I received a lot of reader email following an article that was published a few weeks ago: Tip #637, Routine Vision vs. Medical Eye Exams: Fees and Insurance. I appreciate the comments and support on this important topic. I mentioned a patient education form that we provide to patients at check-in in my practice that explains the difference between vision plans and medical insurance. Many readers requested a copy of this form, so I’ll provide it below.
I think it is important to keep signature forms and disclaimers short. Realize that many patients simply don’t read them and they don’t want them long and complicated. You may be able to combine this vision vs. medical form with other educational documents you offer to the patient at check in, such as HIPAA acknowledgment and retinal image screening forms. You may be able keep the combined form to one page and have one patient signature cover several topics.
Your Practice Name and Logo
About Your Insurance
There are two types of health insurance that will help pay for your eye care services and optical products. You may have both types and Main Street Eye Center accepts most insurance plans in both categories: 1) Vision plans (such as VSP, EyeMed and others) and 2) Medical insurance (such as Blue Cross/Blue Shield, Medicare and others).
· Vision plans only cover routine vision wellness exams, along with eyeglasses and contact lenses. Vision plans do not cover medical eye care (the diagnosis, management or treatment of eye health problems).
· Medical insurance must be used for medical eye care.
· If you have both types of insurance plans it may be necessary for us to bill some services to one plan and some services to the other. We will follow a procedure called coordination of benefits to do this properly and to minimize your out-of-pocket expense.
· If some fees are not paid by your insurance, we will bill you for them, such as deductibles, co-pays or non-covered services as allowed by the insurance contract.
Please provide your insurance cards to our staff member so we can make a copy. We need to have your medical insurance card or Medicare card on file in case we should need it in the future for billing your insurance.