Insurance Coverage and Fees
Like any surgical procedure, you will incur separately billed charges from three places:
- Surgeon’s office
- Surgery center facility
Because these are all separate business entities, the patient is responsible for any insurance co-pays, co-insurance and/or deductibles that may apply for each of these three entities. Our office will pre-certify your insurance benefits only for the surgeon fee associated with the cataract surgery. This pre-certification document, with the estimate of charges, will be given to you at the office or mailed to your home. The amount designated as ‘patient responsibility’ is due five business days prior to surgery. Keep in mind that this is an estimate of benefits obtained from your insurance carrier and the actual amount owed could vary. The surgery center and anesthesia group will submit their charges to your insurance and a separate bill from each entity will be sent for the portion owed after insurance has paid.
Your health insurance will generally cover cataract removal and a single-focus lens implant only. Any advanced technology elective upgrades to your cataract procedure, such as Limbal Relaxing Incisions for astigmatism or the upgrade to a Premium Lens Implant (Multi-focus or Toric IOL), are 100% the financial responsibility of the patient and will NOT be billed to insurance. If you elect to upgrade to a Premium IOL, the upgrade fee you pay to Cavanaugh Eye Center covers the cost of the Premium Lens Implant as well as all additional physician services associated with the lens upgrade, as listed below:
- corneal topography and keratometry
- pachymetry or corneal thickness measurements
- dry eye assessment and treatment advice
- immersion a-scan ultrasound
- laser interferometry lens implant power calculation
- additional follow-up exams, if needed, as outlined in the Lens Options handout
- all extra pre- and post-op counseling
- any refractive enhancement procedures such as LASIK, LRI, CK, etc., if needed, as outlined in the Lens Options handout
Again, it is important to understand that the Premium Lens upgrade fee covers only the implant upgrade and the above Physician services. You will still have co-pays, co-insurance and deductibles due for the cataract surgery for each of the three entities outlined above.
CEC Financial Policy
With today’s rising cost of health care, we are making every effort to keep fee increases to a minimum. Similar to any business, we can only keep the doors open and pay our staff if we receive timely payment for our services. In order to do this, we need your help in fulfilling your financial obligations. In an attempt to provide full fee disclosure and notification of our policies, please review the statement of our Financial Policy listed below.
We require 24 hour notice of rescheduled/cancelled appointments to avoid a fee.
IF YOU HAVE HEALTH INSURANCE COVERAGE…
- Please supply us with a current copy of your insurance card.
- Please notify us of any changes in your address or telephone number.
- All copays are due at the time of service.
- All non-covered services such as refractions (new prescription for glasses) will be due at the time of service.
- All referrals are the responsibility of the member/patient and must be current prior to your visit.
- Your estimated portion, including any deductibles, co-insurance or non-covered service will be expected to be paid prior to your surgery date.
- Patient balances are due 30 days after the insurance notifies our office of patient responsibility.
- Patient will be responsible for any fees associated with enforcement of collection action.
IF YOU DO NOT HAVE HEALTH INSURANCE…
- Payment in full is required at the time of service.
As a courtesy, we will gladly assist you by filing your claim with your insurance carrier. If you receive a statement from our office after insurance has paid or denied, the balance then becomes your responsibility to pay. If you disagree with the balance for any reason please contact our business office at 913-897-9200.
Payment in full is required at the time of service. We accept cash, check, Visa, MasterCard and Discover. We do not provide financing in house for elective IOL upgrades but financing arrangements can be made through CareCredit. Through this option, patients can opt for financing over 1, 2 or 3 years or the one year same as cash option. You apply via www.carecredit.com
and your specific rates will depend on your credit rating. The process is simple and you will have a credit determination quickly. Our surgical counselors can provide you information about Care Credit and help guide you through the process.