Insurance and Billing


 

Do you accept my insurance?

For your convenience, charges for your visit with Dr. Narain will be billed to your medical insurance. Vision plans like VSP cannot be billed for your appointments with us because we do not provide eyeglasses or refraction.

We accept Medicare as well as many PPO health insurance plans. Please consult the list below to see if we are in-network with your plan:

We are in-network ONLY with the plans listed below:

  • Covered California PPO:
    • Blue Shield
    • Health Net
  • Covered California HMO:
    • Anthem / Blue Cross: Physicians Medical Group of San Jose
    • Health Net: Physicians Medical Group of San Jose
    • Blue Shield: San Jose Medical Group
  • Any PPO plan outside of Covered California
  • Any HMO plan outside of Covered California from Physician’s Medical Group of San Jose

We are not in-network for Anthem / Blue Cross mirror plans that utilize the same network as the Covered California plans. These plans will have “pathway” listed on the bottom front of the card.

Please make sure to notify us of any changes in your insurance before your appointment.

For payment, we accept all major credit cards, cash or personal checks.

For patients without insurance, we also accept Care Credit and can assist you in applying for an account if necessary. If special payment arrangements are needed, please contact our office staff prior to your appointment.


Billing

In an effort to clarify billing, which can be confusing, we have put together an explanation of some billing procedures and a key to terminology. Hopefully, this will help reduce confusion and allow you to better understand your statements.

  • CPT Code The 5 digit number under “procedure” is the code used by all insurance companies for the type of service. Service includes exams, tests, and procedures.
  • Duplicate CPT codes Some CPT codes appear twice on the same day because some insurance companies require the each eye be billed separately.
  • ICD-9 code designates the particular diagnosis, disease, or condition that was treated. There may be several ICD-9 codes listed if there are multiple diagnoses.
  • Charges are what was billed to the insurance company. These are not the actual amounts paid. They are based on the usual fees that we charge for a service.
  • Insurance payment is the amount that has been paid by insurance for a claim based on the contractual allowed amount under your specific benefits.
  • Allowable This is the contractual “allowed amount” for each procedure or service. It is the maximum the insurance company will reimburse for a service.
  • EOD or Explanation of Benefits Once a claim has been processed by an insurance company, they send us a payment and an EOB. You should also receive an EOB.
  • Contractual adjustment or Adjustment The difference between the amount allowed by insurance and the charges billed by our office. This is the amount written off by us.
  • Patient responsibility is the co-pay plus the percentage of the allowable charges that you are responsible for. This may also include your deductible.
  • Deductible is the dollar amount that must be paid by the insured before the insurance company begins to pay. Usually it is a fixed amount every year and may vary. Amount and applicability of this varies according to your benefits.
  • Balance is the total amount that you are responsible for based on the EOB received from your insurance company, your deductible and co-pay, and any previous unpaid balances
  • From the time that a payment is mailed, it usually takes 3-5 business days before it is posted to your account, Payment made by phone or in person are posted immediately.

If you have questions regarding your specific benefits like deductible amount or coinsurance, please contact your insurance company.

Keshav Narain, MD

Retina Specialist & Surgeon located in Sunnyvale, CA & Gilroy, CA

Welcome to South Bay Retina, your retinal eye care specialist and surgeon serving the South Bay area, Sunnyvale, and Gilroy, CA communities. South Bay Retina was established by Dr. Keshav Narain, MD to provide state of the art diagnostic and therapeutic technology for the retina, the part of the eye that acts like the film in a camera where images are projected, in a competent and caring environment. South Bay Retina’s philosophy emphasizes individualized care and attention for every patient and accessibility to both patients and referring doctors. Dr. Narain is our lead retinal surgeon and vitreoretinal specialist offering treatment for retinal detachment, retinal tear, floaters, and flashers. South Bay Retina also treats individuals who are diagnosed with macular degeneration, loss of vision, retinopathy, diabetic eye care, and glaucoma.

If you are searching for an eye care specialist who has extensive experience with retinal issues, then Dr. Narain is your top choice for specialized ophthalmology in the greater South Bay area. Many of the patients who are treated at South Bay Retina are referred from general ophthalmologists for evaluation and treatment of serious eye problems. Thanks to the leadership and direction of Dr. Narain we are able to provide you with the most advanced and skilled treatments for retinal eye conditions. Contact South Bay Retina today to learn how you can be treated by Dr. Narain. Dr. Narain routinely gives out his cell phone number to doctors and critical patients, such as post-ops, and is also easily reached through our answering service 24 hours a day, 7 days a week.

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South Bay Retina

Welcome to South Bay Retina, your retinal eye care specialist and surgeon serving the South Bay area, Sunnyvale, and Gilroy, CA communities. South Bay Retina was established by Dr. Keshav Narain, MD to provide state of the art diagnostic and therapeutic technology for the retina, the part of the eye that acts like the film in a camera where images are projected, in a competent and caring environment. South Bay Retina’s philosophy emphasizes individualized care and attention for every patient and accessibility to both patients and referring doctors. Dr. Narain is our lead retinal surgeon and vitreoretinal specialist offering treatment for retinal detachment, retinal tear, floaters, and flashers. South Bay Retina also treats individuals who are diagnosed with macular degeneration, loss of vision, retinopathy, diabetic eye care, and glaucoma.

If you are searching for an eye care specialist who has extensive experience with retinal issues, then Dr. Narain is your top choice for specialized ophthalmology in the greater South Bay area. Many of the patients who are treated at South Bay Retina are referred from general ophthalmologists for evaluation and treatment of serious eye problems. Thanks to the leadership and direction of Dr. Narain we are able to provide you with the most advanced and skilled treatments for retinal eye conditions. Contact South Bay Retina today to learn how you can be treated by Dr. Narain. Dr. Narain routinely gives out his cell phone number to doctors and critical patients, such as post-ops, and is also easily reached through our answering service 24 hours a day, 7 days a week.


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Welcome to South Bay Retina

Patient Portal

We are pleased to provide patients with secure, 24/7 access to their health records through South Bay Retina. Patients can safely and easily:

  • Request prescription refills
  • Update insurance/demographic information
  • Review financial statements/make secure payments
  • View lab and test results
  • Access relevant health education materials

Patient Portal Login

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Certifications and Credentials

Insurance

We accept most major insurance. Please click INSURANCE AND BILLING below for more details. If you have any questions about your elegibility or coverage, please call our office and we would be happy to assist you.

Insurance & Billing

AARP
Aetna
Anthem Blue Cross Blue Shield
Beech Street
Blue Cross
Blue Shield
Care Credit
CareFirst
Cigna
Covered California
First Health
Great West Health Care
Guardian
Health Net
Medicare
Multiplan, Inc.
Testimonials

Words from our patients

  • Demandforce

    "South Bay Retina provides excellent eye care and surgery. The staff is courteous and professional. I would highly recommend their services to my friends."

    William S.
  • Demandforce

    "Very friendly and professional staff. Dr. Narain is always very happy to answer any and all questions."

    Nippani M.
  • Demandforce

    "My experience with South Bay Retina has been very good. The office people are friendly and are able to answer my questions. Dr. Narain explains things very easily."

    Della S.
  • Demandforce

    "Always a great experience. The staff does a great job and Dr. Narain spends quality time with patient and provides easy to understand diagnosis."

    Michael K.
  • Demandforce

    "The staff is very friendly and the doctor always takes time to get your questions answered so that you understand what's going on with your eye care needs."

    Lynnette H.
  • Demandforce

    "I was diagnosed with this weird disease and have been attended to by this group for a few years now. They are awesome. Major props to everyone at South Bay Retina!"

    Doreen F.
  • Yelp

    "Dr Narain was very professional and thorough. I would recommend him if you are in need of a Retinal Specialist."

    Sue W.
  • Yelp

    "Dr. Narain and his staff are awesome! I would come back and refer my family and friends here as well."

    Thai N.
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