What is health/medical insurance? This is coverage that you use for any medical services. This insurance information is what you share with all your healthcare professionals such as primary care providers, surgeons, podiatrists, internal medicine providers, etc.

What is vision insurance? Vision plan coverage you would use for your yearly comprehensive eye examination, glasses, or contact lens services. These services may be advertised as “free” or “low-cost” eye exam coverage during open enrollment periods. Glasses and contact lens benefits vary by carrier and plan. Testing such as visual field tests, photographs, etc., would not be covered under these plans. An optometrist would typically provide these services.

Does my health/medical insurance cover my comprehensive eye exam? This question should be directed to your health insurance carrier. Some carriers do cover eye exams if done for medical reasons which could include diabetes, cataract, or glaucoma. Some health insurance plans may have benefits for routine or wellness eye exams. We encourage you to verify your benefits, along with your deductible, co-insurance, and copayment amounts with your insurance carrier. Eye refractions and contact lens evaluations may not be covered under health insurance coverage.

Does the Eye Clinic of Wisconsin, SC accept my health insurance? The Eye Clinic of Wisconsin, SC accepts many, but not all, health/medical and Medicare Advantage plans. We also accept traditional Medicare coverage and Medicare supplement plans.

Does the Eye Clinic of Wisconsin, SC accept my vision insurance? Currently, the Eye Clinic of Wisconsin only accepts National Vision Administrators for vision plans.

**Beginning in 2024, the Eye Clinic of Wisconsin will ONLY be accepting National Vision Administrators (NVA) for a vision plan. No other vision plans will be accepted.

Please feel free to contact our accounts receivable staff with any questions you may have regarding your insurance and/or billing.

I’d like to talk to someone about advertising, sponsorship or a media request.
You will need to speak to Melanie Ruby from our Marketing Department. She can be reached at  715.261.8500.

I’d like to use one of your logos. How do I get a copy?
Please contact our Marketing department for permission to use our logo.

How do I access the Patient Portal?
You can click the above icon that says “Patient Portal” or click here.

My password isn’t working. What’s wrong?
If it has been over 30 days since you received your password, it has expired for your safety and you will need to get a new one. Please call us at 800.472.0033 to reset it.

I don’t have a password.
You should have received an email inviting you to create a patient portal account. If you did not receive one, please call us 800.472.0033 to request the information to be sent to you.

What can I do in the Patient Portal?
You can:

See a summary of your care, including: demographics, vital signs, care team, care plan, problems, medications, allergies, procedures, lab results, and patient education materials

Take the following actions: See and send messages, request an appointment, change records, view online activity, and see the documentation of your care and send it to other doctors.

What does the messaging function do?
The secure messaging function allows you to communicate with our doctors and staff while securely exchanging information regarding your care with our office (similar to a phone call). Our goal is to respond to you within two business days regarding questions about your recent appointment or visual needs. If you are experiencing new symptoms, do not leave a secure message, but call our office at 800.472.0033 in order to speak with a nurse or doctor.

IF THIS IS AN EMERGENCY, DO NOT USE SECURE MESSAGING – Dial 911 or proceed immediately to an emergency room for treatment

How to Pay Your Bill
The Eye Clinic of Wisconsin accepts cash, Mastercard, and Visa. We offer easy and convenient payment options, including online bill pay and text-to-pay.

Save with Flex Spending Accounts
Does your employer offer a medical flexible spending benefit? Spend your flex funds on something you’ll enjoy for years to come: better vision from the Eye Clinic of Wisconsin. You can pay for LASIK and other vision correction procedures with pre-tax dollars. With flex accounts, you can save up to 30 percent and enjoy clear vision now.

Financing Options
Many people have a number of questions about vision correction surgery and services – especially about how to pay for the treatment. That’s why we offer convenient payment options to make your experience as smooth and convenient as possible. For more information, call the Eye Clinic of Wisconsin at 800.472.0033.

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

View Spanish version here

What is “balance billing” (sometimes called “surprise billing”) 

•  When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

•  “Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

•  “Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You’re protected from balance billing for:
Emergency services

•  If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

•  When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

•  If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

•  You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have these protections:
•  You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
•  Generally, your health plan must:

o Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
o Cover emergency services by out-of-network providers.
o Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
o Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.

If you think you’ve been wrongly billed, contact Eye Clinic of Wisconsin at 800-472-0033.
Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal law.

Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

•  You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
•  If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the healthcare provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.
•  If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.
•  Make sure to save a copy or picture of your Good Faith Estimate and the bill.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.

Notice of Health Information Practices

Effective date: June 1, 2024

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Understanding Your Health Record Information

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination, test results, diagnoses, treatment, and plan for future care or treatment. This information, often referred to as your health or medical record, serves as:

• A basis for planning your care and treatment
• A means of communication among the many health professionals who contribute to your care
• A legal document describing the care you received
• A means by which you or a third-party payer can verify that services billed were provided
• A tool in educating health professionals
• A source of data for medical research
• A source of information for public health officials charged with improving the health of the nation
• A source of data for facility planning and marketing
• A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve

An understanding of what is in your record and how your health information is used helps you to:

• Ensure its accuracy
• Better understand who, what, when, where, and why others may access your health information
• Make more informed decisions when authorizing disclosures to others

Your Health Information Rights

Although your health record is the physical property of the Eye Clinic of Wisconsin, the information belongs to you. You have the right to:

• Request a restriction on certain uses and disclosures of your information as provided by 45 CFR
• 164.522. If you have paid for services out-of-pocket in full and you request that we not disclose health information related solely to those services to a health plan, we will accommodate your request, except where we are required by law to make a disclosure
• Obtain a paper copy of the notice of information practices upon request
• Inspect and copy your health record as provided for in 45 CFR 164.524
• Amend your health record as provided in 45 CFR 164.528
• Obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528
• Request communications of your health information by alternative means or at alternative locations
• Revoke your authorization to use or disclose health information except to the extent that action has already been taken
• Expect that the following uses and disclosures will be made only with authorization from you: (i) most uses and disclosures of psychotherapy notes (if recorded by us); (ii) uses and disclosures of health information for marketing purposes; and (iii) disclosures that constitute a sale of health information

Communication between the Eye Clinic of Wisconsin and Patient

Alternative vehicles of communicating with the patient are utilized at the Eye Clinic of Wisconsin:

• We may speak with you personally by phone or on the premises
• We may leave a message on your voice-mail at home or at work
• We will send recall notices reminding you to make an appointment
• We will send appointment reminders by mail, email, and text
• We will send notifications that you have failed your appointment
• We will send statements by mail

Digital Communication & Security Measures

Eye Clinic of Wisconsin is dedicated to safeguarding your health information through stringent security measures across all digital and physical channels. We employ encryption, secure authentication, and firewall protection to ensure the privacy and security of your digital interactions via our patient portals and email communications. Comprehensive staff training and regular security audits reinforce our commitment to protecting your information from unauthorized access or breaches. Our commitment to your privacy is unwavering, whether your information is stored digitally or in traditional formats. For any inquiries or concerns about our privacy and security practices, please reach out to our Compliance Officer at (715)-261-8500 or compliance@eyeclinicwi.com.

Disclosure and Use of Your Medical Information 

We may use and disclose medical information about you:

• For Treatment
• For Payment
• For Health Care Operations
• For Appointment Reminders and Treatment Alternatives
• For Health Related Benefits and Services
• To Individuals Involved in the Care or Payment
• As Required by Law
  • Public Health Risks
  • Health Oversight Activates
  • Lawsuits and Disputes

The Eye Clinic of Wisconsin participates in one or more Organized Health Care Arrangements. Members of the Organized Health Care Arrangements may share medical information with each other for treatment, payment, or health care purposes described in this notice.

Our Responsibilities 

The Eye Clinic of Wisconsin is required to:

• Maintain the privacy of your health information
• Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
• Abide by the terms of this notice
• Notify you if we are unable to agree to a requested restriction
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations
• Notify you in the event that there has been a security breach of your unsecured health information

Who Will Follow This Notice 

• Any healthcare professional authorized to enter information into your medical charts
• All departments and units of this healthcare facility
• All employees, staff, and other personnel we employ
• Eye Clinic of Wisconsin, including its affiliated entities, sites, and locations
  • In addition, these entities, sites, and locations may share medical information with each other for treatment, payment, or healthcare operations purposes as described in this notice

We will not use or disclose your health information without your authorization, except as described in this notice.

The Eye Clinic of Wisconsin reserves the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will make available to you a revised notice. This policy is reviewed bi-annually and updated whenever changes occur.

Feedback Mechanism

We at the Eye Clinic of Wisconsin value your feedback as a vital part of our ongoing effort to improve our health information practices and the privacy protections we offer. If you have any suggestions, concerns, or questions about our use of your health information, the content of this notice, or our privacy practices, we encourage you to let us know. Your insights are crucial to us providing the highest standard of care. You are welcome to speak directly to our Compliance Officer or any staff member regarding your concerns or suggestions about our privacy practices. We are here to listen to and address your needs.

If you believe your privacy rights have been violated, you can file a complaint with the Compliance Officer or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.

If you have questions and would like additional information, you may contact the Compliance Officer at (715) 261-8500 or compliance@eyeclinicwi.com or by mail to Compliance Officer 800 N 1^st St. Wausau WI 54403.

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