Does my insurance cover routine eye exams? Is my insurance accepted here?
Most major medical insurances offer an annual eye exam each year. Rivertown recommends calling your insurance provider to know your plan’s routine benefits. Rivertown is a participating provider with most of the following plans:
Blue Cross Blue Shield of MN
Minnesota Medical Assistance
Vision Service Plan (VSP.)
Other insurance we submit to but may not be in network with are:
Aetna, Humana, UnitedHealthcare, UMR, and TriCare.
Who is responsible for finding out if my insurance covers my visit?
Rivertown does our best to find out your insurance coverage, but ultimately, it is your responsibility to know your benefits.
Will my insurance cover an emergency visit to your clinic?
our out of pocket expense varies and is based upon your insurance copay, deductible, co-insurance, and out-of-pocket maximum.
Why was my contact lens evaluation not covered by insurance?
Contact lenses are considered an elected alternative to eyeglasses. Insurance companies do not deem contact lenses as a necessity for most refractive corrections.
Does my insurance cover the retinal photos?
At Rivertown, we do screening and medical retinal photography. Screening retinal photography coverage is different for each insurance plan, please call your insurance to know your benefits. Medical retinal photography coverage will be based on your copay, deductible, co-insurance, and out-of-pocket maximum.
Why did my routine eye exam have a copay?
There are times when your routine annual exam turns into a medical annual exam, and copays may apply. Please call our office regarding questions.
Why was my claim denied by my insurance?
Reasons for denial may range from:
a referral is needed, coverage has been termed (ended), the provider is out of network to a submission error.
Please call your insurance company or us to find out more and ensure your claim is accepted.
When should I expect to hear if I owe something?
If there is a balance owed after your appointment, you can expect to hear from us in 4 to 6 weeks via a statement in the mail. Claims are filed within 3 business days of the date of service. The time it takes for the insurance company to process claims and respond can vary from two weeks to two months or more.
What do I do if I can't find my insurance card at my appointment?
Call your insurance company to obtain your insurance ID and group number and request a new insurance card.
Does my Insurance pay you or me?
Most insurance companies will make direct payments to Rivertown Eye Care.
How often can I get an exam?
Annual comprehensive eye exams are recommended for all over the age of 5 years. Check with your insurance company to see how often they will contribute to your annual exam.
How long will it take to find out what Insurance has covered?
Most claims are processed by insurance companies in 4 to 6 weeks.
If I don't have insurance, can I still get an eye exam?
If you do not have insurance or your insurance will not contribute to your annual exam, Rivertown will give you a discount of 20% for payment made on the same day as the annual exam.
Why wasn't my entire exam covered?
Medicare requires eye care to break the exam into two parts: the comprehensive exam and refraction.
Medicare and some other plans do not contribute toward the refraction. It is an out-of-pocket expense.
Do you take new patients with medical assistance insurance?
Yes, we do accept Minnesota Medical Assistance plans.
Why do I have to show my insurance card when I register at the front desk?
Your insurance card has helpful information on it including, but not limited to:
your name, ID number, group number, plan type, deductible, copayment, and payer ID.
Do you give a discount if I pay during the time of service and nothing is submitted to my insurance?
If you do not have insurance or your insurance will not contribute to your annual exam, Rivertown will give you a discount of 20% for payment made on the same day as the annual exam. No discounts will be given for medical visits.
Do you bill Workman's Comp Insurance if needed?
Yes. Complete Workman’s Comp information will be needed including, but not limited to: Workman’s comp company, contact person, address, phone number, fax number, company you work for, date of injury, location of injury and description of injury and your insurance.
Where do I look for my group name and number?
The insurance identification number, group number and name will be printed on the front of your insurance card. If you cannot find your card, please call your insurance company.
How do I know who the subscriber is?
The subscriber is the person who pays for the health insurance premiums or whose employment is the basis for the membership in the insurance plan.
What's the difference between in-network and out-of-network?
In-network providers are participating with your insurance plan. Out-of-network providers are non-participating providers.
Insurance plans may not pay the non-participating provider as much, leaving the patient with a higher out-of-pocket expense. Please call to confirm whether your insurance company is in-network or out-of-network with Rivertown.
Where do I find a list of providers I can go to with my Insurance?
A: Call your insurance company or log in to their website to view a list of participating providers.
Have another question not answered here?
Give us a call, send us an email, or stop by and we will be happy to answer your question the best we can.