Vision Therapy Coverage
Vision Therapy is historically very difficult to get covered by insurance companies. Sometimes insurance companies will cover therapy visits, at least partially. For patients with high deductibles, these codes are often applied to the deductible. Insurance regulations require us to bill you for all charges allowed by your insurance. This includes deductibles, co-pays, and co-insurance amounts. If you choose to bill insurance, you will be responsible for all costs as assigned by your insurance carrier.
Pre-Determination of Benefits
We will make contact with your insurance company prior to your orientation visit. We will do our best to get an estimate on what your out-of-pocket expenses will be. Please keep in mind, however, that insurance companies will not guarantee payment. Unfortunately, the only sure way to know if visits will be covered is to bill them and wait for the insurance claim to be reconciled.
Another way we can estimate coverage is to wait for pretesting to be reconciled. Some therapy codes are billed during the pre-testing process. This is not a guarantee if they will cover it during the unit, but generally if they covered it during pretesting, they will cover at least some visits during the unit. If it was applied to deductible during pretesting, it will also go to deductible during the unit. Again, this is only an estimate of coverage. It also will not help with understanding coverage on developmental testing.
We require all our patients to make payment for our therapy services in advance. Payment can be made in full, or set up on a payment plan at zero interest.
An insurance claim is not settled until receipt of the final EOB. You have only made a pre-payment based on an estimate of coverage. You may still have a balance due at the end of therapy.
Billing and Reconciliation
We will bill your visits shortly after each appointment. We will do our best to keep you updated as to the status of the claims, and let you know if insurance is reconciling the different from the original estimate. Ultimately, however, it is your responsibility to fully understand your insurance benefits and be aware of changes to them.