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FAQs

TOP 5 QUESTIONS WE HEAR FROM PATIENTS

How long does a visit take?

Expect to spend at least one and a half hours, often longer, in our office. A thorough exam is never rushed. Part of the examination involves checking the health of the back of the eye. It takes at least 20 minutes for the drops to fully dilate the eyes.

 

My child has been seeing another eye doctor. Do you need my child's records?

It is helpful to have previous medical records if you can obtain them. The fastest way to obtain the records would be for you to call and request that a copy be sent directly to you. Patients always have the right to their medical records.

 

Do you accept Medicaid?

Our office accepts Medicaid and most NJ FamilyCare HMOs for children who need medical eye care. Most FamilyCare HMOs require that you go to their vision care network if your child does not have a medical eye problem.

 

Will my child get his/her eyes dilated?

Most complete eye exams for new patients require dilation. The doctor will be checking the health of the entire eye, including the back of the eye. A comprehensive eye exam involves much more than a refraction, in which a patient's glasses prescription is checked.

 

Can my child go to school after he/she gets his/her eyes dilated?

Most children can usually resume normal activities within six to eight hours, when the dilation drops wear off. Some children can be sensitive to the sun or have trouble doing close work, such as homework or music lessons. In some cases it can take from 24 to 48 hours for the pupils to return to their normal state, especially if the child has very light blue eyes.

Do you accept my insurance?​

For a complete list of participating insurance carriers, and for all other insurance related matters, please visit our INSURANCE page.

Image by Scott Graham

INSURANCE FAQs

When booking an appointment at our office, we will make every effort to educate you about your insurance plan coverage options; however, it is ultimately the responsibility of the patient/parent to know his/her benefits. 

 

Please be advised, our pediatric ophthalmologists will ALWAYS bill a medical exam and NEVER a routine eye exam.  As a result, your claim will be sent to your major medical insurance, and processed as a medical office visit that may be subject to a copayment, coinsurance charge, and/or deductible. Please contact your carrier for specific coverage and benefit details.

Do you participate with my insurance?

Our office participates with all major insurance plans and will make every effort to work with you if you do not see your plan listed below.  Please check with your carrier for the most up-to-date participation information.

Aetna

Amerihealth - Tier 2

Consumer Health Network (CHN)

Cigna/Great West

Emblem Health (QualCare Network ONLY)

First Health

Horizon Blue Cross/Blue Shield

Humana Military/USFHP/CHAMP VA

Local Carriers (Call for Specific Plan)

Magnacare/Health Care Payors Coalition (HCPC)

Medicaid

Medicare - Dr. Rousta and Dr. Sun ONLY

Multiplan

NJ Family Care Plans - OPHTHALMOLOGISTS ONLY​

  • Amerigroup

  • Horizon NJ Health

Oxford

PHCS

QualCare

United HealthCare​

Do you participate with my Vision Care Plan (e.g., VSP, Davis Vision, MetLife)?

No.  UCEC does not participate with ANY separate vision care plans.  You are welcome to book an appointment as a self-pay patient and we will provide you with an itemized receipt that you may submit to your carrier for potential reimbursement.

Do I need a referral?

If you have an HMO, or if your card indicates that a referral is required to see a specialist, then you MUST OBTAIN A REFERRAL.  Typically, patients with the following carriers require a referral:

  • Aetna HMO

  • Amerihealth HMO

  • Horizon HMO

  • Oxford HMO

  • United HealthCare Compass

 

If you do not see your plan listed, it does not mean that a referral is not required - you must check with your carrier for specific requirements.  Please note that patients who are required to have a referral will NOT be seen if the referral is not received at their scheduled appointment time.

Are contact lenses covered by my insurance plan?

All contact lenses and contact lens related services are considered self-pay at UCEC.  If you have coverage, our office can provide you with a detailed, itemized receipt for services and lenses for possible reimbursement by your carrier.

I have a question about a bill I received. With whom can I speak?

Our billing department can be reached by calling our Main Office at 732/613-9191 and selecting option 4,

or dialing extension 712 directly.

Call usIf you'd like to pay your bill online, you may do so.

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