Insurance, Financing & Forms

Options for Financing Your Procedures

CEC Financial Policy

With today’s rising cost of health care, we are making every effort to keep fee increases to a minimum. Similar to any business, we can only keep the doors open and pay our staff if we receive timely payment for our services. In order to do this, we need your help in fulfilling your financial obligations. In an attempt to provide full fee disclosure and notification of our policies, please review the statement of our Financial Policy listed below.

We require 24 hour notice of rescheduled/cancelled appointments to avoid a fee.

IF YOU HAVE HEALTH INSURANCE COVERAGE…

Please supply us with a current copy of your insurance card.
Please notify us of any changes in your address or telephone number.
All copays are due at the time of service.
All non-covered services such as refractions (new prescription for glasses) will be due at the time of service.
All referrals are the responsibility of the member/patient and must be current prior to your visit.
Your estimated portion, including any deductibles, co-insurance or non-covered service will be expected to be paid at least five days prior to your surgery date (our business office will notify you in advance if this is required).
Patient balances are due 30 days after the insurance notifies our office of patient responsibility.
Patient will be responsible for any fees associated with enforcement of collection action.
IF YOU DO NOT HAVE HEALTH INSURANCE…
Payment in full is required at the time of service.
As a courtesy, we will gladly assist you by filing your claim with your insurance carrier. If you receive a statement from our office after insurance has paid or denied, the balance then becomes your responsibility to pay. If you disagree with the balance for any reason please contact our business office at 913-897-9200.

Forms of Payment

Cavanaugh Eye Center accepts Cash, Check, Visa, MasterCard, Discover, and American Express.

Payment is required prior to time of surgery. Insurance rarely covers refractive surgery, but a letter from carrier certifying full coverage for refractive surgery will be accepted in lieu of prepayment with the exception of co-insurance and deductible amounts. The patient is responsible for any balance not paid by insurance.

Flexible Spending Accounts

Many employers offer flexible spending accounts (also called a flexible benefits program) to help offset medical expenses. With a flexible spending account, you can use pre-tax dollars to pay for medical procedures, including LASIK. This can save you up to 50%. Check with your benefits manager at work to find out if your company offers flexible spending accounts.

Cavanaugh Eye Center would like to remind you that you can SAVE MONEY on vision correction procedures, like LASIK, PRK, or the Staar Visian ICL by utilizing your CAFETERIA PLAN (Flexible Spending Account) offered by your company through your benefit plan. Yes – these procedures, which correct nearsightedness, farsightedness, and astigmatism, and reduce dependence on glasses and contact lenses, are eligible healthcare expenses for Section 125 pre-tax dollar Flexible Spending Accounts. Since most insurance companies do not include vision correction procedures like LASIK or the Visian ICL as a covered benefit, use of your Cafeteria Plan is often the only benefit you have to reduce your out-of-pocket expense for this life-changing procedure. As the end of the year approaches you should be aware that if you have unused money set aside in your Cafeteria Plan, you will forfeit that unused money at year end. There is no rollover of these funds.

Financing Options

As a service to our patients, we are pleased to offer the CareCredit card, the nation’s leading patient payment program. With CareCredit you can finance your eye care and there are no upfront costs, no annual fees, and no pre-payment penalties. So, you can begin your treatment today and conveniently pay with low, monthly payments.

CareCredit offers a full range of payment plans so you can find one that works best for you. With the popular ‘Deferred Interest’ plans there are no interest charges if you pay your balance in full within the specified time period. CareCredit offers 12, 18, or 24 month plan options with low monthly payments available.

CareCredit can be used by the whole family for ongoing treatment without having to reapply. And by using CareCredit for your eye care, you can save your other credit cards for household or unplanned expenses. It only takes a few minutes to apply for CareCredit and you’ll receive an online decision in seconds! Apply Now or see our staff for more details.

Please contact us at 913-387-9200 today to schedule your complimentary screening and find out if you are a candidate for vision correction.

Financing FAQs

In this section, you will find answers to the billing and insurance coverage questions that patients ask us most often.

Do I have to pay my co-payment at the time of registration?
You are required to pay your co-pay at the time of service. You will be billed for your deductibles, co-insurance and any non-covered services after we receive notification from your insurance company.

How do I know if my insurance company will cover my visits?
Coverage varies with each insurance company. Generally, we do not know whether a particular service will be covered. Medically necessary and appropriate services may not always be covered by your insurance contract. Please refer to your insurance member handbook, check with your employer or call your insurance company with questions.

When will I receive a bill?
If you verified your insurance information when you registered, you will not receive a bill until: your insurance company has denied the claim; your insurance company has paid the claim, leaving a co-insurance, deductible or non-covered service; your insurance company has not responded to the claim.

How does my referring eye care provider get paid for their co-management fees?
If you have a referring eye care provider that is interested in co-managing your refractive laser surgery, they will be paid by you, through us at the day of your surgery. Co-management is included in the price of your procedure and does not cost you any extra.

Who can I talk to with questions about my bill?
If you should have specific questions about your financial situation or your account, please do not hesitate to call our Billing Department at 913.897-9200. They are available to assist you in finding the answers to your financial and billing questions.

Paitient Forms

To access our patient forms please connect to our patient portal by clicking here.

HIPAA Notice of Privacy Practices

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.

If you have any questions about this notice, please contact the privacy officer at 913-897-9200.

OUR OBLIGATIONS:
We are required by law to:
Maintain the privacy of protected health information
Give you this notice of our legal duties and privacy practices regarding health information about you
Follow the terms of our notice that is currently in effect
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION:
The following describes the ways we may use and disclose health information that identifies you (“Health Information”). Except for the purposes described below, we will use and disclose Health Information only with your written permission. You may revoke such permission at any time by writing to our practice’s Privacy Officer.

For Treatment. We may use and disclose Health Information for your treatment and to provide you with treatment-related health care services. For example, we may disclose Health Information to doctors, nurses, technicians, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care.

For Payment. We may use and disclose Health Information so that we or others may bill and receive payment from you, an insurance company or a third party for the treatment and services you received. For example, we may give your health plan information about you so that they can process your claim.

For Health Care Operations. We may use and disclose Health Information for health care operations purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and to operate and manage our office. For example, we may use and disclose information to make sure the care you receive is of the highest quality by employing the services of external review organization. We also may share information with other entities that have a relationship with you (for example, your health plan) for their health care operation activities.

Appointment Reminders, Treatment Alternatives and Health Related Benefits and Services. We may use and disclose Health Information to contact you to remind you that you have an appointment with us. We also may use and disclose Health Information to tell you about treatment alternatives or health-related benefits and services that may be of interest to you.

Individuals Involved in Your Care or Payment for Your Care. When appropriate, we may share Health Information with a person who is involved in your medical care or payment for your care, such as your family or a close friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.

Research. Under certain circumstances, we may use and disclose Health Information for research. For example, a research project may involve comparing the health of patients who received one treatment to those who received another, for the same condition.

SPECIAL SITUATIONS:
As Required by Law. We will disclose Health Information when required to do so by international, federal, state or local law.

To Avert a Serious Threat to Health or Safety. We may use and disclose Health Information when needed to prevent a serious threat to your health and safety or the health and safety of the public or another person.

Business Associates. We may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.

Organ and Tissue Donation. If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement, banking or transportation.

Military and Veterans. If you are a member of the armed forces, we may release Health Information as required by military command authorities. We also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military.

Workers’ Compensation. We may release Health Information for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks. We may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

Health Oversight Activities. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Data Breach Notification Purposes. We may use or disclose your Protected Health Information to provide legally required notices of unauthorized access to or disclosure of your health information.

Lawsuits and Disputes. If you are involved in a lawsuit, we may disclose Health Information in response to a court or administrative order. We also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement. We may release Health Information if asked by a law enforcement official if the information is: (1) in response to a court order; (2) limited information to identify or locate a suspect or missing person; (3) about the victim of a crime; (4) about a death we believe may be the result of criminal conduct; (5) about criminal conduct on our premises; and (6) in an emergency to report a crime.

Coroners, Medical Examiners and Funeral Directors. We may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release Health Information to funeral directors as necessary for their duties.

National Security and Intelligence Activities. We may release Health Information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.

Inmates or Individuals in Custody. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release Health Information to the correctional institution or law enforcement official. This release would be if necessary: (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) the safety and security of the correctional institution.

USES AND DISCLOSURES THAT YOU HAVE AN OPPORTUNITY TO OBJECT AND OPT OUT OF

Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your Protected Health Information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.

Disaster Relief. We may disclose your Protected Health Information to disaster relief organizations that seek your Protected Health Information to coordinate your care, or notify family and friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practically can do so.

YOUR WRITTEN AUTHORIZATION IS REQUIRED FOR OTHER USES AND DISCLOSURES

The following uses and disclosures of your Protected Health Information will be made only with your written authorization:
1. Uses and disclosures of Protected Health Information for marketing purposes; and
2. Disclosures that constitute a sale of your Protected Health Information

Other uses and disclosures of Protected Health Information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you do give us an authorization, you may revoke it at any time by submitting a written revocation to our Privacy Officer and we will no longer disclose Protected Health Information under the authorization. But disclosure that we made previously on your authorization before you revoked it will not be affected by the revocation.

YOUR RIGHTS:

You have the following rights regarding Health Information we have about you:

Right to Inspect and Copy. You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes. To inspect and copy this Health Information, you must make your request, in writing, to Cavanaugh Eye Center, PA, 6200 W 135th St, Suite 300, Overland Park, KS 66223. We have up to 30 days to make your Protected Health Information available to you and we may charge you a reasonable fee for the costs of copying, mailing or other supplies associated with your request. We may not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state of federal needs-based benefit program. We may deny your request in certain limited circumstances. If we do deny your request, you have the right to have the denial reviewed by a licensed healthcare professional who was not directly involved in the denial of your request, and we will comply with the outcome of the review.

Right to an Electronic Copy of Electronic Medical Records. If your Protected Health Information is maintained in an electronic format (known as an electronic medical record or an electronic health record), you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or entity. We will make every effort to provide access to your Protected Health Information in the form or format you request, if it is readily producible in such form or format. If the Protected Health Information is not readily producible in the form or format you request your record will be provided in either our standard electronic format or if you do not want this form or format, a readable hard copy form. We may charge you a reasonable, cost-based fee for the labor associated with transmitting the electronic medical record.

Right to Get Notice of a Breach. You have the right to be notified upon a breach of any of your unsecured Protected Health Information.

Right to Amend. If you feel that Health Information we have is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, you must make your request, in writing, to Cavanaugh Eye Center, PA, 6200 W 135th St, Suite 300, Overland Park, KS 66223.

Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization. To request an accounting of disclosures, you must make your request, in writing, to Cavanaugh Eye Center, PA, 6200 W 135th St, Suite 300, Overland Park, KS 66223.

Right to Request Restrictions. You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the Health Information we disclose to someone involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about a particular diagnosis or treatment with your spouse. To request a restriction, you must make your request, in writing, to Cavanaugh Eye Center, PA, 6200 W 135th St, Suite 300, Overland Park, KS 66223. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

Out-of-Pocket-Payments. If you paid out-of-pocket (or in other words, you have requested that we not bill your health plan) in full for a specific item or service, you have the right to ask that your Protected Health Information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor that request.

Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. To request confidential communications, you must make your request, in writing, to Cavanaugh Eye Center, PA, 6200 W 135th St, Suite 300, Overland Park, KS 66223. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our web site, www.cavanaugheye.com. To obtain a paper copy of this notice, Cavanaugh Eye Center, PA, 6200 W 135th St, Suite 300, Overland Park, KS 66223

CHANGES TO THIS NOTICE:

We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a copy of our current notice at our office as well as our website. The notice will contain the effective date on the first page, in the top right-hand corner.

COMPLAINTS:

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact Cavanaugh Eye Center, PA, Attn: Privacy Officer, 6200 W 135th St, Suite 300, Overland Park, KS 66223.

All complaints must be made in writing.
There is no retaliation or penalty for filing a complaint.