Billing and Insurance

Ophthalmic Consultants of Boston accepts most health insurance plans. You should always check with your health insurance plan to make sure you understand your plan’s benefits, costs and whether your eye doctor at OCB  is part of your insurance plan’s network of providers.

We encourage you to take the following steps before your visit:

 

Verify that your insurance plan is accepted.

Call the OCB Billing Department at (800) 649-0733 to have your specific insurance plan verified for coverage and benefits before your scheduled appointment to ensure there are no limitations or restrictions that would prevent you from coming to OCB.

 

Be sure your plan’s referral requirements are met before your visit.

  • If you have an HMO plan, you must have a referral to see one of our doctors.
  • If your primary care physician (PCP) is part of a restricted network, there are stringent requirements to see doctors outside of your network, so it is very important to contact your PCP well before your appointment to ensure that your visit to OCB is covered by your insurance.
  • To obtain a referral, call your PCP and provide the OCB Doctor, appointment date and reason for the visit scheduled with OCB.

We recommend calling OCB’s Billing Department at (800)649-0733 at least 3 days before your appointment to ensure your referral has been issued to cover your upcoming appointment.

 

Preparing for your visit checklist:

  • For HMO plans, call your PCP and request a referral at least 5 days prior to your visit.
  • Identify and understand your plans limitations and any deductibles, coinsurance and copayments that may be required or incurred at your visit with an OCB doctor.
  • Bring all of your insurance cards to the visit to ensure accurate billing to your plan.
  • Be prepared to pay by debit or credit card for any required co-payment at the time of service.

 

Utilize Patient Gateway

Patient Gateway is the most convenient way to see your billing, make payments and has the following benefits:

  • Paying your bills online results in immediate credit of the payment to your account.
  • Saves you time and postage and is convenient
  • Allows you to review your statements on line.

You can send billing questions from Patient Gateway by email directly to the OCB Billing Department.

 

Understanding Surgical Billing

Review your surgical packet of information carefully and ask questions to your doctor’s clinical team to understand all aspects of your upcoming surgery. Please review carefully the surgical billing information letter that is part of your packet to understand the billing process.

Surgical billing information letter

 

Statements and Billing

If you have any questions about a billing statement you receive from our office, please call our Billing Department at (800)649-0733 and we will be happy to assist you. You can also use Patient Gateway for reviewing your statements and to select a paperless billing process.

Billing and Insurance FAQs

Have questions? Contact OCB's Billing Department at 800-649-0733.

What is a Refraction?

A Refraction is a diagnostic test to determine the health of the eye and the refractive state of the eye using specialized equipment to generate a vision measurement and prescription for glasses.

What is the difference between routine visits and medical visits?

The specifics of medical insurance can be confusing, and vision coverage is no exception. Insurance companies usually categorize visits to your eye doctor as either “routine” or “medical”. This has little to do with the steps it takes to perform a full eye exam. A “routine” vision exam often contains the same elements as a “medical” eye exam. The reason for your visit and the results of the examination, or the diagnosis, often determine whether insurance will classify the exam as routine or medical. Insurance companies often look at both when determining payment. The routine vision exam usually produces a final diagnosis, such as “nearsightedness” or “astigmatism”, which generates a prescription for glasses, while the medical eye exam produces a diagnosis of a medical condition such as “conjunctivitis” or “cataract.”

What is a deductible?

This is the initial dollar amount you must pay before your insurance company begins to pay for health services. Your insurance carrier determines your deductible when you chose your policy.

What is coinsurance?

Coinsurance is the share or the percentage of covered expenses you must pay in addition to the copay and/or deductible. For example, your policy may pay 80% of covered charges after you pay the deductible. You would then be responsible to pay the remaining 20 percent as coinsurance.

What is a copayment?

A copayment is a specified dollar amount you pay, as a subscriber to a managed care plan for covered health services. It is paid to the medical provider at the time the services are rendered.

Can I pay my bill online?

Yes!

Patient Gateway provides secure online access to your health information whenever you need it, and it’s easy to enroll. Through Patient Gateway you can

  • check upcoming appointments.
  • communicate with your doctor’s office.
  • review medications and pay medical bills – all seamlessly online 24/7.

You can login by clicking here