We have organized this web page information to help answer any questions you may have concerning our billing practices and insurance procedures.  We are always willing to discuss any financial matters with you and assist in any special arrangements if possible.  While reading this information, please remember the Center for Retina and Macular Disease believes that the most important issue is that you receive the best and most appropriate eye care.  Many of the eyes diseases seen in our clinic can cause permanent visual impairment unless treated promptly.  Our foremost concern is the care of your eyes.

Medicare

CRMD participates (i.e. accepts assignment) with the Medicare program.  This means our staff will prepare and submit your claims directly to Medicare on your behalf.  We will be reimbursed directly at 80% of the established Medicare fee schedule.  You will then be responsible for the remaining 20% plus any annual deductibles that have not been satisfied.  If you have supplemental insurance, it will be filed automatically after Medicare has paid.  If your supplemental insurance has not paid after one month, the balance due on your account will be become your responsibility.

If you have enrolled in a Medicare HMO or a Medicare Replacement Plan, we will interact directly with that carrier on our behalf in accordance with the network guidelines.  However, you may be required to obtain referral forms for your visit.

Managed Care (HMO, PPO, etc)

CRMD participates with most prepaid health plans.  We are unable to list all of them on this site due to the increasing number of plans available.  Ask our staff if we participate or contact your health plan for the approved provider list.

Please read all the literature provided by your health plan regarding patient responsibilities.  Some health plans require you to obtain a referral authorization form before we can provide services.  Most plans require a co-pay and/or deductible payment to be made at the time of service.

Private Insurance

As a courtesy,  CRMD will prepare and submit an insurance claim on your behalf for the services provided.

Please be aware that you are ultimately responsible for your account and medical claims, as we have no contractual relationship with your insurance carrier.  If CRMD has not received a payment or determination from your insurance carrier within six weeks, the claim will become your responsibility for follow-up and payment.

Medicaid

CRMD participates with the Florida Medicaid program.  Our goal is to provide high-quality eye care to all persons within our community regardless of insurance.  The Medicaid program does require us to collect a co-payment from its participants.

No Insurance

Our policy is to provide quality care to all of our patients.

We do understand the financial problems that many families face today.  In some cases, we are able to assist in obtaining alternative financing through charitable organizations or provide information on other available programs.  If necessary, we will arrange a payment plan for you.

Billing Procedure

Like many other businesses, we encourage payment at the time of service. Payment for medical care differs somewhat in that most people have insurance coverage, which becomes the primary payer for a large portion of the services provided.  The balance due, depending on your coverage, will be billed to you should you be unable to pay at the time of service.  If there is a problem, or you are unsure of anything related to the care you received, please contact us immediately so we may answer your questions.

 

Other

Through UnitedHealthcare, UMR and HealthSCOPE Benefits creates and publishes the Machine-Readable Files on behalf of Center for Retina and Macular Disease.
To link to the Machine-Readable Files, please click this link – transparency-in-coverage.uhc.com