Insurance, Billing, Policies

Insurance and Billing:

Triangle Ophthalmology, PA participates in and files with most major insurance plans.   Patients are responsible to understand their coverage with their plan.  Patients must present their insurance card if they wish for us to file a claim for them at the time of service.  If the insurance card is not available, patients are considered self pay and will be expected to pay the amount in full.

Payments are due in full at the time services are rendered unless other arrangements are made prior to the exam.  Depending on the patient’s coverage, this may be a small co-payment.  We will file your claim with your insurance as directed by your plan.  We accept cash, check, or most major credit cards.

As stated previously, patients are responsible  to understand their coverage under their plans. Some insurance plans cover “routine” eye care- this is a check of the general health of the eyes and a refraction (glasses prescription).  Other medical insurance plans only cover specific medical problems, for example:  a red eye, cataracts, floaters, dry eye, diabetes etc…  With such problems, patients would be expected to pay their co-pay for a specialist visit and a refraction fee if the patient would like a new prescription for glasses.   Very few insurance plans cover contact lens evaluations.  Please click on contact lens policies and fees for associated contact lens payments.  Please do not hesitate to ask us for more details so that our staff may better explain.

For Medicare patients, we will file your claim for you.  If you require additional services that are not covered under the exam, for example, a prescription for glasses, you will be responsible for those charges.

If you have additional questions, please contact our office directly before your exam.

Additional Office Policies:

Late cancellations (less than 24 hours in advance) will be considered a “no show”.  An individual who “no shows”  inconvenience others who need access to medical care in a timely manner.

A failure to present at the time scheduled will be recorded in our appointment management system.  The individual will be sent a letter stating that they have failed to show up for a scheduled appointment.  A ” no show” fee of $50 will be billed to the patient (not the insurance company).  This fee is required to be paid prior to scheduling any future appointments.  Three “no shows” in one year may result in termination from our practice.