Vision Care Insurance
WE DIRECT BILL YOUR INSURER
Ontario Health Insurance Plan (OHIP) Coverage
Depending on your coverage plan, direct billing allows us to bill your insurance company directly, so you can save the paperwork time.
We strongly advise all patients to contact the insurer or review the package for more coverage details. Patients are responsible to pay the difference not covered by the plan. Occasionally, the insurer requires policyholders to submit a claim manually.
At times, some insurers will only reimburse the policyholder directly via cheque or direct deposit. In those cases, patients are required to pay the full amount to the clinic after the visit.
Note: It is illegal for the clinic to directly bill any extended health care plan for cancellation or no-show fees.
- Policy number: May also be described as plan, contract, or group number. It is a formal contract-document issued by an insurance company to an insured.
- Member ID number: Also known as certificate ID. Each insured member covered by a health insurance plan has a unique ID number that allows healthcare providers and their staff to verify coverage and arrange payment for services.
- Deductible: a specified amount of money that the insured must pay before an insurance company will pay a claim.
- Co-Insurance: A health care cost sharing between plan members and the insurance company. The cost-sharing ranges from 80/20 to even 50/50. For example, if your coinsurance is 80/20, that means that your insurer covers 80% of annual medical expenses and you pay the remaining 20%.
Direct billing can be only performed on the day of the appointment.
If you need to submit a claim yourself, it must accurately represent the treatment provided. We will provide you a receipt that retains the date of service, cost, name of practitioner, and the practitioner’s license number.
It is illegal to submit a claim under someone else’s policy/ID or to submit a claim on a date you have not received treatment.
Standard Vision insurance usually includes the following services and products:
- LASIK and PRK vision correction at discounted rates
- Annual eye examinations
- Contact lenses
- Eyeglass frames
- Eyeglass lenses