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We are in-network with many insurance carriers. If you do not see your insurance on this list below, please call our office.
Some insurance plans require an insurance referral from your primary care physician as seen in most HMO (health maintenance organization) plans. It is your responsibility to secure the insurance referral from your primary care physician. You can have your referral faxed to us at 703-876-0163 or email to referrals@ceceyes.com. You may bring it with you to your appointment, but it is helpful to have the insurance referral beforehand so we can verify the physician’s office has, in fact, completed the form correctly.
If you have an insurance that our office participates with, we will submit your claim for
you. Your co-payment is due at the time of your service.
If we do not participate with your insurance plan, payment in full is expected at the time services are rendered. For your convenience, Visa, MasterCard, Discover, American Express, personal checks and cash are accepted.
AARP Medicare Supplement
Aetna
Aetna Innovation Health PPO
Aetna Medicare Advantage
Aetna Senior Supplement
APWU
Anthem MediBlue Plus
Anthem PPO
Bankers Life
BlueCross BlueShield
CareFirst
CareFirst Administrators
CareFirst BCBS Federal
Cigna International
Cigna Open Access
Compass Rose
GEHA
GPM Life Supplement
Humana
Humana Medicare Advantage
PHCS Multiplan
Physicians Mutual
Mail Handlers
Medicare
Medicare for Railroad Workers
Meritain
Mutual of Omaha
NALC
SAMBA
Thrivent Financial
Transamerica
Tricare
UnitedHealthcare Choice Plus
UnitedHealthcare MDIPA
UnitedHealthcare Medicare Advantage PPO
USA Senior Network
USAA Life
UMR
Your insurance policy is an agreement between you and your insurance company. The policy lists a package of medical benefits such as tests, drugs and treatment services. The insurance company agrees to cover the cost of certain benefits listed in your policy. These are called “covered services.”
Your policy also lists the services that are not covered by your insurance company. You have to pay for any “uncovered” medical care that you receive. Keep in mind that a medical necessity is not the same as a medical benefit. A medical necessity is something that your doctor has decided is necessary. A medical benefit is something that your insurance plan has agreed to cover. In some cases, your doctor might decide that you need medical care that is not covered by your insurance policy.
There are many different insurance plans. By understanding your insurance coverage, you can help your doctor recommend medical care that is covered in your plan.
Most services your doctor recommends will be covered by your plan, but some may not. When you have a test or treatment or get a prescription filled for a drug that isn’t covered, your insurance carrier will “deny the claim.” If this occurs, CEC will appeal the denial on your behalf and provide treatment and testing results to support the appeal. However, your insurance carrier may uphold their decision of denial. Should this occur, payment for that service, treatment, or prescription becomes your responsibility.
You still have the right to continue to appeal (challenge) the decision in an attempt to secure reimbursement from your insurance carrier.
Adapted from: American Academy of Family Physicians, 2001