Thank you for choosing Jax Vision Care as your ocular healthcare provider. We are committed to providing the best medical care possible. Please understand that payment for your services is essential for us to continue to do so. All payment is due at the time services are rendered or materials purchased unless other arrangements are made PRIOR. The following paragraphs explain our financial policies. We will be happy to discuss these with you or answer any questions you may have. Please read, sign and return to the front desk.
INSURANCE
For some insurances, we accept assignment of benefits, but in ALL cases, the person responsible for payment (guarantor), is personally liable for all balances or procedures not covered by insurance. Please be aware that some, and perhaps all, of the services provided may be non-covered services or may not be considered medically necessary under Medicare guidelines. If you are not insured by a plan that we participate with or you are, but do not have an up-to-date driver’s license or form of government issued identification and/or a current insurance card, payment in full is required at the time of service. If there are any changes with your insurance coverage, please notify our office as soon as possible PRIOR to your next appointment. Failure to do so could result in payment for services being patient responsibility.
USUAL AND CUSTOMARY RATES
We charge what we believe to be usual and customary rates for our specialty and region to our patients and insurance companies. If your insurance company uses a different fee schedule, you will be responsible for any leftover balance.
CLAIMS SUBMISSION
We file claims to your insurance company for payment as a service to you. We will assist in any way to get your claims paid in a timely fashion. It is your responsibility to comply with any requests from the insurance company regarding information for payment. The contract with the insurance company is between you and the company; we are not party to such contract. If your insurance company does not pay your claims within 45 days, the patient is responsible.
DELINQUENT/PAST DUE ACCOUNTS/CANCELLATION POLICY
In some instances, we may bill a patient after services are rendered as a courtesy and expect payment within a timely manner. If balances exceed 90 days, the account is considered delinquent or past due and a $15 billing fee will be added to the current balance. If the account continues in this manner, $15 will be added to each monthly statement. Accounts with balances exceeding 180 days will be sent to a collection agency and the patient or guarantor will be responsible for all additional fees, including but not limited to agency fees, court costs and attorney’s fees. Also, a 1099 will be issued to the IRS for cancellation of debt. Once this step has been taken, Jax Vision Care, P.A. will continue care for 30 days for emergency situations and only on a cash basis. We kindly ask that a 24-hour notice be given for cancellation of an appointment. Failure to do so will result in a $25 fee to be paid immediately.
CO-PAYMENTS AND DEDUCTIBLES
All co-payments and deductibles are due at the time of service. This is part of your contract with your insurance company. Failure to pay/collect could be considered insurance fraud. If co-pays and deductibles are not paid at the time of service, there will be a $15 billing fee added to your account that will not be covered by your insurance company.
PERSONAL CHECKS
***AS OF January 1st, 2019, Jax Vision Care will no longer accept checks from patients. Prior to that, checks that are returned for any reason will incur a $45 returned check fee in addition to any fees Jax Vision care, P.A. may incur from the bank. These fees are not covered by insurance and are expected to be paid immediately by cash or credit card to prevent legal action. All visits will be postponed until the account is current.
REFRACTION
Performing a refraction is essential to your exam and vision care. Medicare, along with some other insurance companies DO NOT cover a refraction, but it IS very important in determining your potential vision and in medically diagnosing causes of vision loss.
What is a refraction?
A refraction is performed for multiple purposes in an eye exam. It helps with determining your need for glasses or contact lenses. More importantly, it can detect vision loss that a patient may not be aware of due to an unknown condition or problem.
Why is it a separate fee from the exam?
Medicare has deemed that a refraction is not a medical service and therefore is not covered. Most insurance companies follow Medicare guidelines. Medicare acknowledges that it is a separate service/procedure from the exam and therefore, it has a separate fee.
Do you have to charge for it?
YES. The Office of Inspector General has deemed that not charging for a provided service is an "inducement" to the patient and therefore illegal. The Federal Government insists that all services rendered must be charged for. The concern is that some physicians may try to lure or entice patients to their practice versus another by offering free services. We are obligated by the government to charge for all services.
The refraction fee is $35 and is due at the time of service. We will still bill it to your insurance company although payment is not expected. If your insurance pays the refraction or a portion of, your account will reflect that and there will be an appropriate credit.