One of the most challenging billing issues in an ophthalmology office is whether we should be billing the medical or vision plan.

Your medical insurance may cover a medical eye problem, but not pay for the exam if it is a "routine" eye exam. If you have a medical problem (infection, corneal disorders, diabetes, a lazy eye, cataracts, glaucoma suspect, dry eye, double vision, etc.), your visit is considered a medical problem and can be billed to your medical plan.

Many medical plans are no longer paying for eye exams because of a diagnosis of blurred vision or a headache. They are considering this a routine vision exam and are often not paying for the exam.

Vision plans provide coverage for routine exams, glasses, and contact lenses, or at least give you some type of discount on the doctor’s fees. If you have trouble with your vision (nearsighted, farsighted, astigmatism, etc.), your visit is considered a vision problem and can be billed to your vision plan.

Our billers will determine the appropriate plan (medical or vision) to file your claim, based on the results of your exam. Contact us by email or, call us at 713-864-8652 to make an appointment!