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Comprehensive Annual Eye Exams |
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Regular eye exams are an important tool
in eye health for detecting and preventing eye diseases and evaluating
the overall health of the patient. Some diseases, such as glaucoma,
develop gradually without symptoms or vision loss, so patients may not
notice that anything is wrong until significant and irreversible damage
as been done. Early detection of eye diseases allows for a better choice
of treatment options and a reduced risk of permanent damage.
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Regularly Scheduled Comprehensive Eye Exams
Patients should schedule a comprehensive eye exam every year.
Children should also have annual eye exams to ensure proper development
of their vision and prevent any interference with academic achievement.
Older adults are often at a higher risk for eye conditions such as
glaucoma, macular degeneration, and cataracts.
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| Even if your eyes are
healthy, a regular eye exam will allow the doctor to view the blood
vessels in the back of the eye. With information obtained during an
examination of the eyes, our doctors have been able to detect chronic
conditions such as cholesterol, diabetes, and high blood pressure. The
early detection of these conditions can lead to early treatment. |
The Comprehensive Eye Exam
An eye exam is different than a vision screening, which only tests
visual acuity, and is commonly performed by a school nurse or other
health care provider. Only your eye doctor can perform a comprehensive
eye exam to evaluate the overall health of your eyes and detect any
changes that may indicate a vision disorder. |
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In addition to caring for your vision and the health of your eyes, we make a special effort to explain your condition to you in clear language and
encourage you to ask questions. We value our relationship with you and look forward to helping you maintain good vision and healthy eyes. |
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| What's better ... 1? ... or 2? |
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This part of the exam uses a phoropter
to determind your refractive error. The refraction, also termed
a vision test, is an examination that tests an individual’s ability to see an object at a specific distance and measures a person’s prescription for eyeglasses or contact lenses.
Although most insurance companies consider refractions to be "routine" and do not cover them as a medical service, the procedure is a necessary part of most ophthalmic examinations in order to determine the patient's best possible vision to help rule out pathology. It is a very detailed procedure requiring significant chair time and professional skill, and is therefore a billable service falling under patient responsibility.
Why do I have to pay for it?
CMS, the department of the federal government that controls Medicare and Medicaid, has decided that refractions are not a payable part of an eye exam.
CMS, directly under control of the US Congress, has determined this is a "non-covered" service. That means you have to pay for that portion of the eye exam.
Further, CMS has declared that if we don’t charge you extra for this service, we could receive various forms of punishment. |
What does
the phoropter do?
This photopter helps us ascertain your need for lenses to correct your refractive error
(also referred to as your refraction) for your eyeglass prescription.
An exam for Contact Lenses require even more and specific detailed tests
and chair time because your your eye health is extremely important to us
and to you. We need to be confident in our findings because you will
have a foreign body (the Contact lens) on your eye, unlike eyeglasses
which sit in front of your eye. This is the part of the exam where the doctor, or other staff member flips various lenses inside the phoropter and asks questions like
"Better 1 or Better 2?". We keep asking these questions until we are
confident that can we help you achieve the best possible vision.
Is this new?
NO! Refraction (CPT code 92015) has been a
"non-covered" service since Medicare was created in 1965.
Since about 2007, Medicare has been enforcing the policy of requiring eye doctors to charge separately for refractions.
As many private insurance carriers adopt the policies of the federal government, many of our contracts with private insurance carriers require us collect the money from you, as well.
Why don’t you tell you about it during the exam?
Many
times we will bring it your attention and tell you "this part is not covered by insurance
- you have to pay for this." The feedback we received from our patients was not pleasant. Most of our patients would be disappointed if we completed the exam without receiving a prescription, so we just proceed, unless you tell us to stop. |
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Emergency Situations
We are available, should an
emergency or urgent situation arise. Simply call our office and our
doctor on call
will assess your situation. If you cannot reach
us, please call 911 and follow the instructions you are given or
go to the nearest hospital emergency room. |
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