130 Almshouse Road, Suite 202B, Richboro, PA 18954
Phone:(215)364-8822 Fax:(215)357-7781
This page contains information for the benefit of you, our valued patient. Please review the table of contents below to see what information is on this page. Sections about eye conditions have links to information about specific options available through Richboro Eye Care and its affiliates.
The information here is meant to informative and in no way should it be taken to be the last word about these topics. Nothing is better for your eyes than getting a comprehensive evaluation at Richboro Eye Care, but being an informed patient means you are more likely to be compliant with prescribed regimens and more likely to improve. The information here should not be used to replace your usual medical eye care. We have provided links to other websites, especially the American Academy of Ophthalmology, to give you a broader range of information.
The purpose of this page is to increase your understanding about medical insurance coverage. Many insurance plans do not pay for routine eye care, though they will pay for medical and surgical care. Let's go over a few important points, but keep in mind that the information here is meant to be an overview of insurance polices and not the "final word". It is extremely important that you fully understand their insurance coverage so that there are no surprises. It is not the responsibility of this office, or any medical office, to teach you about your insurance coverage. That is the job of the insurance company itself!
Click on the name of the insurance for more information on what to expect with this insurance and Richboro Eye Care. If your insurance plan is not listed, or if you have questions with regard to your coverage, please call our office!
Note: As of August 21, 2015, we no longer accept Aetna insurance. Those patients with Aetna who wish to continue seeing Dr. Zeigen will be required to pay for their services.
Richboro Eye Care participates with Medicare. This means that for "covered services" we accept assignment (see below for an explanation). Medicare covers visits specifically related to medical or surgical problems. Medicare does not pay for any of the following:
As you already know, Medicare only pays for 80% of what they approve and you are responsible for the remaining 20%. If you have a true medigap policy, such as AARP or Blue Shield Security 65, it is linked with Medicare electronically and they will forward payment directly to us. However, if your secondary insurance is NOT a medigap policy you will be responsible for the 20% that Medicare does not pay. All of our Medicare claims are filed electronically and we do no paper claim submissions.
We participate with all Blue Shield products, even those of "out-of-state" plans using the BlueCard system. If you have a co-payment you will be expected to pay it prior to leaving the office.
Many of the Blue Shield indemnity plans do not cover office visits of any kind and you will be expected to pay for all rendered services. We are able to electronically bill for many in-state and out-of-state Blue Shield products.
Blue Shield products generally by themselves do not cover routine eye examinations, refractions or the fitting or dispensing of contact lenses. They do not pay for cosmetic or refractive surgeries. We no longer accept Davis Vision offered by Blue Shield because the reimbursement levels are too low for the level of service given by other physicians.
Richboro Eye Care participates with Keystone as a specialist and each visit MAY require a referral directly from your family physician. If you have a medical condition that requires me to "refract your eyes" as part of my medical care, this may be covered. If not, you will be billed for this service.
Richboro Eye Care gladly accepts Private Healthcare System which manages many related insurance plans (such as The Guardian and Great West Life). Please check the back of your insurance card and look for the PHCS symbol. PHCS does not cover routine eye examination or the fitting of contact lenses. You need to call your plan and see if we are on the "panel of physicians"!
The list below shows some of the other plans that we do accept assignment on most of their plans. Most do NOT cover routine eye examinations or the measurement for glasses (a refraction). YOU will need to call your specific health plan to determine if we accept your specific plan!!
Managed care insurance plans require referrals in order to be seen to treat specific problems, or for long term management of chronic problems such as glaucoma. A referral is required for every visit and service rendered. Some primary care offices can generate an "electronic referral" which we can retrieve. Many referrals can cover more than one visit or service. Our office will not call to get your referral for you. Getting a referral, allowing for all requested services, is the responsibility of the patient
We need to point out the following.
Our office participates, or "accepts assignment", on many insurance claims (please see the list below). The term assignment can be confusing. The examples below should help clarify what your responsibilities are under common circumstances.
LASIK can be safely performed on patients with the following refractive conditions:
For more information on LASIK, please visit The American Academy of Ophthalmology page on LASIK.
For more information on Richboro Eye Care's LASIK options, please visit this page
Glaucoma occurs when the pressure of an eye is high enough, long enough for that eye to produce a characteristic abnormal appearance to the optic nerve along with specific changes to the vision and visual field. It is entirely possible for a patient to have glaucoma in just one eye. This type of slowly progressive glaucoma is called Chronic Primary Open Angle Glaucoma, or COAG or POAG for short.
In a less commonly seen type of glaucoma, called Acute Angle Closure Glaucoma, the pressure of the eye sudden rises producing intense pain in the eye, nausea, headache and loss of vision. This latter form of glaucoma is considered a medical emergency and is more typical in patients who are far-sighted (needing magnification for seeing distance clearly).
The risk factors for developing glaucoma include family history, increasing age, myopia, and past ocular trauma. Having high blood pressure does NOT make you more likely to have high eye pressure, and diabetes does NOT make you more likely to have glaucoma. Having diabetes does make managing glaucoma more difficult.
There have been many changes over the years in how to diagnosis glaucoma. For me, it means there is damage to the optic nerve and its nerve fiber layer thickness that is consistent with other findings. Nowadays, I perform Optical Coherence Tomography, or OCT for short, as the main method of diagnosis. Visual field testing discovers this condition far later in it progression.
Some patients can have eye pressures above the usual range and not have glaucoma. This is called Ocular Hypertension. Patients with Ocular Hypertension are typically examined twice yearly once the eye pressures have stabilized into an acceptable range with once or twice daily eye drops. Often, a laser procedure called SLT, or Selective Laser Trabeculoplasty, can be performed a diminish or eliminate the need for drops for several years and can be repeated if required.
Please visit the What We Do section of our website to find out how Richboro Eye Care can help treat your glaucoma.
If you follow this regimen you will much less likely to develop eye irritation from contact lenses.
First, let me discuss a little of the eyes anatomy. The lens of our eye, where cataracts develop, is located behind the pupil. A cataract is not "a film that grows over the eye" as many believe. As an adult, the lens is about the size of an "M&M". When we are born, this M&M is clear and freely allows the passage of light into our eyes. As we get older, the clarity of the lens changes. In the worst case, the clarity of the lens approaches that of a brown M&M... not very clear. Happily in the United States, most cataracts never get that bad before they are removed. In actuality, we want to remove cataracts earlier so that smaller incisions, and less surgery time is required, because dense cataracts take longer to remove and can have more complications.
Early or immature cataracts may actually have no symptoms yet still can be found during your comprehensive eye examination. However, as a cataract develops it can cause a variety of symptoms. These symptoms include blurred distance vision yet clear near vision, increased glare from sunlight and headlights, the need to have brighter and brighter light to read and frequent changes required in your eyeglass prescription. Some of our patients have become so disabled from the glare of headlights that they have stopped driving at night. In general, I do not start recommending cataract surgery until the vision is 20/40 or worse or if glare testing results in a dramatic decrease in visual acuity.
The removal of cataracts has come along way over the past twenty years. Long gone are the days when patients had to keep their head still with sand bags for two weeks after surgery and wear thick cataract glasses. Now-a-days, I remove most cataracts using a procedure called phacoemulsification, which uses high frequency sound waves to break up the cataract into tiny pieces. These microscopic pieces are gently aspirated out of the eye. My phacoemulsification technique uses a tiny, self-sealing incision (typically 1/8 inch), through which a foldable lens implant is inserted to once again clearly focus light rays on the retina. Because the incision in most cases is self-sealing no suture is required to close the wound. My method of cataract removal leads to faster visual recovery, less post-operative restrictions and a quick return to the patient's usual lifestyle, usually three days.
Please visit the What We Do section of our website to find out how Richboro Eye Care can help treat your cataracts.
Dry eyes is a very poor term to describe what is better termed tear dysfunction. It is very common for patients to say to me, "How can I have dry eyes? My eyes always feel wet". This is actually extremely common. Other common symptoms of tear dysfunction include:
Our tears are made of three components; oil, water, and mucus. The oil comes from the 25-30 oil glands of each lid, the water from moisture producing glands under our lids and the mucin (mucus) from the conjunctiva. The lacrimal gland, located under the bone at the upper left corner of the eye socket, makes gushes of tears for crying and washing out foreign bodies from the eyes. I like to describe our normal tear makeup like a perfectly made salad dressing with just the right amount of oil, vinegar and spices. The dressing is always smooth and never separates. But, if you decrease any of the components of this dressing, it no longer has the same smoothness and needs to be constantly mixed and it does not spread well. The same thing happens with tear dysfunction. The oil glands can become blocked, medications or decreased hormones can slow down moisture production and allergies or other irritants can prevent the conjunctiva from producing enough mucin. Therefore, if any of the components of our normal tear is not present in the exact recipe needed for comfort and proper lubrication, our eyes will not feel right.
Treatment actually depends on our findings during your examination. Some patients just need lid scrubs to open up the oil glands, others need prescription drops to decrease conjunctival inflammation, and others need special lubricating tear drops to nourish the conjunctiva back to health. Regardless of the treatment modality, it needs to be done everyday to help prevent the recurrence of symptoms, or at the very least an improvement in symptoms.
The American Academy of Ophthalmology has even more information about your eyes on their website.
There are many causes of conjunctivitis, which by itself just means "inflamed conjunctiva". The conjunctiva is the clear mucus membrane that coats the eye and the under side of our lids. There are many causes of conjunctivitis, too numerous to mention here. More information about conjunctivitis can be found here.
For even more information about these topics and many, many more, visit EyeSmart , a useful patient resource from the American Academy of Ophthalmology.