It is our goal to provide you the best ophthalmic care we possibly can. Part of your care includes the billing of your services provided we’ve received the correct and complete information from you. If complete information is not provided at the time of your visit, you will be responsible to pay on the day services are provided. Please read the following information as it will answer many of your questions regarding our billing policies.
All Patients: Are expected to have their current insurance card, valid picture ID, Co-pay, Deductible, Co-insurance and any Balance that is due at the time of service.
HMO/Managed Care Plans: It is your responsibility to make sure a current referral has been obtained prior to your appointment with our office. If no referral has been obtained, your appointment
will be rescheduled. It is the patient’s responsibility to make sure the correct referral is in place, at the time of the visit.
Co-pays: Primary and secondary insurance co-pays must be paid at time of check in. Patients will be asked to re-schedule if they do not have their co-pay at the time of visit.
Late Fees & Collections: Balances greater than 30 days due will accrue a monthly 1.5% late fee. Patients with balances greater than 90 days due will be sent to Collections. Collection fees are an
additional 30% of the balance. We do not permit patients to carry long term balances so a patient may be discharged from the practice for this reason.
No Shows Fees:
- Failure to cancel an appointment within 24 hours of appointment:$30.00
- Failure to cancel any surgery within 10 days of procedure: $100.00
Please remember a confirmation call is a courtesy done by this office and not an obligation, therefore it will not be a reason to waive a No-Show fee.
Miscellaneous Charges: There may be charges for the following request
- Rx Processing request outside of office visit
- Processing Forms i.e. DMV, employment, etc.
- Letters
I have read, understand, and agree to the above Financial Policy. I understand that charges not covered by my insurance company, as well as applicable co-payments and deductibles, are my responsibility. I understand that it is my responsibility to contact my insurance carrier(s) if they do not respond to payment request made on my behalf.