
When am I expected to pay?
Payment is expected at the time of service.
What billing or insurance information will I receive?
After your insurance has paid, we'll provide you with a monthly statement of your account. Your insurance company will probably mail you what's called an explanation of benefits (EOB).
How long will it take to get things settled with the insurance company?
Generally, it takes from 15 to 45 days to obtain payment from an insurance carrier.
What happens if I don't pay my bill?
Our process is to bill patients twice. If the bill isn't settled after two billings, then our policy is to discontinue care unless the account is resolved within 30 days.
I received a notice that my insurance company has paid on my bill -- but I can't understand how they calculated their payment amount. Do you know?
If we have received any such information from your insurance company, we'll be glad to share it with you. However, for answers to any questions about insurance payments, deductibles, or co-payments, you generally need to check with your insurance company.
I was billed for a refraction. What is that?
A refraction is the determination of the eyeglass prescription that best helps you see. It is necessary not only when deciding which eyeglass prescription to write, but also when we need to know your "best-corrected" vision. If you have cataracts or other conditions that might interfere with your vision, we need to know how much of the interference can be fixed with a simple prescription change and how much is the result of your medical condition. Our fee is only $20, whereas we understand that some practices charge as much as $85. It is a service that is often not covered by insurance, but one that is necessary nonetheless.
Why is health care billing so complicated?!
Health care billing can be mind-bogglingly complex. For example, there are 16 different levels of office-based eye exams that the insurance companies require us to use. That's why, when patients call and ask us how much an eye exam costs, we hesitate to offer a simple answer. Only months of billing training and years of experience permit us to make sense of the subtle differences. Like you, we wish health care billing was more straightforward. If we were to design our own system, it would be much simpler. But, like you, we have to work within the system that exists.
If you have any further questions, or would like to speak to someone in our billing office, please feel free to call us at