Our Patient Financial Policy
Thank you for choosing Lume Family Eyecare as your vision and eye health care provider. The following is a statement of our Financial Policy, which we require that you read and sign prior to your appointment. The following information is provided to avoid any misunderstanding or disagreement concerning payment for services provided by our office.
Insurance
All patients must complete our Patient Information Form and provide current information prior to being seen by the doctor. Bring a valid photo ID and all current Major Medical Insurance Cards to your appointment. We accept assignment from many insurance companies and vision discount plans, however, it is your responsibility to confirm In-Network Coverage directly with your insurance company. In the event that the insurance does not cover the visit within a reasonable time (60 days) the balance may be automatically transferred to the patient’s responsibility. Please be aware that some of the services provided may be non-covered services and considered not reasonable and necessary under Medicare and/or other medical insurance guidelines.
We must emphasize that as medical care providers, our relationship is with you, not your insurance company. We will appeal disputed claims with insurance companies to the extent additional documentation is required from us in order for the claim to be processed.
All co-pays, deductibles, and balances owed are due at the time of service. If your insurance applies any of your charge to your annual deductible or coinsurance, that portion is due and payable by you at the time of service.
Your medical insurance may only cover your visit if there is a MEDICAL REASON for your exam, such as loss of vision, headaches, eye redness, eye pain, eyes itching or burning, glaucoma, cataracts, floaters, dry eye, etc. Not all plans have a Routine Wellness Exam. If you have a vision discount plan (VSP, Eyemed), and you have a medical complaint, OR a history of medically related eye problems, your Medical insurance will be billed for your visit. If your medical insurance rejects the claim or applies charges to your deductible,then depending on your coverage, we can bill the refraction to your vision discount plan.
Patient Responsibility
If you are seeking a non-covered service, do not have insurance, or if you are a participant in an insurance or vision discount plan for which we are not a provider, we require that you be prepared to pay our fees at the time services are rendered.
Custom Eyewear Purchases
If you are ordering glasses or contact lenses, a 50% deposit is required to start any order. The remaining balance must be paid in full upon delivery of any glasses or contact lenses. For contact lens orders that are shipped directly to the patient, we require payment in full before any lenses will be ordered. All returns are subject to a 25% restocking fee.
Glasses or contact lenses must be picked up within 90 days of placing any order. If these materials are not picked up within the 90-day period, unless prior arrangements are made at the time of the order, materials will be returned to either stock or the manufacturer, and any deposit made will NOT be refundable.
Payment Details
We accept cash, check, major credit cards and Care Credit. We have the capability to accept payments over the phone with your debit or credit card information. We reserve the right to process your payment electronically based on the information you provide to us.
Any returned checks are subject to a $30.00 fee. Returned checks must be resolved before any future appointments can be scheduled.
Minor Aged Patients
Adults accompanying minor patients (parents or guardians) will need to complete a Release of Liability and Permission Form. The parent or guardian accompanying the minor is responsible for all decisions made and payment of any fees for that minor not covered by insurance. For unaccompanied minors, treatment will be denied unless we have received the proper paperwork. Insurance cards must list the minor’s name.
Missed Appointments
We ask that if you are unable to keep an appointment that you call us as early as possible to reschedule. In order to provide the best possible service and availability to all our patients, it is our policy that if you miss three or more appointments without notifying us, we may refuse to continue providing care to you.
Account Delinquency and Credit Reporting
An account is considered delinquent and may be referred to collections if payment in full is not made in a timely manner. If you are unable to adhere to the original payment agreement, you must contact us to discuss alternative arrangements. If payment arrangements are not made/ or payment in full is not made, your account with us would be referred to collections and your credit history may be obtained. We also reserve the right to bill a collections fee in addition to the outstanding amounts owed for services and products rendered. All outstanding balances must be paid in full for future visits to be scheduled. If not resolved in a timely manner, we reserve the right to dismiss you from our practice.
Your First Appointment
We do our best to make your visit to Lume Family Eyecare as comfortable and convenient as possible.
You can help us by bringing important information with you.
- Names and addresses of your other healthcare professionals
- A complete list of all medications and supplements you are currently taking
- Your photo ID, Major Medical Insurance & Vision Discount Plan cards
- Payment for all co-pays and/or deductible amounts
- All eyewear including current every day glasses, computer glasses, reading glasses and sunglasses
- Wear in contact lenses and bring all contact lenses boxes and prescription information
For your convenience, we’ve included most of the forms you will need to fill out for your first visit. These forms can also be completed online at our website at. Please allow 90 minutes for your initial visit so that we can fully assess the health of your eyes and do any additional testing that might be necessary.
You will initially be seen by an optometric assistant who will review your medical history, records what problems you are having with your eyes, check your vision and the intraocular pressure of your eyes. You may bring a family member or friend with you to the examination room if you wish.
Your eyes will be dilated so that the doctor can see clearly into the back of the eye. The doctor will then see you, review findings with you and arrange for any additional testing of treatment.
Comprehensive Eye Exams in our office include a Refraction, or an updated glasses prescription. Refractions are a non-covered service for some insurances. If you wish to decline a Refraction, you must notify the optometric assistant prior to seeing the doctor, and you will not receive an updated prescription for glasses or contact lenses at that visit. You cannot decline the Refraction after the service has been completed by the doctor.
Contact Lens Evaluations are a separate service from a Comprehensive Eye Exam. Please let the optometric assistant know if you are need a contact lens evaluation at your visit. Contact Lens Evaluations must be completed to obtain an updated Contact Lens Prescription.
Because your eyes are dilated, you may wish to bring sunglasses for the ride home if it is a sunny day. Some individuals feel uncomfortable driving after being dilated. Please consider having someone drive you home if you feel you may be uncomfortable driving.