At Eye Center of the Rockies, we understand the unique challenges of living in a beautiful mountain town and how that impacts the cost of affordable healthcare.
As a trusted ophthalmology practice, we see the value in making service costs and billing practices as transparent as possible. We believe making these things clear to our patients will help them make the best choices for themselves and their families.
Vision insurance is a low-cost option offered by most employers, and it covers a basic eye exam screening and measurement of an eyeglass or contact lens prescription. However, vision insurance is not intended to address medical problems such as management of infections, dry eyes, glaucoma, retinal disorders, floaters, and so on.
Instead, medical concerns are handled by traditional health/medical insurance; or if the patient doesn’t have insurance, through private payment. Vision insurance reimburses eye care providers only minimally, and there’s a lot to cover: labor, rent, utilities, insurances…the list goes on and on.
No provider in the Vail Valley can cover their practice costs (or make a profit!) with the current vision insurance reimbursement structure.
Unfortunately, this loss is almost always absorbed by the physician.
At Eye Center of the Rockies, we understand the unique geographical challenges of living in the Vail Valley; but we DO NOT inflate exam prices to offset the services we know our patients need, regardless of the reimbursement structure.
This is not true, however, throughout our mountain communities. To make vision insurance profitable, most practices cut the exam time in half by avoiding an important step, and then double the cost by charging you for a photograph.
Here in the Vail Valley, specifically, it’s common for eye care practices to skip a dilated eye exam, a critical step in detecting ocular melanoma, or other retinal abnormalities.
Just like the freckles on your body, small nevi or moles (see photo) are commonly located in the back of the eye, and just like freckles, these pigmented cells should be monitored for changes regularly; changes could signal a problem.
However, these ‘eye freckles’ are best observed during a dilated eye exam, where the entire retina can be seen rather than only a partial view with a photo.
At our office locations in Eagle and Glenwood Springs, we’ve observed ocular melanoma in women in their forties who were not given a dilated eye exam. We’ve also observed other abnormalities that could have been treated sooner had our competitors avoided this shortcut.
Instead, many mountain eye care facilities charge an additional $39 for a photo taken with a wide-angle lens. This method does not achieve a complete picture of the back of the eye and is therefore not comparable to the results achieved with a dilated eye exam…but it does save patients the inconvenience of having their eyes dilated.
Patients who switch to Eye Center of the Rockies often tell us during their vision exam they were told of that “spots” or “hemorrhages” were seen on the photo. They were encouraged to have additional testing performed the same day for additional out-of-pocket fees to be sure that everything is ok.
We’ve been told these fees can cost as much as $200 for what patient’s thought was a routine vision exam. This is how some optometry practices have chosen to make ends meet in a difficult location and in a challenging healthcare market.
If you’re presenting a medical or surgical eye problem, your services should be billed appropriately to your regular medical insurance.
If a legitimate medical problem is discovered during a vision exam at Eye Center of the Rockies, our contract with vision insurance companies calls for you to be brought back on another day; the additional medical testing is then billed to your regular health insurance.
As the only full-time eye M.D. in Eagle and Garfield county, we bill and accept medical insurance regularly, and we’re always happy to discuss our billing practices to show our patients we have their best interests in mind.
For patients without vision insurance, we offer rates that are competitive with other area optometrist practices.
We want to help everyone in the Vail Valley achieve healthy vision, and that means no shortcuts and 100 percent billing transparency.
Call our Glenwood Springs office at 970-928-0105; or contact our Eagle location at 970-926-7773 to schedule an appointment! And feel free to ask any questions you may have about billing or vision insurance.