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Originally Posted by TheMercenary
I am thinking that you would have a hard time proving that. My for profit insurance company pays 100% for a complete eye exam each year for each person in my family.
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How much does your insurance company pay the doctor, though? That's the question. I'll bet it's not doctor's the "regular retail" rate, nor is it as much as Medicare pays.
Quote:
Originally Posted by TheMercenary
Once we can establish what the cost of a general eye exam is, which may or may not include refactory testing, which changes the cost, then we can determine what percent Medicare pays. I have the CPT codes and Medicare rates for NJ. So do you have an EOB with the phyicians charged fee on it?
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92014. Medicare allowable is $111.83, of which they pay 80%, or $89.46. Medicare never pays for a refraction. Are you sure this is your business?