While it is our goal to attempt to assist all patients with the processing of payments and submission of insurance paperwork, we have ethical and legal rules we need to adhere to with respect to insurance. Eye Q is not credentialed with all insurance providers. Typically, if Eye Q has chosen not to credential with an insurance provider, it is because that provider does not aloe any coverage for the type of services we provide. If we are not participating providers with your plan, you will be expected to self-pay for services and receipts will be provided with the appropriate codes that you will need to submit on your own to your insurance provider. If Eye Q has no relationship with the provider, we are not allowed to communicate with them on your behalf.
We believe that our services are worthwhile and beneficial, whether a third party insurance company chooses to pay for them or not. We understand that it can be frustrating that some plans pay for services that other plans choose not to. We have found that writing letters of appeal and making phone calls to the company is fruitless in changing their position about reimbursement for services.
Despite what you may be told by a representative on the phone, the only way to know for sure if you will receive reimbursement for vision therapy services is to submit a claim. Often, a customer service rep will tell you that services will be covered, but when a claim is filed, it is denied as a non-covered service. All insurance companies have a policy that “verbal authorization is not a guarantee of payment of services.” This means they can tell you anything on the phone, but need to obey their rules once a claim is processed.
At the present time, Eye Q participates with the following insurance plans:
- Anthem Blue Cross/Blue Shield of NH
- United Healthcare (without the HPHC logo on the card)
Eye Q is constantly working with insurance providers to maximize their willingness to cover services. Your insurance company’s decision not to cover services or to deny your claims are just a s frustrating to us as they are to you. These decisions should not be a reflection of Eye Q, but should be taken up with your insurance provider independently.