Each insurance company has multiple plans, which cover different services. Professional services covered by your insurance company are NOT determined by our office. They are determined by the contractual relationship between your employer and the insurance company. Some plans require referrals, some require that you use only doctors on a list.
It is your obligation to know the benefits and limitations of your insurance plan not the staff and doctors. The best person to explain the benefits of your policy is the benefits coordinator of your company. The insurance company responds to your employer since they pay the premiums. Our staff will do their best to help you get your maximum benefits. You are responsible for services rendered not covered by your insurance company which are medically necessary.
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 have and HMO you can not be seen without a referral. Referrals can not be back dated. They are obtainable only from your primary care physician.