Billing & Financing

Minnesota Eye Consultants is contracted or works with many of the major insurance carriers in our region. Below is a general list of payers we work with, though not all-inclusive. If you have additional questions or do not see your insurance company listed here, please contact our Business Office at 952-567-6063.

• Aetna
• America’s PPO
• Blue Cross Blue Shield
• Cigna
• HealthPartners
• Humana
• Medica
• Medicare
• Medical Assistance – Minnesota
• Medical Assistance – Other states, please contact our Business Office
• Preferred One
• Select Care
• Tricare
• Ucare
• UnitedHealthcare
• VA

Please note: Your policy may have additional policy requirements, such as authorizations, referrals or coverage restrictions that may impact the final reimbursement of your claim. Please verify your coverage by calling the number on the back of your insurance card, or refer to your plan summary documents for additional details on your policy.

Minnesota Eye Consultants does not participate with any vision carve-out plans. Some employers and insurance plans offer a separate vision benefit plan specifically for routine or well vision exams and eyewear. They are often called “carve-out” vision plans. These plans are administered through a separate company than your medical coverage. Some examples of carve out vision plans include, but are not limited to:

• VSP (Vision Service Plan)
• EyeMed
• Cigna Vision
• Davis Vision
• Spectera
• UHC Vision

If you have this type of vision plan, you will be responsible for payment in full for your services. Please review your benefits carefully.

Regular eye examinations are important to your overall eye health and vital in maintaining vision for your lifetime. In order to understand how the billing of your visit will be handled, it’s important that you be aware of your insurance benefits and how they apply to your appointment. Ultimately, it is your responsibility to know what your insurance policy will or will not cover. Be sure to check your policy to determine benefit coverage prior to your appointment.

For insurance purposes, eye examinations are divided into two categories and benefit coverage for each type of exam varies by the insurance policy. You will be asked to verify the reason for your examination. This reason for your visit and your description of current eye conditions will help us to determine whether your clinical visit is defined as a “Routine/Well Vision Exam” or a “Medical Exam” and how your visit is coded and billed to your insurance.

Well Vision Exams

A well vision exam is performed for a patient who has no specific illness, symptoms, complaints, or injury that needs to be treated or diagnosed. The visit will be a comprehensive exam checking overall health of the eye, screening for potential indicators of eye disease and if applicable, supply glasses or contact lens prescription. If your doctor finds anything abnormal during your well vision exam, further testing of a medical nature may be needed. We may ask that you come back for another visit to complete any testing recommended and further evaluate the medical condition. In this case, your initial visit will be billed as a well vision exam, and the follow-up visit will be billed as a medical visit. Well vision exams do not qualify for prescribing medications.

Medical Exam

A medical eye exam is performed for a patient who is being evaluated or treated for a medical condition, symptom, complaint or injury. The visit will be a comprehensive examination for the diagnosis and treatment of disease or condition of the eye. It will evaluate the reasons for symptoms or complaints and assess any treatment needed. Some examples of disease or conditions evaluated in a medical eye exam include but are not limited to: cataracts, glaucoma, diabetic retinopathy, macular degeneration, dry eye, conjunctivitis, allergies, etc.

You will likely have a Refraction done during your eye exam, regardless of whether your visit is considered a Routine Eye Exam or a Medical Exam. A refraction is a diagnostic test used to determine any optical defect present in the eye. Refraction is necessary:

• To prescribe the best corrective lenses for eyewear. (Please note that for some medical conditions, the refraction is needed even when eyeglasses are not prescribed.)
• To determine the progression or diagnosis of certain ocular diseases.
• To ascertain the basis for your visual complaints.

Unfortunately, the majority of insurance companies do not cover the refraction. Some insurance plans consider this to be non-covered, regardless of the diagnosis or reason for performing the test. Minnesota Eye Consultants will submit this charge to your insurance on your behalf for the determination of benefit coverage. If we know there is no coverage, you may take advantage of a 20% prompt payment discount and pay for the refraction on the day of service.