Pediatric Ophthalmology
(724) 772-3388  
 
  & Adult Strabismus
     
     
 
Pediatric Ophthalmology
& Adult Strabismus
(724) 772-3388
 
PEDIATRIC OPHTHALMOLOGY
& ADULT STRABISMUS
 
Billing & Insurance
 
Fees & Insurance
The physicians at Pediatric Ophthalmology and Strabismus Surgical Associates have always made every effort to provide the highest quality care at a reasonable cost. In an effort to continue to keep the cost of eye care at a reasonable level, we have the following policies:
 
 
Self-Payment
If you are the person responsible for payment for your visit or your child's visit, we ask that you pay in full at the time the service is delivered. This will reduce the cost of preparing, processing, and mailing statements at the end of the month and permit the staff of this office to concentrate on providing the best possible eye care for your family.
 
 
Patient Balance & Insurance Claims
You are ultimately responsible for payment for the care provided to you by this office. We will assist you in filing for coverage for your office visit if you have coverage for medical care. If medical visits are covered by a third party insurance company or an HMO, you should be aware of the reimbursement policies of your insurance carrier. There have been increasing numbers of insurance programs and prepaid methods to cover eye care and health care in general and this has created an increased amount of complex paperwork to process each patient's claim. Each care plan has separate rules for authorization, payment, and handling of claims. These plans can and do change without notice. 
 
You should be familiar with the extent and type of coverage for your family and carry appropriate identification cards to enable you to receive all of the benefits that are available. It is your responsibility to bring all necessary referral forms, current insurance cards, authorizations, and patient's social security number with you for each visit to our office. Medical examinations cover medical and surgical problems. Many plans require preauthorization for coverage.
 
Only some health plans cover office visits for vision care. The extent of coverage is determined by the insurance company policy that you have purchased. Each company will have several different coverage plans. To avoid misunderstanding, you should become familiar with the eye care benefits you are covered for and have appropriate authorization forms available at the time of your visit. If there is doubt regarding coverage, please pay for your office visit and submit appropriate forms to your company for reimbursement. All balances are to be paid in 60 days. 
 
Patients may also be refracted during your office visit. This service is not included in the new evaluation and management codes that have been used since January 1998. Refractions are a non-covered service by Medicare guidelines.
 
 
Accepted Insurnace Plans
Most major insurances accepted including Highmark, UPMC, Aetna, Cigna, United Healthcare, Gateway, Medicare, Medicaid, and others. Our Eyewear department participates with many vision plans that provide benefits for glasses and contact lenses.
  • Davis Vision
  • VBA- Vision Benefits of America
  • VSP- Vision Service Plan
  • NVA- National Vision Administrators
  • UPMC/Opticare
  • Eyemed
  • PA Medicaid/Access
  • UPMC  Vision Advantage
Each plan's benefits are different.  Please be familiar with your coverage.  Our opticians are willing to help you understand your coverage. Your understanding and cooperation in these matters is appreciated by all of our staff. Questions regarding billing should be addressed to the billing department at 724-772-3388, Monday - Thursday, 9:00 am to 3:00 pm.
 
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Pediatric Opthalmology & Adult Stabismus