Is it Vision or is it Medical?

Educating Your Patients

As most optometrists know, one of the most perplexing questions faced on a day-to-day basis is whether any particular visit is properly billed as a routine vision exam, typically to a patient's vision plan, or a medical exam that's billed to their medical insurance. Making matters worse, your patients have no idea and often don't even know the question or choice exists. They come in with a red painful eye, or a corneal foreign body, and they want, they expect, that you'll submit that claim to their vision plan. They have no idea that there is such a thing as a "medical" visit for an eye problem. 

The implications are important. Co-pays, coverage, and deductibles are very different between a vision plan and a medical plan. If you bill a foreign body removal to a vision plan that patient may lose the right to a routine eyeglasses/contact lenses type exam for a year! If billed to their medical insurance, however, the plan may apply the claim reimbursement to a deductible or may have a high office visit co-pay, and, at best, your patient will be upset. 

To address this potential area of conflict with your patients ahead of time Dr. Steinberg has developed his own "Vision vs. Medical" disclosure form that every patient can be provided when they check-in for their visit. This gets out ahead of the problem by educating the patient about the two kinds of insurance coverage and which is responsible for what services. 

To download the sample form in Word format click HERE (Vision vs Medical). 

Feel free to use this form as-is, or modify it as you wish.