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In Network vs. Out of Network

When our office is “in network” it means that our office has contracted to provide services and materials in accordance with a set schedule and program.  As an “in network provider” we will fulfill and follow the obligations and protocols set forward by the plan.

At times, however, it becomes difficult for our office to remain “in network” for a large number of plans at the same time.  Or, specific plans put in place requirements or obligations that we feel compromise the excellence and personal service which has been a hallmark of our office for many decades.   In either of those instances we move “off network.”

When we are “out-of-network” for your vision plan, you are welcome to continue to receive your care at Fig Garden Optometry and your plan will (typically) allow you to continue to see the provider of your “choice.” However, when visiting us as “out of network” – the vision plan pays you – the patient – instead of us, the provider, for the amounts that are their responsibility. When that is the case, your responsibility with our office will be the fees for services and materials that other patients who have no vision plan experience.  Then, to receive a reimbursement from your plan, you would be required to send in paperwork to the benefit plan and wait for reimbursement after the fact.

The amount that the benefit plan will reimburse a patient seeing an “out of network” doctor will vary from case-to-case, employer-to-employer and plan-to-plan.  If you would like us to provide an estimate of your “out-of-pocket” costs continuing to see us as “out-of-network” compared to a previous time when we were “in network,” please contact us at help@figgardenoptometry.com

The Drs and Team of Fig Garden Optometry