Insurance and Billing
Insurance Benefits, Covered Services, and Eligibility
At Spokane Eye Clinic (SEC), we recognize the importance of our patients knowing and understanding the issues that affect the total cost and out-of-pocket cost of care they receive. We have developed the following written policies to ensure that all of our patients understand the services our Business Office provides and the rights and responsibilities our patients have with regard to payment for services.
If you have questions, contact the Business Office (509) 623-9765 between 8 a.m. and 4 p.m.
What is covered and what is my co-pay?
SEC is contracted as a participating provider or preferred provider with a number of health insurance plans. Many of these plans offer more than one insurance product, often with specific limitations. It is the responsibility of the patient to know his or her insurance coverage. As a patient you are specifically responsible for:
- Verifying that Spokane Eye Clinic is a contracted provider for your specific insurance plan
- Obtaining a referral if necessary prior to seeing the doctor
- Determining that you are eligible at the time of service
- Knowing what services (benefits) are covered and what services are not covered by your insurance plan
- Knowing if authorization is required in advance of surgery
- Payment of all co-payments, co-insurance, and deductibles
If you have not already done so, please familiarize yourself with your insurance benefits and cost-sharing agreement. If after contacting your insurance plan you still have questions, our Business Office will gladly work with you and a representative of your plan to resolve your questions. We will need you to provide us with the information on your insurance card.
Do I need a referral?
Contact your insurance company directly to verify if a referral is needed.
The following is a list of insurance plans that SEC is contracted with. This list is subject to change without notice. Please contact your insurance company to inquire about our doctors' participation in your plan.
- Asuris Northwest Health
- Blue Cross of Idaho
- Community Health Plan of Washington (CHPW)
- Department of Social & Health Services (Washington Medicaid)
- First Choice
- First Health
- Humana (effective 1/1/13)
- Idaho Medicaid
- Indian Health
- Kaiser Permanente (usually requires a referral)
- Medicare Part B
- Molina Healthcare
- Private Health Care Systems (PHCS)
- Railroad Medicare
- Regence Blue Shield
- Secure Horizons
- Spokane Community Care
- Uniform Medical Plan
- United Healthcare
- Veterans Administration (VA) (referral required)
- Vision Service Plan (VSP)
- Washington Labor & Industries
- Labor and Industries
Insurance Billing and Statement of Account
How will I know how much I owe?
If SEC is contracted with your insurance plan, you will receive a statement of account by mail disclosing any balance due after we have billed your insurance plan and it has processed your claim. Our charges will be listed on the statement along with any payments made by your insurance plan and contractual discounts required by our contract. This statement should also correspond to the Explanation of Benefits (EOB) you receive in the mail from your insurance plan. You will receive an individual statement of account on a monthly basis. Payment is due upon receipt. Charges unpaid after 60 days may be assessed a rebilling fee.
How can I make a payment?
If you are age 18 or older, you are legally responsible for the charges you incur regardless of who you may live with or the Guarantor of your Insurance Plan. Parents are financially responsible for the charges incurred by their children under the age of 18.
Co-Payments are due at the time of service. Deductibles and co-insurance will be due at the time of service for all elective surgery. Our contracts obligate us to collect all co-payments, deductibles, and co-insurance from you. Please do not ask us to write off these amounts from your account or accept additional discounts.
You may choose from the following Spokane Eye Clinic payment options:
- We accept cash, check and credit cards (VISA, MasterCard, Discover).
- You can arrange for a financing plan/monthly installment payments.
- We also accept CareCredit
What if I don't have insurance or you don't take my insurance?
If you do not have insurance, or if your insurance coverage is with a plan that SEC does not contract with, you will be asked to make a deposit against the charges you will incur. The Business Office is available to assist with an estimate of your charges, but an exact amount may not be known until the services are provided. You will be mailed a statement of account disclosing any balance owed in excess of your deposit amount.
How can I make payment arrangements?
Financial consideration should not be an obstacle to obtaining specialized eye treatment. Patients have many options when they ask, “how can I pay for this?” We are sensitive to the different needs people have in fulfilling financial obligations.
Our goal is to make LASIK and other specialized services affordable for any budget. You may choose from the following Spokane Eye Clinic payment options:
- We accept cash, check and credit cards (VISA, MasterCard, Discover, and American Express).
- We also accept CareCredit.
One option to consider is CareCredit. CareCredit, a part of GE Capital and founded in 1987, offers healthcare financing for patients. Continued advancements in technology, and procedures that are often not covered or fully covered by insurance have created new choices for care, increasing the demand for financing options. CareCredit is a healthcare credit card that can be used as a payment option for certain expenses not covered by insurance or to bridge situations when desired care exceeds insurance coverage. CareCredit is offered primarily for dentistry, vision correction, veterinary medicine, hearing care, and cosmetic treatments and surgery.
Still have Questions?
At Spokane Eye Clinic, the Business Office handles all charges, insurance billing, and payment arrangements. Our doctors do not make judgments regarding patient discounts or amounts owed. If you have questions regarding your statement of account, our policies, financing options or Care Credit, please call and ask for a Financial Counselor between 8am and 4pm M-F, or send an email or standard letter to:
Spokane Eye Clinic, PS
Business Office /Financial Counselor
427 S. Bernard
Spokane, WA 99204