BILLING/INSURANCE.

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Billing FAQs

Why does it look like I am being double billed for my treatment?
Most testing and procedures are done per eye. Therefore, on your billing statement you may see a line item for the left eye and a line item for the right eye.

Is all testing covered by insurance?
Certain testing and treatment is considered investigational and is not covered. Prior to having such testing or treatment, you will be asked to fill out and sign an ABN (Advanced Beneficiary Notice) form. The purpose of this form is to inform you that a specific test or treatment might not be covered by your insurance and you are agreeing to pay for the charges in full.

Insurance
Retina Center of Vermont participates in most insurance plans including:

– Medicare
– CIGNA MVP
– Medicaid (Vermont)
– Vermont Managed Care
– Blue Cross Blue Shield
– Great West
– CBA (Comprehensive Benefits Administrator)

If you are not insured by a plan we accept, or do not have medical insurance, payment in full is expected at each visit. If you are insured by a plan we accept, you must present a valid, up-to-date insurance card. Payment in full will be expected unless proof of coverage can be verified. Please contact your insurance company or your employer with any questions you may have regarding coverage.

Retina Center of Vermont Co-Insurance and Deductible Payment Policy
Co-insurance, co-payments, and deductibles are expected to be paid by the patient at time of services. We will happily try to assist you in determining your co-insurance/deductible obligations. However, not all insurers provide us with that information in an expedient manner. Therefore, we strongly recommend that you address any issues with your insurer prior to your appointment. If your insurer concludes, after reviewing a claim we submit to them on your behalf, that you owe RCV an additional balance, we will forward an invoice to you. Patients are responsible for payment within 30 days. Any overpayments to RCV after a claim is processed will be refunded to you.

Non-covered Services
Please be aware that some – and perhaps all – of the services that you receive may be non-covered or considered not medically necessary by your insurer. We do our best to obtain information regarding which services may not be covered. However, this information may not be available until the claim has been processed by your insurer. If we know in advance that the service will not be covered by your insurance, we will notify you. You will then be responsible for payment at time of services. Any balance on your account for non-covered services will be billed to you and must be paid within 30 days of the statement date.

Coverage Changes
If your insurance changes, please notify us before your visit so we can make appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim within 45 days, the balance will automatically be billed to you.

Nonpayment
Monthly statements are generated only for patients whose accounts have an open balance. Payment is due within 30 days of the statement date. Please note that balances unpaid after 30 days will incur finance/service charges. If you are experiencing a financial hardship, please be sure to contact our Billing Manager to arrange a payment plan.

Patients with No Insurance
Payment for all services is expected on each occasion in which service is provided. If you do not have insurance, or are experiencing a financial hardship, please contact our Billing Manager.

Missed Appointments
We reserve the right to charge you for any missed appointments. All appointment cancellations and rescheduling should be done at least 24 hours in advance.

Our Fees
Our practice is committed to providing the best treatments, testing, and specialty care to our patients. Our prices are representative of the usual and customary charges for our specialty and locality.

Please let us know if you have any questions or concerns regarding our policies. If you would like a copy of our policies, please request one from our office staff.