Most Commonly Asked Questions by Patients: 

  
What causes cataracts?  

Can I do something to prevent cataracts?  Are they hereditary?  

How long does eye dilation last?  Does it affect my vision?  Can I drive home?  

How long are eyeglasses and contact lens prescriptions good?  

How much is the contact lens fitting fee and does insurance cover this cost?  

Can I do something to prevent macular degeneration?  Is it hereditary?  

Is high blood pressure related to glaucoma?  

Am I going to be on these glaucoma drops forever?

What causes flashes?  What causes floaters?

When will my child's eyes quit changing?

What is refraction? 

I thought you accepted only what Medicare allows or pays, why is there an amount due on my bill?  

Why won't my insurance company pay on a routine/medical eye exam?  

I talked to my insurance company, they say you can change the diagnosis and they will pay for the exam?  

Why haven't you followed up with my insurance company?

Did you bill my secondary insurance?  

Are your doctors providers with my insurance company?  

I paid my co-pay, why do I still owe a balance?  

Why am I getting a reminder card to make an appointment two months before my yearly eye exam is due?  

Why can't I talk to the doctor about billing issues?  

 

 


What causes cataracts?

No one knows the exact cause of cataracts.  However, we do know that cataracts are the result of a chemical change within the eye.  This change may be triggered by aging, injury, heredity, or disease.

Can I do something to prevent cataracts?  Are they hereditary?

Currently, there are no proven methods of preventing cataracts.  However, many physicians feel it is important to include a UV screen to your prescription eyewear.  Excessive exposure to ultraviolet light from the sun, cigarette smoking, and certain medications are also considered risk factors that may lead to the development of cataracts.  Cataracts can be hereditary in some family situations.  

 

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How long does eye dilation last?  Does it affect my vision?  Can I drive home?

Generally, dilation of the pupil will last for three to six hours and will primarily affect your near or close up vision.  However, it is not uncommon for dilation to last up to 24 hours for some patients depending on the eye drops used to achieve dilation.  Different eye drops are used for various ages of patients.  Most patients can drive home after their eye exam, and sunglasses are encouraged to be worn.  Disposable sunglasses are provided for those patients who do not have sunglasses.  If a patient feels uncomfortable driving home with his or her eyes dilated, it would be advisable to bring someone with you to drive.

How long are eyeglasses and contact lens prescriptions good?

A prescription for glasses is good for two years from the date of the last eye exam.  Prescriptions for new glasses can still be filled after that period of time but may not be accurate due to changes in the eye.  We recommend having a thorough eye exam every two to three years.  State law (nationwide) states a contact lens prescription is good for two years if the contacts were provided by our clinic and one year if they were purchased outside of our clinic.

How much is the contact lens fitting fee and does insurance cover this cost?

The current fitting fee ranges from $35.00 to $200.00 depending on the patient's specific needs/complicity (updated January 2005). This fee includes measurements for the actual fit of the lens, professional instruction on insertion and removal of lenses, and follow-up visits for up to eight weeks. This process is required every two years unless your physician suggests/recommends sooner. Once the fit process is complete, your contact lens prescription is given to you. Most of the time insurance does not pay for this service. It is best to check with your insurance carrier to find out if this is a fee they cover.

Can I do something to prevent macular degeneration?  Is it hereditary?

Research studies have shown that anti-oxidant vitamins slow down the progression of macular degeneration in patients that have been diagnosed with the disease.  There are, at this point, no proven measures that can be taken to prevent macular degeneration.  It does have a hereditary component in about 16% of those diagnosed.  The American Academy of Ophthalmology recommends that persons over 40 who have relatives with macular degeneration should have a retinal exam every two years.  

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Is high blood pressure related to glaucoma?  

For all practical purposes, high blood pressure is not related to glaucoma.

Am I going to be on these glaucoma drops forever?

Glaucoma drops are usually taken for a lifetime unless an alternative treatment is used, such as surgery.

What causes flashes?  What causes floaters?

"Flashes" are caused by the vitreous pulling or tugging at the retina.  This is related to the aging process and is called a vitreous separation.  Sometimes they can indicate a retinal detachment.  Flashes could appear like a crescent-shaped streak, a lighting flash, or a camera flash.  The flashes could be one or multiple in a series and can come or go (occurs off and on), may not be constant.
"Floaters" are caused by small particles of dead cells or other debris that become suspended in the vitreous clumping together and casting a shadow on the retina.  Most people have floaters in some degree and they are also related to the aging process.  They cast shadows on the retina and appear as spots or cobwebs.

You should contact your ophthalmologist if you notice a new onset of flashes or floaters.

When will my child's eyes quit changing?

Generally the eyes may continue to change until a person reaches their early 20's.  The changing of eye correction will often slow down during the teenage years.

What is refraction?

Refraction is the part of the exam that measures any visual change and a measurement of glasses prescription.  Refraction is the part of the exam where you look through the phoropter, the big glasses, and they ask you, "which is better, one or two?"  Refraction is performed on almost all complete eye exams.  

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I thought you accepted only what Medicare allows or pays, why is there an amount due on my bill?

The patient or secondary insurance is responsible for 20% of the allowable charges and for the portion applied to the deductible.  Medicare will have an allowable amount for each service rendered.  They will then pay 80% of that allowed amount after the yearly deductible has been met.  If you have a secondary insurance, they should pay the remaining 20%.  If not, the patient is responsible for the balance.

Why won't my insurance company pay on a routine/medical eye exam?

The doctor arrives at his diagnosis from the patient's history, which is given by the patient at the time of service.  If there is not a medical reason for the patient being seen, we cannot bill the insurance company using a medical diagnosis.  Routine eye exams are not covered by some insurance companies.  Please call your insurance company and asked about your benefits before you come in for a routine/medical eye exam.

I talked to my insurance company, they say you can change the diagnosis and they will pay for the exam?

The doctor determines the diagnosis at the time of the exam.  We cannot change the diagnosis if the documentation is not in the medical chart and without authorization from the doctor.  Changing a diagnosis without proper documentation is considered insurance fraud.

Why haven't you followed up with my insurance company?

Because we have so many patients, we are unable to call everyone's insurance company; however, we do bill the insurance company and send a statement to the patient.  We can tell the patient about all of the activity that has taken place on their account, but the patient is responsible to contact their insurance company to find out the status of their claim.  The contract is between the patient and their insurance company.  Please let us know if we can do anything to help the process along after the patient has spoke with their insurance company.  

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Did you bill my secondary insurance?

Yes, we bill all secondary insurance companies; however, it is best if you call your insurance company and our office to verify information and receipt of your claim and status of the payment.

Are your doctors providers with my insurance company?

Call your insurance company and verify if our doctors are providers for your insurance.  There are so many different companies and different policies within those companies, many of them have guidelines specific to employers, therefore making it difficult for us to know all of them.  Also make sure to get the name of the person you spoke with at your insurance company.  If your doctor at CHEC is not a provider with your insurance company, call us; we may be able to become a provider.

I paid my co-pay, why do I still owe a balance?

Some insurance companies do not cover the full charge of the exam and will only pay a flat fee; therefore in many cases, the patient is responsible for the balance.

Why am I getting a reminder card to make an appointment two months before my yearly eye exam is due?

We send out reminder cards two months before the actual time the eye exam is due so that the patient will be able to call and get an appointment time that will work best for them and their schedules.  Insurance companies will not pay for the exam if it has not been a full year since the patient's last eye exam.  A suggestion would be to write down the date of the patient's last appointment somewhere so he or she will remember when their last eye exam took place.  Our clinic can also tell the patient when their last eye exam was performed.

Why can't I talk to the doctor about billing issues?

Our well-trained Billing Department is able to help the patient with the information they need, therefore allowing the doctor to concentrate on providing excellent medical eye care to the patient.  If needed, our Staff will check with the doctor and/or the business manager regarding a specific issue and, if necessary, get back with the patient with the result.

 

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