Insurance and Billing
Insurance Coverages and Payment Options
At the Ross Eye Institute, we accept a wide variety of insurance plans and offer many payment methods. The quickest and easiest way to pay your bill is by calling us at 716-881-7900. We offer the following to help you understand our financial policy and aid you in planning for payment.
Insurance Verification and Co-Payment
The patient is expected to present an insurance card and a form of picture ID at each visit. If no card is presented at the time of service, the patient will be responsible for services rendered. All co-payments and past due balances are due and payable at the time of service. All payments are expected to be made in U.S. dollars.
The Ross Eye Institute accepts cash, personal check, Visa and MasterCard. There is a service charge of $30 for returned checks. Patients with an outstanding balance of 120 days may be discharged from our practice unless a payment arrangement is made. Unpaid accounts, including payment arrangements not made, will be turned over to a collection agency.
Insurance Plan Participation
It is the patient’s responsibility to be aware of their insurance coverage, policy provisions and authorization requirements. Not all providers participate with all insurances; please verify whether the physician accepts your insurance coverage when scheduling an appointment. We bill non-participating insurance companies as a courtesy to you. Any outstanding balances are the responsibility of the patient.
Self-pay accounts shall exist if a patient has no insurance coverage. A deposit is expected at the time of service, unless prior arrangements have been made with the physician’s office. The deposit amounts are as follows:
• Office visit = $50
• Testing = $25
• Surgery = $500
Health Savings Accounts/High Deductible Plans
If your insurance is a health savings account (high deductible plan) you will be required to pay a deposit prior to services being rendered. The deposit will be applied to your total cost and you will be billed for the balance owed or issued a refund for an overpayment.
Patients are responsible for providing our office with all information required to properly submit charges, i.e., insurer, claim number, date of injury, etc. Without this information, the fees mandated by New York state will be charged to reflect our private fees and you will be responsible for payment. If you have private insurance with which we participate and obtain any referrals/authorizations, we will submit on your behalf and bill you for any unpaid balance.
We are “participating physicians.” This means that we must accept Medicare’s allowed charge for services rendered. Medicare will pay 80 percent of the approved amount. The patient is responsible for the remaining 20 percent, plus any out-of-pocket deductible. If you have secondary insurance, we will submit the claim for the remaining balance after Medicare has paid. Please remember that the patient, by federal law, must be held responsible for any portion of the approved amount not paid by Medicare or a secondary insurance company.
It is the patient’s responsibility to know if a referral is required by the patient’s insurance carrier. If a referral is required, the patient is responsible for obtaining the referral prior to the time of the visit. If the referral is not obtained, the patient’s appointment will be rescheduled.