Medical Problems Addressed at Annual Visits

If you are scheduled for an annual visit, we are happy to address any ocular problem(s) in addition to performing your annual routine vision exam. However, please be advised that the insurance protocols dictate that if a routine and a medical problem are addressed at the same time, then the medical insurance must be billed. We cannot bill both medical and vision insurances on the same date of service. Your visit will be subject to your medical insurance’s coverage (copay, deductible, or coinsurance).

• Additionally, there is no need to have anyone submit any acknowledgement of the policy. We want it there for informational purposes. Therefore, you can go ahead and remove the fields of patient acknowledgement and signatures.

Understanding the Difference: Routine Vision vs. Medical Eye Exams

Routine Vision Exams
Purpose: Routine vision exams focus on maintaining your overall visual health and updating your prescription for glasses or contact lenses. These exams are designed for individuals without known eye health issues or symptoms.

What to Expect:

• Measurement of your visual acuity (how clearly you see at various distances)
• Refraction test to determine your prescription for glasses or contact lenses
• Basic eye health screening to check for early signs of potential issues
• Discussion of any visual concerns or changes in your vision

Insurance Coverage:
• Often covered by vision insurance plans.
• Typically includes a comprehensive eye exam and may provide allowances or discounts for eyewear

Medical Eye Exams
Purpose: Medical eye exams address specific eye health concerns or conditions. These exams are necessary if you have symptoms, pre-existing conditions, or are at risk for eye diseases.

What to Expect:
• Evaluation and management of eye conditions such as dry eye, floaters, red eye, glaucoma, diabetic retinopathy, or macular degeneration
• Diagnostic testing (e.g., imaging, visual field tests)
• Monitoring of systemic health conditions that may affect the eyes (e.g., diabetes, hypertension)
• Treatment recommendations, such as medications or procedures

Insurance Coverage:
• Typically covered by medical insurance, not vision insurance.
• Co-pays, deductibles, and coverage details depend on your medical insurance plan. Understanding Your Insurance

Vision Insurance:
• Covers routine vision exams and eyewear benefits.
• Does not cover medical eye exams, diagnostic testing, or treatment of eye diseases.

Medical Insurance:
• Covers medical eye exams, testing, and treatment related to eye health issues.
• Does not cover routine vision exams or eyewear.

Key Tip: Be sure to clarify your concerns and the reason for your visit when scheduling your appointment. This ensures proper coding and billing based on the type of exam.