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Non-covered Services
- Refraction:
- Refraction is defined as the
determination of a glasses or contact lens prescription through the use
different trial lenses or other techniques. Medicare, and many other
major insurance companies, have separated the "refraction" out from the rest of the eye examination.
Instead of covering the refraction, these insurances request that the
physicians themselves collect the "refraction fee" as a non-covered, but
billable, service.
Some Vision plans and Medical Insurances may cover the "refraction fee", but many do not
The "refraction fee" is due at the time of the visit, and is
currently $35 (subject to change).
A refraction fee is usually charged when a glasses or contact lens
prescription is dispensed. However in some cases a refraction may
be performed in order to determine the best corrected vision, but the
prescription is not dispensed because of medical reasons (cataract
requiring surgery, etc.)
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- Advance Beneficiary Notice:
- In some cases it may not be likely that Medicare or an insurance
company will cover a particular service. This may be because the
service
is a new diagnostic procedure or treatment that has not been fully
reviewed by the insurance. In many cases insurances will not cover
office procedures considered to be cosmetic. If it is possible that the insurance
may not cover the test or procedure, you will be informed of this and
will be given the Advance Beneficiary Notice to review and sign.
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