Welcome Brochure

Fees & Payment Policies

To best serve you and prevent any misunderstandings, you should verify your eligibility for services with your insurance company prior to your visit. Your insurance company will best be able to guide you on the out-of-pocket expenses you may be required to pay. It is your responsibility to understand your insurance coverage and the payment policies. Full payment is due at the time services are rendered immediately following your visit. This includes all co-payments, coinsurances, deductibles, and/or non-covered services. This also applies to “Accepted Assignments.” You will be

required to pay any charges not covered by your insurance plan. The latest fee schedule is available online by scanning the QR code or visiting the website. Returned checks are subject to a $20 fee.

If your account goes into collection, you are responsible for the original charges and any additional expenses our office or the collection agency incurs to collect this balance. If you have financial difficulties, please contact us as soon as possible. IMPORTANT INFORMATION ABOUT INSURANCE COVERAGE AND FEES Our exams are comprehensive and adhere to the optometric standard of care. While we will do our best to work with patients, especially to address any financial concerns, we cannot “skip” parts of the exam that are not covered by insurance. Refraction (the determination of your eyeglass prescription needs) may not be a covered service. Most medical insurances do not cover this procedure. A refraction is a procedure that measures your ability to see clearly and determine if you need glasses, bifocals, or a change in your current prescription lenses. During the exam, test lenses are placed in front of your eyes and the patient is asked, “Which is better or clearer — one or two?” It is typically performed during both a routine exam as part of an initial evaluation and when monitoring of a medical condition such as diabetes, cataracts, glaucoma, dry eye, or macular degeneration. Contact lens fitting and/or evaluation are not part of a routine examination. Your insurance may not pay for this service. There may be a separate fee depending upon your individual insurance coverage. Required referrals must be obtained in advance. If your insurance plan requires a referral, you must obtain the referral prior to services being rendered. If your plan requires a referral from another provider, you must obtain that referral prior to your scheduled appointment and services being rendered. You will be responsible for payment if the referral is not obtained in advance. Your doctor can complete a referral form online: universityeyecenter.org/referrals

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