Insurance and Billing Information for Patients at Eye Doctors of Washington

At Eye Doctors of Washington, we strive to make it as simple as possible for you to improve your vision and receive comprehensive eye care. We accept most medical insurance plans and some vision insurance plans. However, since not every doctor in our practice participates with all plans or products, we highly advise all of our patients to verify with their insurance provider prior to their office visit. Our friendly and knowledgeable staff can assist you in filing any required paperwork for you to receive your insurance benefits.

Please review the information and Frequently Asked Questions below. Feel free to contact us if you do not find the information you need.

Medical Insurance for Eye Care

Most health insurance plans will cover medical eye exams. A medical eye exam may include treatment of conditions such as diabetes, cataracts, glaucoma, or uveitis. We accept most major medical insurance carriers, including Medicare, BCBS, AETNA, and CIGNA, but we may not participate with every individual plan that is offered. Please check with your provider to confirm your coverage prior to your examination.

Vision Insurance for Eye Care

Vision plans cover routine eye services such as annual eye exams, glasses, and some contact lens services. Many vision insurance plans do not cover contact lens fittings/evaluations as this is typically considered an elective service. If your eye doctor decides during your eye exam that you need to be examined for a medical condition, such as glaucoma or cataracts, you will be referred to one of our ophthalmologists for a separate medical visit and further treatment.

We accept vision insurance plans administered by Vision Service Plan (VSP), including Metlife Vision & Cigna Vision. Feel free to contact us if you need assistance figuring out if your specific vision insurance plan is accepted.

Billing for Routine Eye Exams vs Medical Eye Exams

We understand that navigating insurance can be confusing. Your visit to the eye doctor may be categorized as “medical” or “routine” by your insurance provider. Your medical insurance covers a medical eye problem but may not cover a routine eye exam – some plans include routine benefits. Depending on your policy, a routine exam may not be covered due to vision plans that are combined with your medical insurance but are considered separate coverage. Though this type of coverage is very common, there are some medical insurances that cover one routine eye exam every one to two years.

We know that this may seem very complicated, and we work with our patients to provide assistance in figuring your individual coverage. We always advise you to verify your benefits with your insurance provider.

Eye Doctors of Washington Billing Policies

Self-Pay Patients
Full payment is due at the time of service for self-pay patients.

Patients using insurance
Patients must pay for all co-pays or deductibles required by your insurance at the time of service. We are unable to waive these fees.

You must bring your insurance information to your appointment.
If you do not have your insurance information with you on the date of service, you will be considered a self-pay patient. You will be required to pay in full and you may submit for reimbursement on your own.

Referrals for HMO Insurance Plans
Patients with HMO insurance plans typically require a referral from your primary care physician (PCP) in order to have coverage to see a specialist practitioner. Referrals are due on the date of service. Please confirm that your doctor’s office has faxed us a copy of the referral beforehand or bring a copy yourself. If your plan requires a referral and you do not have one, you will be responsible for the balance of the visit.

Online Bill Pay
In order to make bill payment as simple as possible for you, we’re happy to offer 24/7 access to bill pay using a secure online payment:

Please have your account number ready and enter “EDOW” for the Doctor code. Your account number can be found on your statement.

Questions About Your Bill
Should you have any billing questions please reach out to our billing office at 301-670-4250 ext: 426. Our billing office is open from 8:30 am – 5:00 pm M-F

Frequently Asked Questions About Billing

If I paid my co-pay at the office why am I still receiving another bill?
Based on the type of medical insurance you have apart from your co-pay, you may have other out-of-pocket expenses that you are responsible for as part of your plan such as a deductible or co-insurance.
What is a deductible?
A deductible is a specified amount of money that the insured person must pay before an insurance company will pay a claim. Not everyone has a deductible and not all deductibles are the same. We always advise our patients to call their insurance for exact information of their own plans.
What Is a co-insurance?
A coinsurance is a shared cost of healthcare service. It’s usually figured as a percentage of the amount we allow to be charged for the services. You start paying your coinsurance after you have met your deductible.
Why am I being charged for a refraction?
A refraction may be performed by either the doctor or a technician, and typically involves questioning along the lines of, “Is 1 better than 2?” Medicare and many other insurance plans consider refraction to be routine vision care not covered under their medical coverage. Therefore this amount is charged separately and is paid directly by the patient.
How much is my visit going to cost if I’m a self- pay patient?
The cost of your visit is based on the reason for your visit and the level of care provided. Therefore we are unable to give you an exact charge amount beforehand.
Is LASIK covered by my insurance?
Lasik surgery is not covered by medical or vision insurance since it is considered an elective procedure. Please check out our LASIK page for more information and financing options.
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