1902 N Sandhills Blvd., Suite A & E
Aberdeen, NC 28315
Optical Shoppe:
1902 N Sandhills Blvd., Suite E
Aberdeen, NC 28315
Pediatric Ophthalmology - General Optometry 910-692-2020


Do I need a referral to be seen at your office?

September 27, 2016

Some insurance do require a referral from your primary care office or a prior authorization to be presented in order for services to be covered. These requirements should be explained in your coverage handbook, on the insurance carrier’s website or by calling the customer service number on the card. It is the patient’s responsibility to […]

When a patient presents for a routine vision exam (and this is the reason for the visit) and the doctor finds a medical eye condition, can the charges be filed to the medical insurance plan?

No. If the reason for the visit was for a routine vision examination, the visit cannot be billed to medical insurance per federally accepted billing guidelines. Therefore either: the vision insurance is billed (if the patient has vision insurance and the doctors are participating providers in their vision insurance plan) or, the patient is responsible […]

If a patient has both medical and vision insurance, which gets billed?

This depends on the reason for the visit. Examinations for medical care, evaluation of an eye complaint or to follow an existing medical condition are billed to the patient’s medical insurance plan. Examinations for the purpose of checking vision, screening for disease, or updating eyeglasses or contact lenses are billed to the patient’s vision insurance […]

What is a refraction? Is it covered under Medicare? Is it covered under commercial insurance?

A refraction is the part of the office visit that determines the eyeglass prescription. Many times this involves the comparison question “which choice is clearer, choice one or choice two?” as different lens combinations are presented to the patient. Medicare does not consider a refraction to be a “medically necessary” service, and therefore Medicare will […]

Are routine exams covered by Medicare?

Medicare does not pay for routine vision exams or refractions. Medicare beneficiaries may choose to have a routine or annual eye examinations performed, but the patient is responsible for full payment for these examinations on the day of service. Some Medicare beneficiaries may have “vision benefits” that cover routine eye examinations through their secondary or […]