604130490

What is a Refraction and Why is it often Non-Covered?

Fri, 31 May 2024 10:31:48 GMT

What is a Refraction and Why is it Often

Not Covered by a Patient’s Insurance?

For many people, an eye exam is a trip to the eye doctor (either an ophthalmologist or an optometrist) for a prescription for eyeglasses or contact lenses.

An Ophthalmologist (MD) is a medical doctor and provides services beyond a typical "routine" or “annual” eye exam. A Comprehensive Vision Exam when an underlying medical problem was either found at your optometrist at your last visit and referred to us, or you have been seeing us for some time now and we are continuing medical management & treatment.

An Optometrist (OD) will perform your "routine" or “annual” vision exam. If you have trouble with your vision (nearsighted, farsighted, astigmatism, etc.), your visit is considered a vision problem and will be billed to your vision plan. Vision plans may provide coverage or discounts for routine exams, glasses, and contact lenses. It is important that you understand your Vision Plan benefits.

What is a Refraction Test?

During your “routine” or “annual” vision exam, a refraction is the test done to determine the best corrected vision for your glasses prescription. A refraction must be performed if you wish to get a new or updated prescription for glasses and/or a contact lens prescription.

A refraction test is usually given as part of a routine eye examination. It may also be called a vision test. This test tells your eye doctor exactly what prescription you need in your glasses or contact lenses.

Normally, a value of 20/20 is considered to be optimum, or perfect vision. Individuals who have 20/20 vision are able to read letters that are 3/8 of an inch tall from 20 feet away.

If you don’t have 20/20 vision, you have what is called a refractive error. A refractive error means that the light is not bending properly when it passes through the lens of your eye. The refraction test will tell your doctor what prescription lens you should use in order to have 20/20 vision.

Why is this test used?

This test tells your doctor if you need prescription lenses, as well as what prescription lens you need to see properly. The results of the test are used to diagnose if a patient is suffering from astigmatism, farsightedness, or nearsightedness. The results can even help diagnose more serious problems such as macular degeneration or retinal detachment.

Refraction Policy

While a refraction is essential for a comprehensive eye exam, the charge for a refraction is only covered by some insurances but not all. The charges for a refraction are covered by some insurances (Vision Insurances at your Optometrist) but not by insurances when an eye exam is done at your Ophthalmologists office.

Some people have both health insurance--which covers medical eye problems--and vision insurance--which covers “routine” eye care (no medical problems) such as refractions and eyeglasses. If you come in for a routine exam with no medical eye problems or complaints and you have a vision plan, you will need to plan your eye exams with one of the local optometrists in the area, and then the refraction would most likely be covered by your vision insurance.

If you have a medical eye problem like cataracts, dry eyes, or glaucoma then Medicare and most other health insurances will only cover the medical portion of the eye exam and you will be responsible for the amount of the refraction.

The Cost of REFRACTION: Medicare does not cover refractions because the test is considered to be a part of a routine exam and not a medical need.

note:

Although our staff members are very knowledgeable about insurance plans, and try and stay up to date with day to day changes in policies, please remember that it is not the doctor’s or staff’s responsibility to know the details of your individual plan. It is to your benefit to be aware of possible deductibles and co-pays that are part of your plan. Your insurance plan may cover routine vision care at your Ophthalmologist and/or your Optometrists office, but if your deductible has not yet been met, you will still have to pay for the service until your deductible is met.

Your insurance is a contract between you, your employer, and the insurance company, not with the doctor.

We encourage you to speak with your insurance company PRIOR to your appointment about your plan’s specific details. Then, as always, feel free to ask us questions about how they will apply to your upcoming visit. We will do everything we can to help you better understand your policy, but the more knowledge you have about how it works ahead of time, the less frustrating it will be for you at the time of the exam.

What is a Blepharoplasty (BLEF-uh-roe-plas-tee) & What to Expect From My Appointment and Procedure?

Sat, 27 Aug 2022 22:35:46 GMT

What is Blepharoplasty (BLEF-uh-roe-plas-tee) & What to Expect From My Appointment and Procedure?

Eyelid surgery is not just a procedure for people who are worried about their drooping lids—it can actually help improve peripheral sight that’s been restricted by excess skin. Drooping lids can block peripheral vision and limit your visual field. A simple oculoplastic procedure, called a blepharoplasty , to lift your lids can help restore your range of vision.

What is a Blepharoplasty (BLEF-uh-roe-plas-tee) & What to Expect From My Appointment and Procedure?

Blepharoplasty is a type of surgery that removes excess skin from the eyelids. With age, eyelids stretch, and the muscles supporting them weaken. As a result, excess skin and fat can gather above and below your eyelids. This can cause sagging eyebrows, droopy upper lids and bags under the eyes.

A lid lift surgery such as a blepharoplasty might be right for you if you have excessively baggy eyelids that hang over the tops or sides of your eyes. Our experienced ophthalmologists will examine your eyes and your lids to see if you appear to be a good candidate. They will take photos of your lids from multiple angles as well. After that, a simple visual field test will determine how much of your peripheral vision is being blocked by your eyelids. You will also need to be able to lie mostly or completely flat safely and comfortably for the procedure. If your lids block your peripheral vision and you can have the procedure safely, you are a good candidate for eyelid surgery.

Once you have been cleared for the procedure, one of our experienced surgeons will discuss the process and its risks to you in detail. You will then talk with one of our surgery coordinators and pick out a surgery date. You will need to stop taking blood-thinning medications and some herbal supplements a couple weeks before your surgery. Day of surgery, your lids will be carefully numbed, then your surgeon will remove the excess skin and tighten your upper lids. The procedure typically takes one to two hours. You will be given a sedative, so it is important to have arranged transportation.

After your surgery, you’ll be able to go home to recuperate. Avoid rubbing your eyes and be sure to apply your ice packs to reduce swelling around your lids. You may experience bruising and swelling, giving you temporary “black eyes.” Limit your activities and take it easy for a few days as well. Avoid any heavy lifting for at least a week. Follow-up appointments will make sure the surgery was successful and you don’t have any problems with your lids.

There’s no reason to accept heavy, droopy lids or decrease peripheral vision when it can be prevented. Don’t let your lids get in your way! Our team at Shipp & Wooten Eye Center will help you determine if a lid lift procedure is right for you. Contact us for more information or an appointment at Shipp & Wooten Eye Center . Simply call (662) 286-2020 today.

Headaches? Migraines? Botox treatments are not just for wrinkles anymore.

Sat, 20 Aug 2022 01:36:42 GMT

At Shipp & Wooten Eye Center we have found that many of our patients have found relief from chronic migraines with Botox® injections. If you have fifteen or more headache days each month with migraine pain that lasts four hours or more, and regularly miss work or activities you enjoy because of debilitating migraine symptoms, there’s an effective alternative to taking headache and migraine prescription medications each time you feel a migraine coming on.

Discover why Botox® may be the best proactive solution to managing your migraine pain.

Botox® is the most prescribed branded chronic migraine treatment.

Surprising, isn’t it? Most people think of Botox® as a cosmetic injectable that smoothes out fine lines and wrinkles across your forehead and around your eyes. While Botox® is certainly an effective anti-aging treatment, it’s also an FDA-approved chronic migraine therapy.

When your provider at Shipp & Wooten Eye Center injects Botox® into seven specific muscle areas in your head and neck, the botulinum toxin — a neurotoxin that occurs in nature — helps reduce migraine pain for the next 12 weeks.

How Botox® works to help you manage migraine pain?

Botox® for migraines is a preventive medication. You don’t wait until you have symptoms to take it, but rather it helps prevent migraines from starting in the first place. Initially, you begin with two Botox® treatments spaced about 12 weeks apart.

After your initial two Botox treatments, if you’re having fewer headaches each month, then you can continue receiving Botox injections every 12 weeks, or as your health care provider at Shipp & Wooten Eye Center recommends.

During each appointment, your provider injects Botox® into the muscle groups of your head and neck. The needle is so tiny that you feel something similar to a pinprick, but nothing really painful.

The injections aren’t deep either, so discomfort is minimal and temporary. Botox® goes just below your skin into the targeted muscle groups. The medication enters the nerve endings that contribute to your migraine pain.

There, the botulinum toxins block the release of chemicals that transmit pain signals to your brain. As a result, the pain networks that usually come to life with the onset of a migraine no longer activate, so you don’t feel the usual pain and migraine symptoms.

Botox® for migraines could cut your headache days in half.

After a series of Botox® injections for migraine pain, you may have up to eight to nine fewer headache days each month. For many women and men, that’s like cutting your migraine symptoms in half — especially if you suffer from 15 or more headache days each month. Imagine waking up ready to take on the day more often than not, thanks to Botox® injections for migraine pain.

When it comes to dealing with migraines, would you rather rely on prescription medications you take as soon as you feel symptoms coming on, or are you ready to try a more preventive approach with simple Botox® injections you only need every three months?

We invite you to learn more about Botox® for migraines by scheduling a consultation today. Call our friendly office staff at the Shipp & Wooten Eye Center or request an appointment online.

Understanding Copays & Deductibles

Fri, 19 Aug 2022 00:01:49 GMT

UNDERSTANDING COPAYS & DEDUCTIBLES

Understanding health care can be confusing. That’s why it’s helpful to know the meaning of commonly used terms such as copays, deductibles, and coinsurance. Knowing these important terms may help you understand when and how much you need to pay for your health care. Let’s take a look at these terms to better understand what they mean, how they work together, and how they are different.

What’s a deductible?

A deductible refers to the amount of money you pay for healthcare services before your health insurance plan kicks in. For example, if you’re on a medical plan with a $1,500 annual deductible, it means that you are personally responsible for paying the first $1,500 you accrue in healthcare expenses that year. After that initial $1,500 has been paid, your health insurer will begin to pay for all or some of your care.

What’s a copay?

Once you’ve reached your deductible, you might still need to pay some money to access certain healthcare services. This fixed out-of-pocket amount is known as a copay, and it means that you are sharing the cost of care with your insurance provider. For example, you might pay a $25 cost per appointment every time you visit your doctor, or $10 to refill a prescription.

What is coinsurance?

Coinsurance is a portion of the medical cost you pay after your deductible has been met, and your health plan kicks in. Coinsurance is a way of saying that you and your insurance carrier each pay a share of eligible costs to add up to 100%.

Here’s an example of how coinsurance works once you’ve met your deductible. If your coinsurance is 20%, you pay 20% of the cost of your medical bills. Your health insurance plan will pay the other 80%. Let’s say you meet your annual deductible in July. In August, you need an surgery that costs $2,000. Your coinsurance share is 20%. That means you need to pay $400 ( $2,000 x 20%). Your insurance company pays the other $1,600. The higher your coinsurance percentage, the higher your share of the eligible cost is.

Out-of-pocket maximums

Both deductibles and copays count toward your annual out-of-pocket maximum, which means that once you’ve reached a certain figure in both deductibles and copays, your insurance will cover 100% of medical costs without you needing to share those expenses. In other words, a health insurance plan with a low out-of-pocket maximum will mean less money spent in deductibles and copays – but you could end up paying more in monthly premiums.

Light adjustable Lens™ from RxSight®. The perfect IOL?

Thu, 18 Aug 2022 01:08:30 GMT

Light adjustable Lens™ from RxSight®.

The perfect IOL?

The Light Adjustable Lens (LAL) is the only intraocular lens implant (IOL) of its kind. Most IOLs implanted during cataract surgery or refractive lens exchange have a pre-set power or prescription that is determined before surgery. The LAL, however, is a photo-reactive lens can be adjusted to fine-tune a patient’s refraction after surgery. Patients simply come in for a few quick, non-invasive, pain-free sessions where the lens is exposed to a special UV light that allows the doctor to adjust their vision to best suit their unique needs and lifestyle. Once optimal vision is achieved (usually after two to four sessions), the refraction is locked into place. This revolutionary lens allows us to provide our patients with the most precise and accurate vision correction available.

5 REASONS TO CONSIDER THE LIGHT ADJUSTABLE LENS

1. The Light Adjustable Lens Can Be Adjusted to Achieve the Best Vision.

2. It Can Be Used to Correct Nearsightedness, Farsightedness, And Astigmatism.

3. You’ll Be Glare and Halo-Free.

4. You'll Experience a Better Quality of Vision.

5. The Lens Is Highly Customizable.

CATARACT SURGERY AND INSURANCE COVERAGE

Thu, 18 Aug 2022 00:51:03 GMT

Is Cataract Surgery Covered By Insurance?

A Cataract is when the lens in the eye becomes cloudy and hard. Cataracts may cause blurred vision, dulled vision, sensitivity to light and glare, and/or ghost images. If the cataract changes vision so much that it interferes with your daily life, the cataract may need to be removed. Surgery is the only way to remove a cataract. You can decide to not have the cataract removed. If you don’t have the surgery, your vision loss from the cataract will continue to get worse. To restore vision, the cloudy lens must be removed and replaced with a new artificial lens called an intraocular lens implant (IOL). Surgery is the only effective treatment for cataracts . With one in six people over age 40, and more than half of people over age 80 having cataracts , you will be relieved to know that, yes, cataract surgery is generally covered by insurance. At least, most of it.

Medicare, Medicaid and most private insurance programs deem cataract surgery to be “medically necessary,” assuming the development of the cataracts is such that it interferes with the patient’s normal daily activities. Often, in the early stages of cataract development, your eye doctor will recommend against surgery until the daily impact is evident, and this generally aligns with insurance programs’ guidelines as well.

To be clear, when we talk about insurance covering cataract surgery, we’re referencing your general health insurance plan, not vision-specific insurance. Vision insurance plans are highly unlikely to cover any costs related to cataract surgery.

Insurance plans generally cover the primary costs of cataract surgery, including:

Pre-operative eye scan
Traditional cataract surgical procedure
Monofocal intraocular lens implant
Any related medications

Depending on your plan, some diagnostic procedures and pre-surgery treatments may not be covered. Additionally, many advanced intraocular lenses designed to also correct presbyopia or astigmatism are often not covered. Many patients opt to pay for these items out-of-pocket, as they can permanently eliminate the need for eyeglasses.

The specifics of health insurance plans vary, so it’s a good idea to talk with your health insurance provider in advance, so you know exactly what to expect.

If the time is right to restore your vision through cataract surgery, consider Shipp & Wooten Eye Center for your vision care. Darwin Wooten, M.D., F.A.C.S., John R. Shipp, M.D., Bernard Shipp, M.D. , along with their talented medical team, are well-known for their experience, friendliness and results. Our helpful administrative staff will work with you and your insurance provider to ensure you get the coverage benefits to which you are entitled.

Contact Shipp & Wooten Eye Center today at 662-286-2020.

604130490

What is a Refraction and Why is it often Non-Covered?

What is a Refraction and Why is it Often

Not Covered by a Patient’s Insurance?

For many people, an eye exam is a trip to the eye doctor (either an ophthalmologist or an optometrist) for a prescription for eyeglasses or contact lenses.

What is a Refraction Test?

During your “routine” or “annual” vision exam, a refraction is the test done to determine the best corrected vision for your glasses prescription. A refraction must be performed if you wish to get a new or updated prescription for glasses and/or a contact lens prescription.

A refraction test is usually given as part of a routine eye examination. It may also be called a vision test. This test tells your eye doctor exactly what prescription you need in your glasses or contact lenses.

Normally, a value of 20/20 is considered to be optimum, or perfect vision. Individuals who have 20/20 vision are able to read letters that are 3/8 of an inch tall from 20 feet away.

If you don’t have 20/20 vision, you have what is called a refractive error. A refractive error means that the light is not bending properly when it passes through the lens of your eye. The refraction test will tell your doctor what prescription lens you should use in order to have 20/20 vision.

Why is this test used?

Refraction Policy

If you have a medical eye problem like cataracts, dry eyes, or glaucoma then Medicare and most other health insurances will only cover the medical portion of the eye exam and you will be responsible for the amount of the refraction.

The Cost of REFRACTION: Medicare does not cover refractions because the test is considered to be a part of a routine exam and not a medical need.

note:

Your insurance is a contract between you, your employer, and the insurance company, not with the doctor.

What is a Blepharoplasty (BLEF-uh-roe-plas-tee) & What to Expect From My Appointment and Procedure?

What is Blepharoplasty (BLEF-uh-roe-plas-tee) & What to Expect From My Appointment and Procedure?

What is a Blepharoplasty (BLEF-uh-roe-plas-tee) & What to Expect From My Appointment and Procedure?

Headaches? Migraines? Botox treatments are not just for wrinkles anymore.

Understanding Copays & Deductibles

UNDERSTANDING COPAYS & DEDUCTIBLES

Light adjustable Lens™ from RxSight®. The perfect IOL?

Light adjustable Lens™ from RxSight®.

﻿ The perfect IOL?

CATARACT SURGERY AND INSURANCE COVERAGE

Is Cataract Surgery Covered By Insurance?

The perfect IOL?