Billing Department

We have an excellent, well-informed and up-to-date Billing Department with many years of combined experience. Omayra Martir is the Billing Department Supervisor. She has worked in the medical field for 14 years with a background in Chiropractic, and 7 of those years have been with Santamaria Eye Center. She is a Certified Ophthalmic Coder by the American Academy of Ophthalmology. Charmaine Critchlow has worked in the medical field for 10 years in the areas of internal medicine and ophthalmology. She has been working with us for eight years and is a Certified Ophthalmic Coder by the American Academy of Ophthalmology. Barbara Curtis brings to us her valuable experience with insurance carriers, having worked in cardiology, radiology and ophthalmology. She has been at Santamaria Eye Center for eight years. Janet Parente's experience as a bookkeeper and with accounts receivable is a definite asset when dealing with our many insurance carriers. She has been with us for eight years. If you have any questions regarding your bill or questions about your insurance, you can contact our friendly, knowledgeable billing staff. Â

What is a refraction?
Refraction is done to determine the eyeglass prescription of your eyes. Refraction is the first step in determining the health of you eyes. A change in refraction can be the first sign of some eye problems (i.e. cataracts). A refraction can also help determine how well the treatment of certain diseases is working.

Even if you don't wear glasses, a refraction can still be important in evaluation your eyes.

Medicare and most insurance plans do NOT cover this important service.

I have a secondary insurance, why am I getting a bill?
Either your secondary insurance carrier did not cover the service, it was applied to your deductible, or we were never given a copy of your secondary insurance.

Why does it take so long to receive a bill?
We did not hear from your insurance carrier until now.

What is the difference between copay and coinsurance?
Your copay is a set amount you pay at the time of each service. Coinsurance is a percentage of the bill that is the patient's responsibility after the insurance carrier pays. Amount of copay and coinsurance varies with each insurance company and policy. If you are not sure of your amount, call your insurance company.

I have insurance, why isn't my bill paid in full?
Per your insurance carrier it is not a covered service, there was no referral issued or your insurance denied service as plan terminated.

You took my copay at time of service, why am I still getting a bill?
Your insurance denied claim as a non-covered service or patient terminated. We do not get eligibility status on patients. You need to know your insurance carrier guidelines.

What is an HMO Plan?
If you have an HMO Plan, you require a referral from your primary care physician to see a specialist. Otherwise the doctor is unable to see you for your appointment.

What is a PPO Plan?
If you have a PPO Plan, you do not require a referral for your visit. Depending on your coverage you might have an annual deductible, which is the patient's responsibility.

• Aetna
• Amerihealth
• BC/BS
• Cigna
• GHI
• HealthNet, aka PHS
• Horizon NJ Health, aka Horizon Mercy
• Locals
• Magnacare
• Mastercare
• Medicare
• Medicaid
• Oxford
• Qualcare
• Superior Vision
• United Healthcare
• University Health Plan
• Vision One
• Vision Service Plan (VSP)
• Worker's Comp
• Other private insurances accepted

KNOWING YOUR INSURANCE POLICY IS THE PATIENT'S RESPONSIBILITY.