Payment and Insurance.
East Valley Ophthalmology offers many payment options. We
are pleased to discuss our fees with you before we provide any
services.
Vision Care Financing.
In
addition to cash, personal checks, and most major credit cards,
East Valley Ophthalmology makes
world-class vision care available through independent financing
from CareCredit and Capital
One Healthcare Finance. If
you'd like assistance with your application, your questions answered,
or to make an appointment, please call: 480-981-6111
Capital One Healthcare
Finance provides predictable payment plans with the convenience
of a credit card. Unlike most credit
cards, Capital One Healthcare Finance allows you to customize your
loan by selecting the amount you need and your repayment terms — from
three months to five years. Use Capital One Healthcare Finance to pay
for elective procedures, from $995 to $25,000.
CareCredit works just like a credit
card, but is exclusively for healthcare services. It's
better than most credit cards because you get no-interest financing or
low monthly payments every time you use it. Plus, you can use your card
over and over for elective procedures and follow-up appointments.
Flexible Spending Account (FSA)
Find out if your employer health care plan includes a Flexible
Spending Account, also called a Flex Plan or Reimbursement Account.
Contributions to these plans are made through
automatic and regular deductions from your paychecks. This employer sponsored
benefit allows you to pay for eligible medical expenses on a pre-tax basis.
Since the funds placed in the account are not taxed, they go much further
in covering eligible medical expenses. For more information, go to: FSAFEDS
What Is Covered?
The eye care services that are covered by your insurance
company are not determined by our office. Rather, they are determined
by a contractual agreement between the
insurance company and your employer.
Each insurance company has multiple plans
that cover different services. It is completely your
obligation to know the benefits and limitations of your own insurance
plan. Some plans require referrals,
some require that you use only doctors on a list. You must be
familiar with what your coverage is and the necessary fulfillment
requirements before making your appointment.
If you have the typical medical plan (indemnity, HMO, PPO,
IPO), you should know that most eye care programs specifically
"exclude
refraction" and
contact lens related examinations. This means that the determination
of your eye glass and contact lens prescription are not a covered
service. If you elect to have our office evaluate the fit of
your contract lenses and/or change your prescriptions, there
will be an out-of-pocket fee involved.
Acceptance Of Insurance.
Your insurance will be accepted strictly according to the benefits
of your policy. The necessary information must be obtained
during your pre-registration call, so please have the information
handy. If you do not have insurance, you will need to make
other arrangements in advance or your appointment will be postponed
or cancelled.
If your insurance requires you to pre-certify, pre-authorize
or get a second opinion, you must do this prior to your eye surgery
date or your surgery will be postponed or cancelled.
If you would like further information, please call our office at:
480-981-6111
Accepted Insurance Plans:
We would be delighted to file for your insurance and Medicare
claims as long as you provide us with complete and accurate information.
It is necessary to keep in mind
that we work for you, not your insurance company, which means
that you are ultimately responsible for all payments. Any charges
not covered by your insurance, are due and payable at the time
of service, unless other arrangements have been made before your scheduled
appointment. If you are not on one of these insurance plans,
you may still see us "out of network." Plans that Dr.
Nirenberg and Dr. Kao accept include:
- Aetna (Dr. Kao only)
- Arizona Foundation for Medical Care
- Banner Choice Plus
- Beech Street
- Blue Cross Blue Shield PPO (No HMO)
- Coventry Healthcare/First Health/CCN PPO
- Medicare
- Medicare replacement (certain restrictions apply)
- MercyCare
- Multiplan
- Private Healthcare Systems (PHCS)
- United Healthcare
- Workman's Compensation
If your insurance is not listed please feel free to
contact our office to verify, as this does change often.
Dr. Hill's Specialized Services
There are perhaps five ophthalmologists in the entire U.S. offering the kind
of IOL power calculation services that Dr. Hill does, and no other
in our region. As Dr. Hill is a Medicare provider, our office will submit a
claim for those services covered by Medicare, but for any non-covered Medicare
services, it is customary for payment to be made on the day of your visit.
For other heath plans, a visit with Dr. Hill will likely be
considered "out of network" and may also require
prior authorization if you are to be reimbursed by your insurance
carrier. We wil provide you with the necessary insurance forms
to send to your health plan, but it is customary for payment
to be made on the day of your visit.
Gap Insurance
Because Dr. Hill's expertise is highly specialized, a patient receiving
his services may qualify for GAP insurance and/or out of network benefits.
When a patient does not have out-of-network benefits, he or she may still be
eligible for GAP insurance due to Dr. Hill's "specialized services" for IOL
power calculations.
For IOL power calculations, there are five separate insurance
codes used to arrive at the final reimbursement. Under normal circumstances,
these codes are all that may be required by an ophthalmologist to receive
insurance reimbursement. However, the "specialized services" interpretation
cannot be performed by most ophthalmologists, as this requires a particular
expertise and a different reimbursement rate.
In order for a patient to receive GAP insurance benefits,
he or she must obtain prior authorization
for these specialized services. In this case, the expertise of a Certified
Procedural Coder (CPC) would be required to work with the utilization review
staff of your insurance company.
East Valley Ophthalmology has two staff member that are Certified Procedural
Coders (CPC) and are readily available to assist you on an individual basis.
Please call and ask for either Becky Farris, MHA, COE, CPC, CCP or Samantha
Collins,
CPC,CCP, RMC and they will be happy to help.
The eye specialists of East Valley Ophthalmology perform advanced
technology diagnostic testing and treatment, as well as taking
the time necessary to provide each patient with information needed
to fully understand their condition and to achieve their best possible
visual outcome.
If you would like further information, please call our office at:
480-981-6111
East Valley Ophthalmology
Eye Doctors - Mesa, ArizonaIf you or a family member
or friend have not had a recent routine eye examination, have a specific eye condition that needs addressing, or are looking for
an eye specialist or professional eye consultant please take a moment to Request an Appointment.
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