Effective March 27th 2018
This notice describes how our office operates. Please read this notice carefully so that you are aware of what is expected from you, and you understand what to expect from our optometry practice and optical dispensary. Any exceptions to these policies are at the discretion of management.
PAYMENT FOR PROFESSIONAL SERVICES AND OPTICAL PRODUCTS
- Optometry Services: Full payment is due at the time of service. Copays are due at the time of service.
- Optical Dispensary: Full payment is due at the time of placing an order for all custom glasses and contact lenses. Free shipping is included with an annual contact lens supply order. Designated family members may pick up your order from our office with your permission.
- Health Insurance and Vision Benefit Plan Coverage Information: We are happy to answer any questions about in-network health insurance coverage to the best of our ability; however, we don’t always have access, or the resources, to obtain your coverage information. We encourage you to contact your insurance company and obtain details about your vision coverage.
- Per your insurance, verification of eligibility and benefits is NOT a guarantee of payment. Payment is determined when the claim arrives and is processed with its provisions and guidelines found in your benefits package; therefore, if your health insurance or vision benefit plan denies, changes, and/or recoups payment for services that you received at our office, it is your responsibility to pay the remaining balance.
- If we have not received payment from your insurance or vision benefit plan within 6 months from the date of service, it is your responsibility to pay the remaining balance.
- If your insurance company denies reimbursement for your visit for any unexpected reason, it is your responsibility to pay the remaining balance.
- Outstanding Balances: All balances must be paid in full before additional appointments can be scheduled with the optometrist.
- Balances Over 90 Days: Any remaining balance on your account over 90 days past due will incur a finance charge of 1.5%. Balances over 180 days past due are subject to collections. Patient is responsible for all late fees, financing charges, collection and legal fees associated with past due balances.
- Forms of Payment: We accept all major credit cards (except American Express), cash, check, Care Credit, HSA and FSA accounts, as forms of payment. Personal checks that are returned for non-sufficient funds will incur a $50 processing fee.
- Out-Of-Network Insurance Reimbursements: Dr. Michael Noble and Dr. Alma Fuentes are out-of-network providers with certain insurance carriers. This simply means that you have to pay out-of-pocket at the time of your appointment. You may be eligible to submit your out-of-pocket expenses to your insurance company. An itemized receipt will be offered to you for your records and reimbursements. Our staff is not authorized to contact any out-of-network insurance providers on your behalf.
- Requesting Prescriptions and Pupillary Distance: Our office adheres to Washington State health regulations for optometry and ophthalmic dispensing. After your comprehensive eye exam is completed, we will provide a copy of your prescription, in paper or electronic format. We will also give you online access to your personal health record where you can access your prescription upon request. If you wish to obtain your pupillary distance (PD), there’s an additional service fee of $25 to perform this measurement.
- Rescheduling or Cancelling Appointments: Please notify our office at least 24-hours in advance if you wish to reschedule or cancel your appointment. In order to be able to offer timely appointments to all patients we have the following missed/cancellation structure.
- Same Day Cancellations and Missed Appointments for Exams: We understand unexpected events occur out of our
control therefore no a ction is taken the first time you make a same day cancellation; however, the second time you make a same day cancellation a fee of $50 will be assessed. A scheduled appointment will not be allowed to be made without payment of the fee. If you “no call, no show” to your appointment a $50 fee will be assessed immediately. A scheduled appointment will not be allowed to be made without payment of the fee.
- Same Day Cancellations and Missed Appointments for Procedures: Due to the allotted time and staffing requirements for specialty procedures any no show or cancellation with less than a 48-hour notification will have a fee assessed of 50% of the specialty procedure cost. This fee will be taken out of any prepaid specialty procedure fees. If there is a remaining balance due for the procedure a scheduled appointment for the specialty procedure will not be allowed to be made without payment of the fee.
OPTICAL PRODUCTS GUARANTEE
- Satisfaction Guarantee: Our goal is to make sure that you are completely satisfied with your purchase; therefore, we will do everything we can to make sure that the glasses or contact lenses, you purchased at our office function as prescribed. If you are dissatisfied with the performance of your glasses, or contact lenses, please call us. We will carefully review your concern, and work with you to find the best possible solution.
- Our Frames and Lenses: We are proud to offer high-quality designer frames, and high-quality lenses, from the world’s leading manufacturers. When you purchase a complete pair of glasses from us you’ll receive a great product that’s custom fitted to your prescription specifications and comfort. You’ll have peace of mind knowing your lenses are made accurately, and your purchase is backed by a 1-year warranty against manufacturer’s defects on frames and lenses. Our premium anti-reflective lens coating includes a 1-year scratch warranty; therefore, if your lenses scratch we will replace them at no charge. If our doctor needs to adjust your prescription, within 3-months of your original exam date, we will remake the lenses at no charge. You also receive complimentary adjustments and minor repairs for the lifetime of your glasses. Plus, if your glasses are not covered under warranty and are broken beyond repair, within 1 year of the original purchase, we may be able to replace them for only 50% of the retail cost. See our optician for more details about our warranty.
- Refunds and Exchanges: Prescription glasses and contact lenses are custom ordered to your specifications and measurements; therefore, all sales are final. If you received your eye exam and purchased your contact lenses at our office, and your prescription changes within 12 months of your original purchase, we may be able to exchange unopened/undamaged boxes of contact lenses for your new prescription. If you received your eye exam and purchased your glasses at our office, and your prescription changes within 3-months of your original exam date, we will remake the lenses at no charge. There are no refunds on services that have already been performed.
- Outside Prescriptions: We welcome outside prescriptions and we will make your glasses to the prescription specifications. Please keep in mind that if your doctor changes your prescription after 90 days from the glasses order, and the lenses have to be remade, you will have to pay for the cost of the new lenses.
- Using Your Own Frames: We understand that you may want to reuse an old frame, or a new frame that you purchased somewhere else, for your new lenses from our optical. We will honor your request in these instances and take extra care of your frame. However, we cannot guarantee your own frame against breakage, cracks, scratches, or any other unexpected damages, during the lens installation process. By requesting to use your own frame you agree to release our office from any liability.
GLASSES PURCHASED ELSEWHERE
- Adjustments for Glasses: We may be able to perform minor repairs and adjustments on glasses that you purchased elsewhere. This is subject to the condition and quality of the glasses. We will quote the price for any frame adjustment, replacement nose pads, or missing screws, at the time of service. Our trained professional opticians will take extra care of your glasses; however, we cannot guarantee your glasses against any unexpected damages during the adjustment process. By requesting to have your own frame adjusted you agree to release our office from any liability.
- Service for Glasses: We offer a 1-year service package for new glasses purchased elsewhere. The package includes prescription verification, adjustments, and minor repairs. Please see the optician for more information.