Insurance & Billing
Transparent pricing and billing information
Accepted Insurance Plans
Don't see your insurance provider listed? Contact our office to verify coverage for your specific plan.
How Billing Works
Verify Coverage
We verify your insurance benefits before your appointment to confirm coverage and estimate your out-of-pocket costs.
Service Provided
You receive exceptional eye care from Dr. Plummer and our team. Any applicable co-pays are collected at the time of service.
Claim Submitted
Our billing team submits claims to your insurance company on your behalf, handling all the paperwork and follow-up communications.
You Pay Remainder
After your insurance processes the claim, we send you a statement for any remaining balance such as deductibles or coinsurance amounts.
Understanding Your Costs
Co-pay: A fixed amount you pay at each visit, typically ranging from $10 to $50 depending on your plan.
Deductible: The amount you must pay out-of-pocket before your insurance begins covering services. Deductibles reset annually.
Coinsurance: Your share of costs after meeting your deductible, usually expressed as a percentage (e.g., you pay 20%, insurance pays 80%).
Explanation of Benefits (EOB): A statement from your insurance explaining what was covered and what you owe. This is not a bill.
Self-Pay Options
We believe everyone deserves access to exceptional eye care. For patients without insurance coverage or those choosing to pay out-of-pocket, we offer several options:
Flexible Payment Plans
We work with patients to establish manageable payment arrangements that fit your budget. Our team will discuss payment plan options during your visit.
Transparent Pricing
Before any procedure or treatment, we provide clear cost estimates so you understand exactly what to expect. We believe in no surprises when it comes to your healthcare costs.
Good Faith Estimates
Under the No Surprises Act, you have the right to receive a Good Faith Estimate of expected charges for scheduled services. Request your estimate when booking your appointment.
Your Rights Under the No Surprises Act: You have protection against surprise medical bills. If you receive care from an out-of-network provider, the most they can bill you is the in-network cost-sharing amount. For questions about your rights, visit cms.gov/nosurprises.
Billing Questions
Do you accept my insurance?
We accept most major insurance plans including Medicare, Medicaid, and commercial insurers. Call our office at your earliest convenience to verify whether we accept your specific plan and are in-network providers.
When is payment due?
Co-pays are due at the time of service. For any remaining balance after insurance processing, payment is due within 30 days of receiving your statement. We accept cash, checks, and all major credit cards.
What if my insurance denies coverage?
If your insurance denies a claim, our billing team will work with you and your insurance company to understand why and explore appeal options. We'll communicate clearly about any patient responsibility and discuss payment arrangements if needed.
Are surgical procedures covered by insurance?
Medically necessary procedures like cataract surgery and glaucoma treatment are typically covered by insurance, subject to your deductible and coinsurance. Premium lens options for cataract surgery may have additional out-of-pocket costs. We'll provide a detailed cost breakdown during your consultation.
Can I get a cost estimate before my procedure?
Absolutely. We provide detailed cost estimates for all procedures once we verify your insurance benefits. For self-pay patients, we offer Good Faith Estimates as required by law. Contact our billing department to request an estimate for any scheduled service.
Questions About Your Coverage?
Our billing team is here to help you understand your insurance benefits and payment options.
Contact Our Billing Team