New Patient Registration Packet
Medical Information Release Form
Advanced Eye Care, SC participates with Medicare, most Medicare Replacement plans, and most commercial insurance plans. Some of the commercial plans in which we participate include:
If your plan is not listed, please contact your insurance company to confirm participation.
Since the founding of this practice, we have always offered the best medical care possible. In order to continue to do so, we have implemented a Patient Financial Policy.
We send monthly statements to inform our patients of any balances due, and we also remind patients of money due when they call to schedule appointments and when we call to confirm appointments. We expect that patient balances will be paid upon receipt of our statement or at the next visit. In order to make it easier for our patients, we accept cash, checks, VISA, MasterCard, and Discover. All may be given as payment at the front desk or sent with statements.
We expect payment at the time of treatment for patients who have no insurance coverage. We will do our best to give patients an estimate of charges the day ahead of their visit when we call to confirm their appointment. Before visits, we will expect payment of the actual charge by one of the methods listed above. For large balances, and also if a surgical procedure is necessary, we will work with our patients to develop a payment plan.
We require that patients bring their insurance card with them to each appointment in our office so that we can be sure that we have the correct insurance information on file. We will scan your card into our system if necessary. As a courtesy to our patients, we will file a claim with the primary and secondary plans. If the plan has a co-pay, we expect payment upon check-in for visits. When primary and secondary plans have paid their portion of the charge, the remainder will become the patient’s balance and will be indicated on the statement patients receive from the office.
While our billing professionals will do all they can to help our patients in communicating and negotiating with their insurance plan, we must inform patients that any question regarding coverage, benefits, or payment for service provided is their responsibility to resolve.
Any balance on a patient account, for any covered or non-covered service, that is 30 days old will be considered due and is the patient’s responsibility to pay. Any balance on an account that is greater than 30 days old is considered past due. It is our policy to send two statements (at 30 and 60 days) and send one letter to patients before taking further action on the account. If there is no response following these efforts, the account will be placed with a collection agency. In addition, the patient will be responsible for all court costs, filing fees, and attorney fees should this account require litigation.
Advanced Eye Care, SC is pleased to offer our patients the CareCredit® credit card, North America’s leading patient payment program. CareCredit lets you begin your procedure immediately — then pay for it over time with monthly payments that fit easily into your budget. There are no up-front costs or pre-payment penalties.
Through CareCredit, Advanced Eye Care offers 6 or 12 months interest free payment plans.
Ready to apply? Apply online here for your CareCredit card today.
Regular eye examinations are important to maintain your vision for your lifetime. It is important that you be aware of your insurance benefits and how they apply to your visit, so you will know how billing will be handled. Ultimately, it is your responsibility to know what your own medical or vision plan covers. We hope this information will help you to understand how your visit is submitted to your insurance for today’s visit and future visits with Advanced Eye Care SC.
Benefits may vary based upon the reason for your visit. Your description of your eye condition will help us to determine whether your visit to the clinic is defined as “Routine” or “Medical”. Your symptoms and eye examination will determine how your visit is coded and billed to your insurance.
A “routine eye exam” takes place when you come for an eye examination without any medical eye problem, and there are no symptoms except for visual changes that can be corrected by eyeglasses or contact lenses. The doctor screens the eyes for disease and finds no medical problems. Glasses and contact lens prescriptions may be updated.
Your visit will be coded as a “medical eye examination” whenever you are being evaluated or treated for a medical condition or symptom that you bring up, eye problems you tell our staff about, or a condition that the doctor finds during the examination. Examples that will necessitate your visit being submitted to your medical insurance include headache, diabetes mellitus, eye irritation, dry eyes, allergies, floaters, contact lens intolerance, glaucoma, cataract, eye muscle imbalance, “lazy eye”, macular degeneration, and others. Please note that if you have diabetes mellitus, and would like us to send a letter to your primary care physician regarding your eye examination, the visit will be coded as a “medical eye examination”.
If your vision plan is Vision Service Signature Plan (VSP), we need to be aware of this coverage prior to your exam to obtain an authorization from them. VSP covers only routine eye examinations. If you report symptoms during your visit related to an eye problem, disease, or injury, or your doctor determines that your problem falls under the category of a “medical eye examination”, your visit will be billed to your medical insurance instead of your vision care insurance, which will be subject to co-pays and deductibles according to your plan. If you determine that you have coverage with VSP after your exam has been completed, we will not bill VSP for you, but will be happy to provide you with a financial printout so you may file a claim with VSP.