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Financial Information

In order to control the cost of billing, we ask that the patient’s portion is paid at the time services are rendered unless other arrangements are made in advance. All professional services and materials are charged to the patient. The undersigned will ultimately be responsible for any bill incurred in this office regardless of insurance. Accounts 90 days old are subject to collection fees. There will be a service charge of $25 on all returned checks. Payment from my vision plan/medical insurance is to be paid directly to Clearfinity Eyecare Optometrist and I understand that (name of vision plan or medical insurance*)

will be billed as my primary insurance. I understand that billing any secondary insurance is my responsibility. I understand that all benefits quoted to me are not a guarantee of payment by my insurance company and that final determination can only be made once the claim is processed. All eyewear purchases are final sale and only a store credit can be issued that can be used for any future eyewear purchases.

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About your vision plan/Medical Insurance

There are two types of health insurance that will help pay for your eye care services and products. You may have both and our practice accepts ONE or BOTH:

  1. Vision Care Plans (such as VSP, Davis, Eyemed, etc..)

  2. Medical Insurance (such as Blue Cross/Blue Shield and United Health Care etc..)

  • Vision care plans ONLY cover ROUTINE vision exams along with eyeglasses and contact lenses. Vision plans only cover a basic screening for eye disease. They DO NOT cover diagnosis, management, or treatment of eye diseases, dry eye, itchy eyes, cataracts, etc...

  • Medical insurance MUST be used if you have any eye health problem or systemic health problem that has ocular complications. Your doctor will determine if these conditions apply to you, but some are determined by your case history.

  • If you have both types of insurance plans it may be necessary for us to bill some services to one plan and other services to the other. We will use coordination of benefits to do this properly and to minimize your out-of-pocket expenses.

  • We will bill your insurance plan for services if you are a participating provider for that plan. We will try to obtain advanced authorization for your insurance benefits so we can tell you what is covered. If some fees are not paid by your plan, we will bill you for any unpaid deductibles, co-pays, or non-covered services as allowed by the insurance contract.


Appointment Policy

If you are unable to keep a scheduled eye exam appointment, we ask that you please give us at least 24hrs notice. "Late Cancellation" or "No Show" appointments may be charged $40 on weekdays and $50 on Saturdays.


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Visual Screening/Retinal Imaging

At Clearfinity Eyecare Optometrist, Dr. Laura Frederick believes in providing a yearly complete comprehensive eye examination, which can result in early detection of potential vision-threatening and even life-threatening diseases that are not just limited to the eye.

We currently have a state-of-the-art Visual Field diagnostic device which is helpful in diagnosing any potential issues that occur between the eye and the brain beyond what we can see in a dilated eye exam.

The Visual Field diagnostic device tests different points of your peripheral (side) vision. Any cluster of defects found in the screening may signify a neurological concern.

The most common issue that can be detected very early with a Visual Field Screening is Glaucoma.

Glaucoma is a painless, slow eye disease that causes the death of optic nerve fibers resulting in gradual loss of peripheral vision over time. There is a much higher risk if an immediate family member has it.

The cost of the Screening Visual Field is $29.

A Wellness Retinal Imaging procedure is an additional screening tool that involves capturing an image of the back central part (retina) of your eyes. This is not an x-ray or ultrasound procedure and will not touch your eye. This permanent record is very valuable in assessing the current health of your eye. It also serves as an initial baseline from which to compare as we follow your eye health in subsequent years.

The cost of the Wellness Retinal Imaging is $39

Since these are screening tests, medical and vision plans will not cover them, however any abnormalities that are detected in the screening assessment will result in you returning to the office for a more extensive medical visual field test/retinal imaging that can be billed to your medical insurance minus any contracted co-pays.

Together, both screenings provide a complete documented assessment of the appearance and function of your retina. If you choose to have both screenings done it will be packaged at $59 – a $5 savings.

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