Eye Conditions
This condition occurs when eyes do not produce enough tears or they evaporate too quickly.
Dry Eye Disease
This symptom involves seeing a "shadow" or "curtain" over the vision and is a medical emergency.
Retinal Detachment
A patient says, "Everything looks cloudy, and it's like I'm looking through a fog"
Cataracts
This most common visit type is used for routine checks and updating glasses prescriptions.
Comprehensive Eye Exam
This is the primary factor that determines which insurance is billed for a visit.
The Reason for the Visit
This is the clouding of the natural lens inside the eye, often causing blurry vision and glare.
Cataracts
These sudden visual changes, described as light bursts or new spots, require immediate escalation.
Flashes and Floaters
A patient reports their eye is red, has thick discharge, and was "stuck shut" in the morning.
Eye Infection
This specific exam is required to renew a prescription for lenses worn directly on the eye.
Contact Lens Exam
This insurance type typically covers eye infections, injuries, and chronic diseases.
Medical Insurance
A group of diseases that damage the optic nerve, often due to high eye pressure and starting with peripheral vision loss.
Glaucoma
Rare but urgent symptoms of this condition include severe eye pain, nausea, and halos around lights
Acute/Emergency Glaucoma
A patient describes their eyes as feeling gritty, "like sand," or burning.
Dry Eye Disease
This medical visit is used to monitor retinal health in patients with high blood sugar.
Diabetic Eye Exam
This is the specific test used to find a prescription, which medical insurance often does not cover.
Refraction
This condition affects the central part of the retina, making it difficult to read or recognize faces.
Macular Degeneration
This occurs when the eyes are exposed to harmful liquids and requires urgent evaluation.
Chemical Exposure
A patient complains that "straight lines look wavy" and the middle of their vision is blurry.
Macular Degeneration
These exams focus on vision development and eye alignment in children.
Pediatric Eye Exam
This fixed amount is what a patient pays at the time of their visit.
Copay
A disease where high blood sugar damages retinal blood vessels; it often has no symptoms in early stages.
Diabetic Retinopathy
This is the immediate action an agent must take when a patient reports any "red flag" symptom.
Immediate Escalation
A patient reports extreme itching and watery eyes, usually with clear discharge.
Eye Allergies
This procedure uses the "air puff" or other tools to check for internal eye pressure, often for glaucoma.
Eye Pressure Testing (Tonometry)
Instead of promising coverage, agents should tell patients they will provide this regarding their benefits.
An Estimate