Payments and Insurance

Paying for healthcare is complicated in the modern world. We do our best to help you navigate your own benefits so that your costs can be as low as possible. Our office is happy to help you file any paperwork that your insurance company requires – and we’ll do it with you, while you’re here for your appointment.

While the cost of quality health services has risen over the years, the nature of the medical profession has also changed. Dr Portfolio provides a premium level of service that is personal and deep, two qualities often missing in modern medicine.

Over the past ten years there have been many changes in the health insurance business. Premiums have gone up dramatically, while payouts to doctors have gone down. Most in-network doctors receive less than Medicare pays, and Medicare is not a very good payer. Doctors are struggling to pay increasing overhead, while maintaining high-quality levels of care to their patients.

At some point the reimbursements are so low that they will not allow a doctor to stay in business. That will not be good for patients. The alternative is to see twice as many patients, but that means rushing patients through without taking the time to address all of their questions and concerns. Dr. Portfolio wants to do what is right for his patients. This means he cannot be an in-network physician and provide the quality care that his patients have become accustomed to.

Patients are advised to get an insurance policy with out-of-network benefits, if possible. It is important to remember that routine eye exams are not covered by most vision plans. Coverage only applies if one has a complaint and a diagnosis.

Out of Network

For the reasons mentioned, Dr Portfolio does not participate in any insurance networks. However, if your plan provides out-of-network benefits, you may be covered for part of your bill.

Out-of-network benefit plans may reimburse you for 20%, 30% – even 80% – of your costs. Be sure to bring your plan information to our office, and we’ll help you find out the details.

Medicare

Dr Portfolio accepts Medicare patients, but his office is a “non-participating” member, which means that payment for services is required at the time of delivery. We will help you file all claims with Medicare so that payments are sent directly from the government to you. By paying at the time of your appointment, and taking later reimbursement from Medicare, you help us keep our paperwork overhead lower – so the doctor can spend more time with his patients.

Cosmetic Surgery

Most laser vision correction surgeries, such as LASIK and PRK, are considered to be cosmetic in nature (i.e., non-essential to your health) and therefore are not covered by any insurance plan.

Cataract surgery is covered by most insurance plans (including Medicare) as a medical necessity. However, your coverage may be limited to older technology like monofocal lenses. We can read the fine print on your policy and let you know your options.

Financing

We can help you navigate the loan process if that is an appropriate option for you.