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Insurance

Can I use my vision insurance benefits (VSP/EyeMed/Davis/Spectera/Superior) at your office?

Very likely yes!  Our practice now works with all types of vision insurance on an open-access basis. As an open-access provider, we are not contracted directly with your vision plan, but we can still perform eye exams and utilize your vision insurance benefits. 

If you provide a few pieces of information, we can look up your benefits to let you know what your insurance covers and what your out-of-pocket expenses will be.

Why is your office no longer directly contracted with my vision insurance?

Many patients don’t realize that their vision insurance does not fully pay providers their exam fees. In fact, many vision plans only reimburse providers $40-$60 for an exam, and contracted doctors are required to “write off” the balance.  This low provider reimbursement rate has remained the same for the last 15+ years.

Providers are now faced with higher costs than ever to run a practice. These costs include paying doctors and staff, paying rent, and paying for exam equipment and supplies necessary to run an office. It is no longer economically viable to continue as a contracted provider with these low reimbursement rates. We believe that doctors who continue to remain as contracted providers will end up having to delegate more of the exam to technicians and spend less time with each patient. Ultimately, we have decided that we are unwilling to see more patients in less time and compromise our quality of care.

Does this mean I have to submit the paperwork myself in order to see you?

We still submit everything for you!  Our goal is to remove the headache of dealing with insurance carriers.  For some plans, the insurance will reimburse the patient directly for what they cover toward an exam.  For other plans, the insurance will reimburse the provider. Either way, we will tell you upfront what your benefit covers, and what your out-of-pocket expenses will be so there are no surprises.

Does this change have any additional benefits?

Yes.  Becoming an open-access provider has allowed us to include our Optomap retinal imaging on every patient as part of the exam fee.  Since incorporating the Optomap into our practice over a decade ago, we have diagnosed many eye diseases in patients of all ages using the Optomap.  Some of these conditions were vision-related and some life-threatening.  These cases included patients of all age ranges, but a surprising number of cases included younger patients (under 30 years old) that were asymptomatic at the time of diagnosis.  To be able to include Optomap retinal imaging as a standard part of our eye exam will help make sure that these cases are diagnosed promptly and treated properly.

Should I just go to a practice recommended by my vision insurance company?

We understand why that would be tempting.  A vision insurance company will often recommend a practice that they control (either directly or indirectly).  So when a patient goes to a practice recommended by an insurance company, they will likely be sold products made by the same company that told them to go there.  This conflict of interest is usually not disclosed and is often not in the best interest of the patient.  Many times, it ends up costing the patient more money.

In contrast, our practice only does eye exams.  We do not sell glasses or contact lenses.  Our recommendations after an exam are completely independent from the sale of any product.  Because our exams are completely separate from the sale of glasses, you can be assured that our recommendations after an exam are completely unbiased.  Often this includes recommending the patient not spend money on new glasses at all!  This approach to eyecare has created happy and loyal patients, and we look forward to serving those patients for years to come.