We are pleased you have chosen John L. Bonner Eye Clinic for your eye care needs. To help answer some of your billing and insurance questions, we have compiled some information to guide you through the process.
If you have Medicare, our office will bill Medicare and/or your secondary insurances. You are responsible for the following:
- Any deductibles and co-pays
- 20% co-pay of the allowed charges
- Any non-covered services
- Services ordered by the physician that do not meet Medicare guidelines for medical necessity
- Routine eye examinations or refraction charges
MEDICAIDE (Minnesota Only)
If you have Medicaid, you are required to present a current Medicaid card at every visit. You are responsible for the following:
- All non-covered services
- A co-pay of $3.00 which is due at the time of service
HMO & PPO PLANS
If you have HMO or PPO coverage, you are required to obtain an insurance referral for most services. It is your responsibility to obtain all insurance referrals before services are rendered. You can do this by calling the referral department of the clinic listed on your insurance card. If you fail to obtain an insurance referral and services are denied, the balance will become your responsibility. Please call us at 218-326-3433 and we will be happy to assist you in obtaining this referral.
If you have a commercial plan, we will bill your insurance company as a courtesy. If payment from your insurance company has not been received within 30 days, you are responsible for the balance in full. You are also responsible for the co-pay and/or any non-covered services. Co-pays are due at the day of service.
If your insurance information is verified at registration, you will not receive a bill until:
- Your insurance company has denied the claim
- Your insurance company has paid the claim, leaving a co-insurance, deductible or non-covered service.
- Your insurance company has not responded to the claim
ROUTINE VISION PLANS:
Some employers have separate vision benefit plans specifically for routine eye exams called “carve out” plans. These plans are separate from your medical insurance coverage and are handled by a different company. We do NOT participate with these plans. These include, but are not limited to:
- VSP (Vision Service Plan)
- Cole Managed Vision
If you have this type of vision plan, you will be responsible for payment in full for your services. If you are scheduled for a routine vision exam, please review your vision benefits carefully.
ROUTINE EXAMINATION AND REFRACTION CHARGES
Benefit coverage for routine eye examinations and refraction charges vary by health plan and by employer. Specific benefit coverage can also change from year to year.
An examination is considered routine when performed for a patient who has no specific illness, symptom, complaint, or injury that needs to be treated or diagnosed.
A refraction is a test that is used to determine any optical defect present in the eye. A refraction is necessary
- To prescribe the best corrective lenses
- To determine the progression or diagnosis of certain ocular diseases
- To ascertain the basis for your visual complaints
You will want to check benefit coverage with your insurance carrier to determine if vision care is a covered service.
John L. Bonner Eye Clinic will submit this charge on your behalf to your insurance carrier for determination of benefit coverage. However, if you know this charge will not be paid by your insurance carrier, you may make payment on the date of service.
For questions regarding your account, call our Billing Department at: