Frequently Asked Questions
1. Will my insurance cover the visit?
We can never guarantee that a visit will be fully paid for by the medical insurance because we don’t know what the diagnosis is. Based on your diagnosis, your insurance ultimately decides whether they can cover the visit or not. Because we strictly bill the medical insurance only, if the diagnosis is medical, your insurance may pay for it. However, if it is a vision diagnosis, your medical insurance may not cover it.
2. I have a vision plan; can you bill my vision plan for the visit?
We cannot bill any vision plan because Dr. Prepas is not a provider for any vision plan. If you paid in full for the visit, we will be able to provide you with the superbill, with all the codes, so that you can bill your vision plan for out of network reimbursement.
3. Why didn’t my medical insurance cover my visit?
Based on your diagnosis, your insurance ultimately decides whether they can cover the visit or not. Because we strictly bill the medical insurance only, if the diagnosis is medical, your insurance may pay for it. However, if it is a vision diagnosis, your medical insurance may not cover it.
4. Why did my medical insurance cover one if my kids’ visit and not the other?
This all depends on the diagnosis. The visit was covered for one patient because the diagnosis for that patient was medical and the visit for the other patient was not covered because it was a vision diagnosis.
5. Can you change a vision code to a medical code for billing purposes?
The coding we use to bill for all of our patients is the same. We don’t bill using any vision code. If the visit is for a first time patient, we bill it as an initial visit and if the visit is for a returning patient, we bill it as a follow-up visit. We will not be able to change the diagnosis code unless that was the code that was determined during the visit.
6. I have a PPO insurance; do I still need a referral for my appointment?
If you have a PPO insurance, you will not need a referral to see Dr. Prepas. Only if you have an HMO will you need an authorization.
7. I have an HMO insurance, will you cover my visit?
As mentioned before, we never guarantee payments for services provided at the office. If you have an HMO, as long as there is a valid authorization, we will be able to bill for the services. From our experiences with GNP, as long as there’s an authorization, most, if not all of the visits have been paid for.
8. Can you bill my insurance for my contact lens fitting appointment?
We cannot bill your insurance for your contact lens fitting because that is considered cosmetic and will not be covered by your medical insurance. If you have a vision plan, we will provide you with the superbill so that you can bill your insurance. For our HMO patient with HealthNet, if you obtain a valid authorization, we can bill Greater Newport Physician for it.
9. Can you bill my insurance for my glasses/contact lens?
We cannot bill your insurance for your glasses or contact lens because that is considered cosmetic and will not be covered by your medical insurance. If you have a vision plan, we will provide you with the superbill so that you can bill your insurance.
10. My glasses prescription is over one-year-old, can you order a new pair of glasses for me?
Glasses and contact lenses prescription expires after one year. Most optical shops won’t honor an expired prescription. If you have a prescription that is over a year old, we would not be able to extend the prescription. We suggest that you call to schedule an appointment to get a more updated prescription.
11. Can Dr. Prepas give me a prescription for contact lenses?
Dr. Prepas does not handle any contact lens issues. Anything that deals with contact lenses are handled by our Optometrist, Dr. Kara McEachern
12. Would I be able to use my glasses prescription to get contact lenses?
Glasses prescription and contact lens prescription are two separate prescriptions. You will not be able to get contact lens with your glasses prescription.
13. I ran out of contact lenses, can your office supply me with some sample lenses?
The sample lenses in the office are strictly for first time contact lens wearer. If you know that you will be running out of contact lenses, please contact our office so that we can order them for you. If your contact lens prescription is expired, we will not be able to order them for you because most, if not all places will not honor a prescription that is over a year old. It is very important that you contact our office to schedule another contact lens fitting if your contact lens prescription is soon to be expired so that you will have an updated prescription.
- Pediatric Ophthalmology
- Adult General Eye Exams
- Optical Services
- Optometrist - On Site
Monday - Thursday
9:00 a.m. - 12:00 p.m.
2:00 p.m. - 5:00 p.m.
Closed for lunch
12:00 p.m. - 2:00 p.m.
9:00 a.m. - 12.00 p.m