I’m working for an Optometry company currently and I am very confused on the billing practices.
Scenario-
A patient comes in for a routine yearly exam, they have vision insurance with a copay of $10 for the routine. While in the pretest room they opt in for the retinal screening which is $39 and not covered by their insurance. When discussing medical history, the patient mentions they have type 2 diabetes, but it’s well managed and they have no vision concerns. The imaging they opted in for shows no complications, they get their regular glasses rx and get ready to check out.
From what I’ve been told by the company, now that they have disclosed the DM, I’m required to now charge the patient their medical specialist copay instead of the vision insurance copay. Bringing the copay up to $50 for a routine exam, plus the $39 still for the retinal imaging. They now are leaving with an $89 bill rather than $49.
This doesn’t seem like the right way to be billing to me. Yes they have diabetes, but it’s managed, they have no concerns, we aren’t sending records to anyone, and the retinal check that’s done for a diabetic exam- they are already paying extra for. Why wouldn’t we just bill the vision insurance? Why are they paying significantly more just because of the label “diabetes”?
Scenario-
A patient comes in for a routine yearly exam, they have vision insurance with a copay of $10 for the routine. While in the pretest room they opt in for the retinal screening which is $39 and not covered by their insurance. When discussing medical history, the patient mentions they have type 2 diabetes, but it’s well managed and they have no vision concerns. The imaging they opted in for shows no complications, they get their regular glasses rx and get ready to check out.
From what I’ve been told by the company, now that they have disclosed the DM, I’m required to now charge the patient their medical specialist copay instead of the vision insurance copay. Bringing the copay up to $50 for a routine exam, plus the $39 still for the retinal imaging. They now are leaving with an $89 bill rather than $49.
This doesn’t seem like the right way to be billing to me. Yes they have diabetes, but it’s managed, they have no concerns, we aren’t sending records to anyone, and the retinal check that’s done for a diabetic exam- they are already paying extra for. Why wouldn’t we just bill the vision insurance? Why are they paying significantly more just because of the label “diabetes”?