Patient's Perspective

My OD's Staff Cured My Headaches

A smart approach helps one busy woman avoid confusing bills and insurance plans.

By Susan Cullman, as told to Erin Murphy, Contributing Editor

I have zero time to read the fine print of my family's complicated health and vision coverage. Thankfully, most of our office visits are simple. And when the visits are routine, our copays are simple, too. But things aren't always routine.

That's why I believe a doctor's staff is almost as important as the doctor himself. My optometrist is the perfect example. He does a great job, and his staff's efforts to simplify things and take the work and worry off of my shoulders have made me a fan for life.

Are We Covered?

I have a basic understanding of my family's coverage. But when the optometrist's staff asks me, “Does your insurance cover retinal exams?” I have no idea. I deal with the issue once every year or 5 years, but they deal with it all of the time. Shouldn't they be the experts?

My optometrist's staff thinks so. No matter the reason for my visit, they never ask me if I'm covered. Someone at the front desk always smiles and says, “I'll handle everything.” Music to my ears!

For example, my son Ryan wears contact lenses, and he's covered for an eye exam every 2 years. While working at a home improvement store one summer, Ryan racked up three injuries requring doctor visits, including a visit to the optometrist to remove an iron shaving from his eye. After removing the shaving, the doctor also fit Ryan for a new pair of eyeglasses because he'd lost his backup pair.

It had been only 18 months since Ryan's last visit, so I wasn't sure if we'd be covered. I thought I was in for long customer service calls to our insurer, but my optometrist's staff handled all of the details of the vision plan and health insurance coverage for his visit.

They've also handled complicated insurance situations with my mother's Medicare and supplemental coverage.

Is the “Amount Due” Due?

We can blame insurance companies for coverage that's confusing, but doctors often send bills that leave us scratching our heads. I get plenty of them, but not from my optometrist.

The usual doctor's bill lists the services and the amount due. But the amount due isn't always due. The staff usually mails a bill the day after I leave the office — before my insurance company reimburses the doctor. Sometimes my insurance company pays for everything, and sometimes it pays only a certain percentage. Meanwhile, I receive a bill that says, “amount due” for the total. What am I supposed to do with that?

My optometrist used to send me a similar bill, along with a note that read, “You do not owe anything at this time. This is the bill that we're submitting to your insurance company. Keep it for your records. If you owe anything to our office, we will send you another bill later.” Eventually, he included this note on the bill itself. Simple!

If I receive a second bill that needs to be paid, the billing person adds a quick note explaining why my insurance didn't cover certain charges. As a result, I've never had any reason to question a bill.

Insurance, Billing Made Easy

Remarkably, I've never had an experience like this with any other doctor. Between all of the headaches involved with juggling my family's insurance policies and keeping my billing straight, my optometrist's staff has made my life easier. The staff's smart, straightforward approach is refreshing, and it's something that would be easy for any practice to adopt. I wish all of our other doctors would follow suit! nOD