Insurance & Billing
At your first appointment, our staff will review our financial policies with you. Southwest Retina Specialists accepts most insurance plans, which you can review below, and will collect any co-pays or deductibles not covered by insurance at your first visit. Co-pays, when applicable, cannot be billed to you, so be prepared to make this payment when you check in at our office. We accept payment via credit/debit cards, cash, or personal checks.
Referrals
Our office does not require patients to have a referral to be seen. However, many insurance plans require authorization to see a specialist and for certain procedures and tests. It is your responsibility to know if your insurance plan requires a referral.
Even if another eye doctor refers you to our office, some plans require a referral number from your primary care physician (PCP). Not having a referral in advance can add to your wait time. Often, this can be handled via telephone. With some plans, you may not be able to obtain a referral number without being seen by a plan PCP. In this situation, you will still be responsible for payment of services. Your health plan has the final word on authorization of referral services.
Billing Policies
Our fees vary with the complexity of your examination or treatment and can be provided upon request. Please do not hesitate to ask our experienced billing and insurance staff any questions about your insurance coverage, including these special billing policies:
MEDICARE: We accept assignment on Part B Medicare patients. You will be expected to pay your deductible and a 20% co-pay.
SECONDARY INSURANCE: We will file any secondary insurance coverage with your verified insurance carrier. If we are unable to collect directly from the carrier within 45 days, you will be responsible for payment at that time—but you may continue to work with your insurance company for reimbursement.
MEDICAID: If your coverage is active, we will file your claim.
PPO/MANAGED CARE: Our physicians have agreed to be specialty providers for many HMO/PPO plans. Please consult with billing personnel before your visit to verify coverage amounts and confirm your payment responsibility.
Surgical Billing
Prior to your surgery, our team will pre-approve the procedure with your insurance plan and determine any payments you may be responsible for. We will collect these payments prior to scheduling the procedure. If your insurance carrier requires pre-approval or special forms, please notify our staff before your surgery.
Cancellations and No-Show Fees
If a patient cancels or reschedules their appointment or surgery with less than 24 hours' notice, a cancellation fee may apply. For office visits, the fee is $25. For surgeries, it is $200.