Routine Exams - If a patient's insurance has a routine eye exam benefit, they do not need a referral for routine exams.
Office visits
We always need to verify if a patient needs a referral to be seen for an office visit. The insurance card will sometimes say whether or not a referral is necessary. PPO does not need referral. HMO does need referral.
Referrals should be made out to "Dr. Anthony Fusco" and faxed to the store fax number. Referrals come from the patient's family doctor or primary care doctor (PCP).
Patients with Anthem BC/BS, whose PCP is located in Massachusetts, need to ask their PCP to do a cross-border referral.
Patients who come in for an office visit without a referral, need to pay for the exam up front. We will reimburse them if their PCP back dates a referral after the exam. The only exception is for a patient who had a routine exam that we brought back for an office visit and we did not tell them they would need a referral. If they were told to bring one, it should be noted on that appointment at time of scheduling.