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Insurance/Payment Policy |
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Your insurance will be accepted according to the benefits of your policy. Necessary information must be obtained during your pre-registration call, so please have the information handy. If you do not have insurance, payment in full is due the date of service. For your convenience, we accept Visa, Master Card, and Discover, as well as cash and checks for in-house payments. As a courtesy to our patients we will file insurance claims for all insurance plans in which we participate. We are happy to file for your insurance as long as you provide us with complete information. It is important that you keep in mind, we do not work for your insurance company, we work for you and this means that you are ultimately responsible for payment. Any charges not covered by your insurance, are due and payable at the time of service, unless other arrangements have been made ahead of time. You may be responsible for any co-payments and deductible amounts or any non-covered services. Any balance not covered by insurance is the patient's responsibility. |
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Insurance Participation |
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We participate with most major insurance plans. Below is a list of some accepted plans, if you don't see your plan listed please call our office to see if your plan is accepted . Many medical insurance companies, as well as HMOs, require pre-authorization for medical services. If your insurance requires you to pre-certify, pre-authorize or get a second opinion, you must do this prior to your exam date. Please consult with your insurance company or primary care physician to obtain a pre-authorization, if required. Our billing staff will be happy to answer any of your insurance questions at 303.838.9165. |
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AARP
Aetna/US Helathcare
Anthem Vision
American Postal Workers
Amerigroup
Blue Cross / Blue Shield
Champus
Cigna/Opticare
ECPA (Eyemed)
GEHA
Great West
HMO Blue
Humana
Liberty Mutual
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Mail Handlers
Medicare
Mutual of Omaha
Pacificare/Eyespecs
Principal Life
Rocky Mountain Healthcare
Rocky Mountain UFCW
Secure Horizons
Sloan's Lake Managed Care
Tricare
United Healthcare
USA Health Network
VSP
Wausau |
**If you don't see your insurance please call our office to confirm participation.*
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| Frequently Asked Questions |
Why do I need to bring my medical insurance card to my annual
eye health & vision exam appointment? |
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Vision coverage is often included in your medical insurance so it is important to contact your medical insurance company before your visit to verify your vision benefits and then show your medical insurance card at your time of visit to insure appropriate insurance billing. |
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Also, if an eye injury or infection occurs during the year, in between your annual eye health & vision exams, having the medical card on file allows us to bill your medical insurance for your medical visit.
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Why didn't my insurance pay for my exam? |
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There are two types of insurance that cover eye care, Vision Insurance and Medical Insurance. Eye Consultants of Colorado must bill the appropriate insurance as legally directed.
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Vision Insurance - (Vision Service Plan, Eye Med, etc.) |
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This type of insurance covers your annual eye health and vision exam(i.e. regular eye exams for glasses and contacts) when no medical eye problem or related complaint specifically exists. Vision coverage is often included or networked through the medical plan (for example, BlueCross BlueShield often outsources vision coverage through Eyemed)
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Medical Insurance - (United Health Care, Blue Cross/Blue Shield, Medicare,
Aetna, etc.)
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This type of insurance provides benefits for the treatment of medical problems including medical eye problems. To obtain coverage under medical insurance, a symptom or complaint indicative of eye disease, eye injury, or a chronic medical condition is the reason for your visit. |
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**Although the examination that you receive may be the same or similar to previous visits, the reason for the exam and the doctor's diagnosis dictate how we must bill our patients.**
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Why wasn't my $29 Optos charge filed to my insurance? |
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The $29 Optomap service takes the place of the standard dilation but is not yet covered by any vision insurance as part of the standard eye health exam. We are hoping that it will soon be covered but, until that time, filing this charge often delays the claim processing, even for the covered services.
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How much does my insurance cover towards glasses? |
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If you have vision insurance for glasses then usually a set amount or a percentage of the total is covered by insurance. Please check with your insurance company to determine your specific coverage. |
Common Misconceptions
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I came in for my yearly eye exam - shouldn't it be billed to my vision insurance? |
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If you have a medical concern such as cataracts, blurry or dry eyes, or any medical diagnosis and medical insurance must be billed. |
Why do I have a $19 charge for a 'refraction fee'? |
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A refraction is a test generally used to determine how well a person sees. Refractions may be necessary for the physician to diagnose your eye condition. If you have a medical problem, your visit must be billed to your medical insurance and you may still need a refraction. Unfortunately, refractions are not covered by some insurances, such as Medicare, even if a patient has glaucoma, cataracts, etc. |
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