Financial Policies

MAKE A PAYMENT

At your first appointment, our staff will review with you our financial policies. Southwest Retina Specialists accepts most insurance plans and will collect any co-pays or deductibles not covered by insurance upon your first visit. Co-pays, when applicable, cannot be billed to you, so be prepared to make this payment when you check in at our office. (We accept payment via credit/debit cards, cash, or personal checks.)

Billing Policies

Our fees vary with the complexity of your examination or treatment and can be provided upon request. Please do not hesitate to ask our experienced billing and insurance staff any questions about your insurance coverage, including these special billing policies:

• MEDICARE: We accept assignment on Part B Medicare patients. You will be expected to pay your deductible and a 20% co-pay.
• SECONDARY INSURANCE: We will file any secondary insurance coverage with your verified insurance carrier. If we are unable to collect directly from the carrier within 45 days you will be responsible for payment at that time—but may continue to work with your insurance company for reimbursement.
• MEDICAID: If your coverage is active, we will file your claim.
• PPO/MANAGED CARE: Our physicians have agreed to be specialty providers for many HMO/PPO plans. Please consult with billing personnel before your visit to verify coverage amounts and confirm your payment responsibility.

Surgical Procedures

Prior to your surgery, our team will pre-approve the procedure with your insurance plan and determine any payments for which you may be responsible. We will collect these payments prior to scheduling the procedure. If your insurance carrier requires pre-approval or special forms please notify our staff before your surgery.

Referrals

Many insurance plans require authorization for seeing a specialist as well as for certain procedures and tests. Even if another eye doctor refers you to our office some plans require a referral number from your primary care physician (PCP). Not having a referral in advance can add to your wait time.

Often this can be handled via telephone. With some plans, you may not be able to obtain a referral number without being seen by a plan PCP. In this situation, you will still be responsible for payment of services. Your health plan has the final word on authorization of referral services.

Financial Assistance

If you do not have insurance or the ability to pay, a state agency or program may be able to assist you. Our office staff will be happy to provide you with more information.