VISION AND MEDICAL INSURANCE POLICIES
As part of the services provided by Acuity Eyecare, we are happy to assist you in determining the benefits of your individual policy and in collecting the reimbursement of insurance benefits for vision and medical services provided. The following are our policies regarding insurance and payment for services and materials our practice provides to you:
VISION AND MEDICAL INSURANCE AUTHORIZATIONS
I authorize the use of this form and the release of my personal and medical information to all my insurance companies for the purpose of obtaining payment for covered services.
I authorize Acuity Eyecare to act as my agent in obtaining payment from my insurance companies.
I authorize payment of my insurance benefits for any services provided to be made directly to Acuity Eyecare.
POLICY FOR COMMUNICATING BY EMAIL OR TEXT:
As part of our patient communication system, we can send you emails or texts for any of the following purposes:
We will only contact you via these methods for the above purposes. We will only send the above messages through our certified Electronic Medical Record system, and not with personal devices. We will adhere to HIPAA guidelines and will not put any protected health information (PHI) into these messages.
DIABETIC PATIENT CARE:
Diabetic care is managed by your Medical insurance and Primary Care Physician (PCP). It is required for all diabetics to have a retinal examination. This exam must be completed through your medical insurance for purpose of coordination of care and enable your PCP to maintain complete documentation essential for ensuring the quality of care. Retinal Optical Coherence Tomography if not covered by your medical plan as part of comprehensive diabetic care will be billed to you at the cost of $39.
SCREENING RETINAL PHOTO AUTHORIZATION:
Our doctors recommend a screening digital retinal photo be taken during your routine eye examination. Screening photos are not covered by vision or medical insurance. The purposes of these photos are to: