Insurances and Payment
The cost of medical care and the insurance reimbursement environment have undergone very dramatic changes. Patients are facing new challenges in how they choose their doctor and how the cost of treatment is paid for.
No place is this more important than a patient in need of ophthalmic or neuro-ophthalmic care. Few things in life are more precious than vision and brain health.
The fact is that quality care takes time and expertise. Trends in insurance reimbursement are dramatically reducing the payment for all types of medical care. Doctors who participate in insurance plans are forced to accept far less than traditional fees and the level of reimbursement is continuing to decrease, while the costs of maintaining a practice are increasing. As a result, the level of care may be compromised.
Dr. Banik does not participate in any insurance plans because she feels she is unable to deliver outstanding care at the level of reimbursement most plans offer. That means that patients must make a choice in deciding whether they can or should go “out of network” and pay out of pocket for medical care in excess of the amount covered by their insurance.
Many insurances, such as Medicare, also require doctors to file tremendous amounts of documentation for billing, requiring a sizeable staff. This level of documentation is not feasible for a doctor in solo practice to manage.
Keep in mind that any additional testing necessary, such as bloodwork or radiology, is billed to your insurance. Your responsibility would only be Dr. Banik’s office fee.
Should surgery be necessary, in considering a provider, the patient should keep in mind that the total cost of a surgical procedure includes much more than the surgical fee. Surgical facility charges, anesthesia, and many other services are usually covered by insurance. Therefore, when deciding to go outside of your insurance, the added cost will be Dr. Banik’s professional surgical fee, not the entire cost of your care. This requires a personal choice.
If you need to discuss your personal financial situation, please let our office know. Dr. Banik does take into special needs into consideration.
The cost may be higher to choose Dr. Banik, but the time she spends with each of her patients, the level of care she provides, and the support she and her staff give each patient are unparalleled. Please visit our Testimonials page to read what patients have said about their experiences under Dr. Banik’s care.
When choosing the best ophthalmologist or neuro-ophthalmologist for your needs, remember that you are dealing with life-altering vision and/or brain health issues. Our abilities to see, think, and function
Please download the New Patient Registration Packet by clicking HERE.
Each physician must choose to be participating, non-participating, or opt-out with Medicare. Dr. Banik has chosen opt-out status. This means that she charges Medicare patients her usual fees and expects payment from patients at the time services are rendered. You may not submit the bill to Medicare for out of network reimbursement, though you may submit it to any other primary or secondary insurance that you may have.
For all patients age 62 and above, prior to receiving care with
Payment in full is due at the time of your office visit. We accept cash, checks, Visa, MasterCard, Discover, and American Express. For credit card payments, please note that a 2.75% credit card processing service charge will be added to your bill.
Upon receiving payment in full, we will provide you with a paid receipt containing all appropriate codes suitable for submission to your insurance company for reimbursement. Our office staff is always available to answer any questions and assist you in this process.
Take The First Step Towards Better Eye and Brain Health
Maybe you have some questions you’d like to ask before you make a decision on becoming a patient.
Dr. Banik is happy to answer any questions you have to see whether or not her practice is right for you.