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Billing & Insurance

We are a participating provider with Medicare, Blue Cross Blue Shield and most other medical insurance companies. If you have questions regarding our participation in your specific plan, feel free to contact our business office at (269) 329-5870.

To better serve you, please keep us informed of any changes in your address, telephone number or insurance coverage.

Kalamazoo Ophthalmology participates in the following insurance programs. If your plan is not listed, call our office since we are continually adding programs.

  • Aetna
  • BCBS
  • Blue Care Network
  • Blue Choice POS
  • Champus / Tricare
  • Choice Care
  • Cigna
  • C N A
  • Cofinity
  • Caresource
  • GEHA
  • First Health
  • Medicaid
  • Medicare
  • Multiplan
  • One Health Plan
  • PHP
  • Priority Health
  • Teamsters
  • United Health Care

Vision Plans

  • BCBS Vision
  • Heritage
  • Eye Med

  1. Kalamazoo Ophthalmology is a participating Medicare provider, therefore, we directly bill any services for Medicare patients.
    ◦ Medicare requires a deductible at the beginning of every calendar year.
    ◦ Medicare pays 80% of the approved amount.The remaining 20% of the approved amount is the your   responsibility or a coinsurance’s responsibility if that applies.
    ◦ Not all insurance companies will cover Medicare’s annual deductible. Please be aware that some   supplementals also require an annual deductible. It is your responsibility to understand your policy’s   deductible.
  2. Medicare will not pay for glasses unless you have had cataract surgery. After each cataract surgery, Medicare will cover 80% of the cost of one basic pair of eye glasses or contact lenses.
  3. Medicare and many other insurance companies will not pay for a refraction fee. This is usually an out of pocket cost to the patient.
  4. We are here to serve you. Please feel free to call us if you have any questions at: (269) 329-5860 or
    1-800-537-3327.

If financial problems arise, please call our billing department at (269) 329-5870. We will work with you to make arrangements that are mutually agreeable.

If surgery is planned, you and your family are invited to discuss the fee and appropriate methods of payment with our business office at the time of your pre-operative conference.

REFRACTION POLICY

A refraction is the procedure performed by an eye doctor or technician to determine if a glasses prescription is needed or if there is any progression in your medical condition. A phoropter, fitted with various lenses, is used to perform the refraction. This is the part of the the exam where the doctor or technician gives choices and asks questions such as, “which is better, one or two?” The refraction is part of a comprehensive eye exam and necessary to help the doctor determine if your vision can be corrected with glasses.

As dictated by the federal government, the refraction is a non-covered service that must be billed separately from the exam. Because Medicare ruled the service non-covered, many other medical insurance carriers have mandated the same policy. It is also required by Medicare and therefore, required by other medical insurance carriers that the patient pays for the the refraction separately from the exam.

CONTACT LENS POLICY

Historically, KOPC has not charged additional fees to our contact lens patients for services involved in the annual renewal of your contact lens prescription. However, due to additional doctor/technician time involved in evaluating and renewing your contact lens prescription, there will now be an additional charge for this service. This fee is not covered under medical insurance plans, is not a medical procedure and payment is expected at the time of your visit.

Additional contact lens service fees still apply such as gas permeable lens inspection and cleaning, etc. In the event that you need to be refit with a different type of contact lens. The total cost of the refit fee varies by type of lens and is outlined in our contact lens brochure.