The doctor will see you, but not your insurance

  • Tue Sep 25th, 2012 9:17am

By John Wolcott HBJ Freelance Writer

SNOHOMISH — If you get an eye exam at the new Seattle Hill Vision Center, east of Mill Creek, you may think you need to have your eyes checked again when you see the bill.

Instead of the market price of around $300 for an exam, you’ll see $85.

That’s because Dr. Sara Wees doesn’t process insurance paperwork. She’s charging service fees that cover her expenses, plus a profit margin.

That’s all.

From her prior work with area optical businesses, the doctor of optometry knows there’s a large segment of the population, even those with medical insurance, who don’t have vision coverage. She set up her business to serve those clients in particular.

Her professional fees for eye exams start at $85, compared to insured clients who are charged about $300 for an eye exam by many eye doctors or clinics. She knows that insurance company payments don’t cover that full fee.

“Often, insurance companies pay as little as $60 to $100 for the $300 service,” along with a small payment from the insured person, Wees said. Medical businesses write off the loss on the $300 bill on their IRS income tax return.

“I’ve seen a lot of people over the years who couldn’t afford eye exams and didn’t have insurance to cover glasses or contacts, so I want to keep prices as low as possible for them,” Wees said. “But I won’t be processing insurance claims. I need to avoid those low reimbursements and all the paperwork. People with insurance can still take my itemized receipts and send them to their insurers for reimbursement.”

She said she knows of a number of physicians who charge lower basic fees and no longer process insurance claims for patients with insurance coverage, but she doesn’t know of any other optometrists who have taken that step yet, either locally or nationally.

“I can keep my prices low because it covers my time and costs,” Wees said. “But I don’t have to hire a staff to handle insurance transactions that don’t get fully covered.”

She said contractual agreements with insurance companies have forced doctors and optometrists to charge higher fees as the cost of doing business, knowing they will get the agreed-upon lesser reimbursement amount, plus what patients pay.

“I see a large market because there are many more people who are uninsured or underinsured than insured for eye care,” she said. “Because I keep my fees low, those people will still be able to get reasonably priced, quality eye exams at Seattle Hill Vision Care.”

After 21 years of practicing optometry, including many years with Costco and The Everett Clinic, Wees opened Seattle Hill Vision Care in a shopping center at the corner of Seattle Hill Road and 132nd Street SE.

“I’ve been thinking about it for a long time and now that our oldest son, Nicholas, is a sophomore at Western Washington University and our youngest, Greg, is at Glacier Peak High School, it seemed like a great opportunity to start my own business,” she said.

Her husband, Mark, is an elementary school music and band director in Burlington.

On Sept. 11, Wees was busy setting up her waiting room. Optometry equipment was already set up in an adjacent room and workmen were installing her new business signs on the building, which is shared with Chase Bank. Her first appointments began arriving Sept. 18.

“I’ve got a good number of people coming in even this first week, which is nice, of course,” she said.

Born and raised in Eugene, Ore., Wees earned her college degree at Pacific University’s College of Optometry in 1991 through a U.S. Army scholarship, then spent three years in Army service. For the past 15 years she has practiced optometry at the Silver Lake Costco and at The Everett Clinic.

“I knew from a very young age that I wanted to go into some health-care role,” Wees said, recalling seeing her mother working as a certified midwife in Eugene. “When I’m helping clients, I look at how they’re using their glasses as well as testing their eyes. Many people need a different lens for working on computer screens, for instance. Also, I look for eye diseases and signs of eye injuries, then refer them for proper care.”

She said many customers followed her from Costco to The Everett Clinic and expects those people who knew her before will find her at Seattle Hill Vision Care.

“I like getting to know people, listening to their stories and finding out how they use their glasses or what vision issues they have, how they use their eyes on a daily basis,” Wees said. “There’s much more to vision checks than just looking at eye charts.”

Learn more

Visit Seattle Hill Vision Care at 13119 Seattle Hill Road, Snohomish; call 425-332-2276; or go to www.sarawees.com.