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

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?

September 27, 2016

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:

  1. the vision insurance is billed (if the patient has vision insurance and the doctors are participating providers in their vision insurance plan) or,
  2. the patient is responsible for the examination fees on the day of service

Subsequent office visits and testing (on a different day) for the purpose of addressing the medical condition that was discovered as part of the routine eye examination are billed to the medical insurance.

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