Patients
- Frequently asked questions:
Physicians - Frequently
asked questions:
How
many visits does it take to make a new
prosthesis?
A new prosthesis will take
approximately 3 to 4 appointments to make,
depending on your case.
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Will
Mager & Gougelman, Inc. accept insurance?
Mager & Gougelman, Inc.
accepts most major insurances, however,
the amount of coverage will differ depending
on your particular plan.
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If
I have insurance, what is required at
the time of my appointment(s)?
We do accept most major
insurance plans. The amount of coverage/payment
of your insurance company depends on your
plan and the type of treatment you receive
at your visit. Some of your appointments
may be fully covered while for other appointments
you may be responsible for a portion of
the payment. Patients are fully responsible
for any payments that their insurance
does not cover.
Patients are responsible
for obtaining authorization for the visit
to our office. However, our office will
be happy to help you obtain authorization
and as much coverage as possible. Below
are some general guidelines for what is
usually required by insurance companies:
- NEW PROSTHESES
- All insurance companies require you
to obtain a Letter of Medical Necessity
from your Ophthalmologist or your Primary
Care Physician.
- OTHER VISITS
- every individual’s insurance
plan varies, however, most insurances
will require authorization prior to
your visit. The authorization may be
in the form of an authorization number
that you would receive from your Doctor
or the authorization may be in the form
of a Letter of Medical Necessity.
- MEDICAID
– You must have a Letter of Medical
Necessity from your Ophthalmologist
which includes the Doctor’s license
number.
- MEDICARE
- You must have a Letter of Medical
Necessity from your Ophthalmologist.
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Will
I be responsible for payment?
All services rendered are
the responsibility of the patient. Our
office will be happy to assist patients
with their insurance company’s policies.
The amount of coverage/payment
of your insurance company depends on your
plan and the type of treatment you receive.
Some of your appointments may be fully
covered while at other appointments you
may be responsible for payment. Our office
requests that you make copies of your
insurance so that we may verify your insurance
policy.
Again, patients are responsible
for obtaining the authorization for the
visit to our office. However, our office
will be happy to help you obtain authorization
and as much coverage as possible.
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What
happens when I come to the office for
a new prosthesis?
A new prosthesis will take
approximately three to four office visits
depending upon your case. Generally, your
appointments would be as follows:
- Initial consultation
for prosthetic evaluation; possibly
an impression of the socket
- Measurements of anophthalmic
socket or blind globe for size, volume,
and contour
- Custom painting of prosthesis
or shell while patient is present and
then delivery of custom prosthesis
- Follow-up for comfort
and cosmetics (not needed but recommended)
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What
is the difference between a stock prosthesis
and a custom made artificial eye?
A custom made artificial
eye is fitted and fabricated (hand-made)
to all the specific aspects of an individual
patient’s case utilizing all fitting
and fabrication techniques needed for
a proper fitting. A custom artificial
eye replicates the iris, sclera, pupil,
and veins to match the fellow eye. The
palpebral fissure, eyelid contours, specific
motility implant contours are duplicated
to conform to the fellow eye.
A stock prosthesis is pre-fabricated (pre-made
shapes and color) in several shapes and
colors. A stock prosthesis is not specifically
fitted for each individual’s socket.
An eye-fitter may modify the shape and
color of a pre-fabricated prosthesis to
help achieve a better cosmetic result.
The result is inferior to a custom made
prosthesis.
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How long
does an artificial eye last?
An artificial eye does not
last forever and is not permanent. A prosthetic
eye is custom fitted and individually
painted for the ocular socket at a specific
time. The eye socket changes over a period
of time and either a new prosthesis or
an adjustment to the existing prosthesis
may be needed to accommodate these changes.
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Is
it necessary to return to the Ocularist
office on a regular basis?
Regular visits are necessary
to evaluate the fit and cosmetic appearance
of your prosthesis. These visits are the
only way we can assure the best fit possible
for your prosthesis. The visits allow
us to accommodate for any changes that
may be needed.
Routine re-surfacing and polishing of
the prosthesis helps in comfort and retention
of prosthesis for extended wearability,
and it also significantly reduces the
occurence of ocular cavity infection.
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How
do I care for my ocular prosthesis?
Please see the section on
this site called “Care
for your Prosthetic.”
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How
often will I have to remove the prosthesis?
Removing a prosthesis depends
upon the comfort of each patient. Some
patients must clean their prosthesis once
a day and others once a week. Your Ocularist
will help determine the best cleaning
schedule for you.
Cover shells over an exiting
globe/cornea must be removed before retiring
at night to rest the cornea/globe.
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How do
I remove and insert the prosthesis?
Please see the section on
this site called “Care
for your Prosthetic.”
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When
I insert my artificial eye how will I
know which is the top of the prosthesis?
Most of the ocular prosthetics
from our office have some sort of marking,
such as numbers, to show you the top.
Please refer to “Care of your Prosthetic.”
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Will
wearing a prosthesis hinder me from doing
anything?
In most cases, the wearing
of a prosthetic eye should not prevent
you from performing your daily routine,
activity or occupation. We do recommend
that you wear protective eyewear especially
while participateing in sports, such as
goggles while swimming, safety glasses
while playing tennis, etc.
It is recommended that you
wear polycarbonate lenses to protect your
sighted eye.
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What
are the different types of ocular prostheses?
Different types of ocular
prostheses include scleral cover shells,
impression fitted ocular prostheses, empirical
custom ocular prostheses, expansion conformers,
and prostheses for congenital anomalies.
Please refer to “Services”
for descriptions of each of these types
of prostheses.
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What
is involved in obtaining an ocular prosthesis
for my child?
There is no one answer to
this question. Every case is different
and unique. You will need to have a consultation
with an Ophthalmologist and/or Ocularist
to help answer this question.
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Do I need to
wipe the prosthesis a certain way? And
why?
Please refer to “Care
for your Prosthetic.”
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Physicians - Frequently
asked questions:
How
soon do you want to see patients after
surgery?
When you feel the patient
is ready. We generally recommend the following:
Enucleations
- 4 to 6 weeks
Eviscerations- 3 to
4 weeks
Ptsosis Surgery - 3
to 4 weeks
Inferior Lid Tightening
- 2 to 3 weeks
Peg Placements - 3
to 4 weeks
Congenital Anophthalmia-
As soon as possible for consultation/and
conformer expansion therapy
Congenital Microphthalmia-
as soon as possible for consultation
and conformer therapy.
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How many
appointments does it take to have a prosthesis
fabricated?
A new prosthesis usually
takes 3-4 appointments to fit and fabricate,
depending on the case.
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Do you accept
insurance?
We accept most major insurances.
All insurance policies are different.
We will gladly work with the patient and
their insurance company to verify his
or her coverage.
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In case
of infections, is it best to suggest that
the patient not wear their prosthesis
until their socket is fully healed?
If an infection in the eye
socket is present, in most cases, the
patient should not be without wearing
their prosthesis more than 24 hours. Any
longer than 24 hours could lead to the
socket contracting. If possible, the patient
should have something in the socket to
keep contractions from occurring.
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How can
an Ophthalmologist or Ocular Plastic Surgeon
help the Ocularist give their patients
the best prosthetic possible?
We believe that communication
between the Ocularist and Ophthalmologist
and/or Ocular Plastic Surgeon is necessary
and the key to achieving the best result
for the patient. There are times that
adjustments either to the prosthetic eye,
orbit, or lid may need to be made for
optimum results.
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