Patient Information


 

Patient Information

Rothchild Eye Institute provides the following patient forms to download:

Please select the form you need, click on it to open it up.

You can then PRINT the form, fill in the information and fax it to 561-495-9538.

Insurance

The Rothchild Eye Institute accepts Medicare assignment. We file the Medicare claims directly. If you have private insurance, we will provide you with a fee slip to file with your insurance company. Although most Refractive Surgery is not covered by insurance, if you have insurance you think might pay, we'll be happy to file for predetermination of benefits. We also have several sources for financing Refractive Surgery procedures and credit cards are accepted. If you have any questions, our staff will be happy to assist you.

 

Accepted Insurance Providers

*Patients should always contact the office directly to see if we are still active with their insurance carrier.*

AARP HEALTHCARE OPTIONS
AETNA
ALLSTATE INSURANCE CO
AMA INSURANCE AGENCY
AMERICAN PIONEER
APWU HEALTH PLAN
ASO PLUMBERS LOCAL UNION 1
ASSURANT HEALTH
ATLANTIC MEDICAL INSURANCE
BANKERS LIFE & CASUALTY
BANKERS LIFE & CASUALTY CO
BCBS FEDERAL CLAIMS
BLUE CROSS BLUE SHIELD OF FLORIDA
BRITISH CAYMANIAN INSURANCE
C AND R CONSULTING INC
CELTIC INSURANCE CO
CELTIC LIFE
CHAMP VA
CIGNA
CIGNA GOV DME JURISDICTION C
CIGNA HEALTHCARE
COLONIAL-PENN LIFE INSURANCE
CONSTITUTION LIFE INSURANCE COMP
CONTINENTAL GENERAL INSURANCE CO
CSO ADMINISTRATOR BY PHILADELPHIA
DEPARTMENT OF THE TREASURY
EMPIRE BCBS OF NEW YORK
EMPIRE PLAN
FCCI INSURANCE GROUP
FIRST UNITED AMERICAN LIFE INSURANC
GALLAGHER BASSETT
GEHA
GENWORTH LIFE
GERBER LIFE INSURANCE CO
GHI
GOLDEN RULE INSURANCE CO
GUARANTEE TRUST LIFE
GUARDIAN LIFE INSURANCE CO OF AMERI
GWH CIGNA PPO
HARTFORD INSURANCE CO
HARVARD PILGRIM HEALTH CARE INC
HORIZON BCBS OF NEW JERSEY
HUMANA INC
HUMANA OPEN ACCESS
LINCOLN HERITAGE LIFE INSURANCE CO
MAGNACARE
MAIL HANDLERS BENEFIT PLAN
MASTERS MATES AND PILOTS HEALTH
MEDICAL MUTUAL
MEDICARE PART B OF FLORIDA
MERITAIN HEALTH
METROPOLITAN LIFE INSURANCE CO
MIDWEST NATIONAL LIFE
MIDWEST SECURITY INSURANCE CO
MONUMENTAL LIFE INSURANCE
MONUMENTAL LIFE INSURANCE CO
MUTUAL OF AMERICA
MUTUAL OF OMAHA
NALC HEALTH BENEFIT PLAN
NEIGHBORHOOD HEALTH PARTNERSHIP
NEW ERA LIFE INSURANCE CO
NEW YORK DISTRICT COUNCIL OF CARPEN
OXFORD HEALTH PLANS
OXFORD LIFE INSURANCE CO
PAN AMERICAN LIFE INSURANCE CO
PENSION HOSPITALIZATION BENEFITS
PHCS
PHCS NETWORK
PHYSICIANS MUTUAL
PHYSICIANS UNITED PLAN
PRINCIPAL FINANCIAL GROUP
PRINCIPAL LIFE INSURANCE COMPANY
PRIORITY HEALTH
PYRAMID INSURANCE
SELF PAY
STANDARD LIFE & ACCIDENT INSURANCE
STANDARD LIFE INSURANCE CO
STATE FARM INSURANCE CO
STATE MUTUAL INSURANCE
STERLING INVESTORS LIFE INSURANCE
STIRLING AND STIRLING
THE HARTFORD
THE HARTFORD GROUP
THE HARTFORD INSURANCE CO
THE LOOMIS COMPANY
THE ULLICO FAMILY OF COMPANIES
TRANSAMERICA ASSURANCE CO
TRAVELERS INSURANCE
TRICARE
TRICARE FOR LIFE
TRICARE SOUTH
UMR
UNICARE
UNICARE HEALTH PLANS OF THE MIDWEST
UNION BANKERS
UNITED AMERICAN INSURANCE CO
UNITED HEALTHCARE COMMUNITY PLAN
UNITED HEALTH CARE MEDICARE
UNITED HEALTHCARE MEDICARE COMPLETE
UNITED HEALTHCARE OF FLORIDA
UNITED INSURANCE CO OF AMERICA
UNITED MEDICAL RESOURCES INC
UNITED TEACHER ASSOCIATES INSURANCE
UNITED TEACHERS ASSOCIATION
UNITED WORLD LIFE
UNIVERSAL HEALTHCARE
USAA
USAA LIFE INSURANCE CO
US DEPARTMENT OF LABOR

Location
Rothchild Eye Institute
16244 S. Military Trail, Suite 690
Delray Beach, FL 33484
Phone: 561-287-3186
Fax: 561-495-9538
Office Hours

Get in touch

561-287-3186