Thank you for choosing Associate in Eyecare to serve your eye care needs. We are dedicated to building a successful physician-patient relationship with you. Your clear understanding of our Patient Financial Policy is vital to our professional relationship. Your payment for services is a part of that relationship. Please ask if you have any questions about our fees, our policies, and your responsibilities. It is your responsibility to notify our office of any patient information changes (i.e. address, name, insurance information, etc.).
Please bring your insurance cards to every visit. In order to accurately bill your insurance company, we require that you provide accurate and current insurance information including primary and secondary insurance. Failure to provide complete insurance information may result in patient responsibility for the entire bill. Although we may estimate what your insurance company possibly will pay, it is the insurance company that makes the final determination of your eligibility and benefits. If your insurance company is not contracted with us, you agree to pay any portion of the charges not covered by insurance, including but not limited to those charges above the usual and customary allowance. It is your responsibility to check with your insurance company to be sure we participate with your plan. Some insurance companies have coverage that fall into a Tier plan. Please confirm if we are under Tier 1 or Tier 2 under your plan. If we do not participate with your plan, you will be responsible for full payment.
We participate with several Vision Plans. Please check with your plan to see if we are members of your Vision Plan. If we do not participate, services are payable at the time of service.
Patients are expected to pay AT TIME OF SERVICE all amounts known not to be covered by their insurance company. These amounts include co-payments, co-insurance, and/or deductibles. Payments may be made by cash, check, and/or credit card.
Patients without Insurance coverage
Self-pay accounts are for patients without insurance coverage, patients covered by insurance plans in which the office does not participate, or patients without any insurance card on file with us. It is always the patient’s responsibility to know if our office is participating with their plan. If you come for an office visit and we do not participate with your insurance company, we assume you decided to see us as an out-of-network provider.
Extended payment arrangements for established patients are available. Please ask to speak with a billing coordinator to discuss a mutually agreeable payment plan. If you pay cash, please be sure to ask for a receipt so that you will have a record of your payment.
Care credit is a financing option that is available to our patients. You can apply online www.carecredit.com
Routine vs. Medical Exam
A Routine Vision Exam is a screening exam which is performed as a “healthy” eye visit. It is most frequently requested by patients to determine the need for corrective lenses. Not all insurances cover screening exams or offer a “vision” benefit. It is your responsibility to know if you have this benefit and how often it may be available. You will be responsible for payment if your vision exam is not covered. A medical exam is billed to your medical insurance with the symptom or condition which was examined on the day of the visit.
Glasses and Contact Lens Exam
Examinations for spectacles and contact lenses are SEPARATE exams. If you require both exams on your visit, you will be charged a fee for your contact lens evaluation. The cost of the contact lens exam is payable at the time of service. You may have a vision plan which covers the contact lens exam fee, but it is then deducted from your materials benefit (for glasses or contact lenses). Also, if you decide to use your materials benefit elsewhere, your contact lens exam will NOT be covered. To avoid confusion and future billing issues, it is our office policy to accept payment for the contact lens exam at the time of your visit so you can apply your materials benefit to glasses and/or contact lenses.
This is the test to determine if you need a prescription for eyeglasses. Unfortunately, most insurance companies do not pay this fee, it is billed to the patient in addition to the exam charge and is payable at the time of service. Our Refraction fee is $50.00.
In the case of a workers’ compensation, you must obtain the claim number, phone number, contact person, name and address of the insurance carrier prior to your visit. If this information is not provided, you will be asked to either reschedule your appointment or pay for your visit at the time of service.
The charge for a returned check is $25.00 payable only by cash or credit card. This will be applied to your account in addition to the insufficient funds amount. You may be placed on a cash only basis following any returned check.
The parent(s) or guardian(s) who accompanies the minor is responsible for full payment and will receive the billing statements.
If your account becomes delinquent and you have not established or met payment options with our billing department, your account will be turned over to a collection agency. Outstanding balances must be resolved prior to any non-emergency appointments. If you have a financial hardship, or if you are unable to pay your bill in its entirety, please contact our billing department to discuss payment options. Our staff is always available to listen and help.
This Financial Policy helps the office provide quality care to our valued patients. If you have any questions or need clarification of any of the above policies, please feel free to contact us at 973-232-6900