At Neuro-Vision Associates of North Texas, our goal is to promote good eye health and enable you to have the clearest vision possible. We accept several types of vision insurance, cash, checks, CareCredit and most credit cards. We inform our Plano patients about exam and treatment costs at the beginning of your appointment. If you require a breakdown of costs, please let us know.
Questions and Answers about Vision Plans and Medical Insurance:
1) Does your office take my insurance?
This is one of the most common questions we get, and yet the answer is a bit convoluted. First, there are several different types of commercial medical insurance. We are contracted to many commercial insurance plans. Our friendly staff will do their best to explain your coverage to you. Some of your questions may be answered below.
2) What is the difference between a Vision Plan and Medical Insurance?
We often have patients that have both vision and medical insurance. They are very different in terms of the services they cover and it’s important for our patients to understand those differences. Vision coverage (such as VSP and Superior Vision) is mainly designed to determine a prescription for glasses, help pay for eyeglasses or contact lenses, and to evaluate the health of their eyes. It is not designed or equipped to deal with medical conditions, diagnoses, and/or treatment plans.
When a medical diagnosis or condition is present (such as high blood pressure, diabetes, or an eye disease such as infections, dry eyes, allergy, neurological vision problem and cataracts, to name just a few) it is necessary to file the claim for your visit with your major medical carrier and the co-pays for that insurance will apply as well as any non-covered service. Vision insurance does not cover medical eye problems, just as medical insurance does not cover routine vision problems. These rules are defined by the insurance carriers themselves.
We make every effort to be a provider on every major carrier for your convenience and we will file those claims for you when there is a medical problem. In the event that we do not take your major medical/vision insurance, we will provide you with an itemized receipt so that you may file with your carrier for reimbursement.
3) Are there any fees that insurance will not cover?
Unfortunately, due to the nature of our unique specialty of Neuro-developmental Optometry, there are many elements of our extended examination that are not covered by insurance. Medical insurance does not pay for everything, even some care that you or your health care provider have good reason to think you need. Oftentimes, there are no CPT Codes for the procedures that we do as part of our specialty evaluations. If there is no CPT code, then we are unable to bill the insurance company. The unfortunate reality is that many of our Neuro-Developmental vision evaluations take 3-4 hours and insurance effectively reimburses us for about 45 minutes. While we would love the insurance companies to pay for all the time spent, we just don’t see that happening anytime soon. If we were to accept just what the insurance company pays for 45 minutes of time, then we could not pay our staff, doctors, electricity, material supply, rent etc and then no one would be providing these valuable services. So, in order for us to help the people that need these services, we must effectively charge for our time as to be able continue offering these services.
The following procedures that we do, have no known CPT codes and therefore are not billable to commercial insurance:
- Neuro-developmental Vision Evaluation
- Traumatic Brain Injury Vision Evaluation
- Platform Posturography
- Vision Therapy (however some do pay for Neuro-vision rehababilitation depending on diagnosis).
- Right Eye Testing
There are also some other procedures that are not covered by specific insurance plans. We will discuss these with you on an individual basis.
4) Do you offer payment plans?
Our office accepts all major credit cards. We try not to be in the banking business (and we appreciate the banks not being in the eye care business), so if you need a payment plan we are happy to offer Care Credit. You can even apply online!