It is important that you know what your insurance covers and doesn't cover.
If We Participate With Your Plan:
Co-pays, co-insurance, deductible and non-covered services are expected to be paid at time of service. The staff will calculate, as closely as
possible, what your payment responsibility will be and request this from you. We will bill your insurance company for the remaining balance.
When your claim is processed and returned any balance your insurance company indicates you owe that we have not collected will be billed to
you. Likewise, if an overpayment is made, a refund check will be issued and mailed to you.
If current and correct insurance information is not provided and the insurance carrier refuses payment, we will bill you for the visit.
If We Don't Participate in Your Plan:
All services rendered require payment in full at the time of service. A receipt will be provided. If you provide your insurance card, this office
will file a claim and request that the insurance company send their reimbursement to you. If payment is made to us, we will issue you a refund
For private pay or non-insured patients, payment in full is expected at time of service.
Insurance – Only an actual insurance card will be accepted. Written or verbal information is not sufficient.
This is done to determine the best eyeglass prescription for your eyes. This not only allows us to prescribe glasses, but more importantly determine how well you can see. This helps your doctor to separate glasses problems from eye disease problems that can make you go blind or systemic diseases that can cause severe illnesses. A Refraction may or may not be performed at your visit, depending on the doctor's judgment of its necessity. This service is NOT usually paid for by insurance plans as a non-covered service. Therefore, the charge for this service will be collected from you. Should your insurance company pay for this service the overpaid amount will be refunded to you.
We will look to the adult accompanying the child to the visit for payment. If there is insurance, correct insurance card (including the insured's name, address, phone number, date of birth and social security number) and accompanying adult's drivers license will need to be provided. Without complete insurance information the accompanying adult is required to pay for services in full at check-out. A paid receipt will be provided.
We will send you a statement in the mail if you owe a portion of the charge that was not collected at or prior to the time of service. If payment IN FULL is not received within 25 days of the statement date, a billing fee of $6.00 will be charged at each additional billing for the same balance. In some instances we will agree to a short-term payment arrangement, however, the billing fee will still be charged for each statement mailed. If the balance goes unpaid or if we are unable to contact you regarding the balance we will review your account with the doctor to discuss further collection action including possibly using a collection agency. There is a $25.00 service charge on all returned checks.
Because everyone's time is valuable, we request 24-hours notice for cancellations. We would prefer not to charge for missed appointments. Your cooperation would be greatly appreciated.
Our surgeries are performed at either Oil Center Surgical Plaza (OCSP) or The Surgery Center. It is your responsibility to check with your insurance plan to determine if the location of your surgery is approved by them. We will provide you with an estimate of the amount that you will be responsible for. This amount applies only to our office and does not include the surgery facility amount. This amount will need to be paid to us prior to the surgery date. We request 24-hours notice for cancellations. We would prefer not to charge for cancelled surgeries. Your cooperation would be greatly appreciated.
Payment in full is expected at the time of service. A receipt is provided for you to secure reimbursement.
Payment must be made prior to the exam by you or your attorney. Contact our office for an estimate of the charges. The amount quoted must be paid prior to the exam. If there is a credit remaining after the exam and a return visit is scheduled the credit will be held and an additional quote will be provided that must be paid prior to exam. Upon discharge a remaining balance will be refunded to whomever made payment.
Your employer or WC Insurance Carrier is required to complete a Workers Comp Verification Sheet providing billing information with authorized signature prior to being seen. Have either one contact this office at 337-981-6430 prior to your visit.