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PLEASE NOTE: We are not in network for any of the Medicaid plans at this time.

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Why Is Medical Billing Happening?

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When Is Medical Billing Done for Eye Exams in Independence and Sandusky?

First of all, not every eye exam is equal. That’s why not all of them qualify for vision care insurance. For example, when you just need to check that your vision prescription for eyeglasses is up-to-date, you’ll need a vision test. This isn’t the same as a comprehensive eye exam –  when our eye doctors in Independence and Sandusky inspect your eye health thoroughly, looking for any signs of a problem such as diabetic eye disease, glaucoma and cataracts.

To clarify when medical billing applies, let’s begin with the following helpful review of the basic types of eye exams.

A Comprehensive Eye Exam

The inside structures of your eye can show our Independence and Sandusky eye doctors quite a bit about your health. Not only can a comprehensive eye exam detect sight-threatening eye disease, such as macular degeneration, cataracts, glaucoma and diabetic retinopathy, but it can also detect the signs of systemic problems, such as high blood pressure, diabetes and certain cancers.

In sum, a comprehensive eye exam is a medical evaluation to diagnose or treat a health condition.

A Vision Exam

When you think about getting a vision test, you likely think of a chart on the wall with lines of letters or numbers that you need to read. This is a classic exam to check visual acuity. In addition to having you read an eye chart, your eye doctor will also perform a refraction to determine your prescription. That’s when you put on those bulky frames and the optometrist inserts different lenses, all the while asking “Which is better, #1 or #2?” Based on the lens powers that give you the clearest vision, the optometrist will then give you a precise vision prescription for glasses or contact lenses.

A vision exam determines your vision prescription; it is not regarded as a medical exam.

Medical Insurance vs. Vision Insurance: Which Eye Exams Do They Cover?

Medical Insurance:

In general, when you visit eye doctors near you for a comprehensive eye exam, it will be billed to your medical insurance. That’s because a comprehensive eye exam is usually done to inspect for or evaluate an eye problem caused by a medical condition, including eye injury or disease. Some examples of ocular problems that fall into this category are dry eyes, infections, allergies, vision loss, cataracts, diabetic eye disease, macular degeneration, glaucoma, and long-term use of steroids or arthritis medications.

Vision Insurance:

Most qualified medical health insurance plans do not provide coverage for adult vision. That’s why it’s often recommended to purchase a stand-alone vision care insurance plan. Generally, vision insurance in Ohio covers annual vision tests, discounted eyeglass frames, eyeglass lenses and sometimes contact lenses (either yearly or every two years).

How do I know which insurance will be billed?

Every insurance plan has different policies and processes. The best way to understand when and why we’ll apply medical billing or vision insurance Ohio eye doctors recommend asking the staff of our eye care center in Independence and Sandusky, in advance. Also, be sure to inform our staff of the purpose of your visit to our eye doctors, so we bill the correct insurance and provide you the eye care service you seek.

Insurance plans and medical terminology can be super confusing! We’re here to help you sort out what will or will not be covered by your insurance plan. Give us a call today!