REJUVENATE YOUR VISION
To expedite your first consultation please complete and sign the following forms and bring them to your first appointment.
What to Expect on Your First Visit
If you have not already completed, signed, and mailed us the following forms, please bring them to your first appointment:
- Patient Information Form
- Medical History
- Medication List
- Consent for purposes of Treatment, Payment, and Healthcare Options Form
- Notice of Privacy Practices
- Receipt of HIPAA Notice
- Payment Policy Form
Check In: Your forms will be collected at our reception desk and placed inside your chart. We will make a photocopy of your insurance cards. Please be prepared to pay $105.00 for special testing that Dr. Harris will be performing that is NOT covered by insurance but is necessary in order to properly evaluate your surgical needs.
Waiting Time: Our goal is for our office to run on time however, high demand and daily medical emergencies can result in delays. Generally a comprehensive eye exam with dilation requires approximately one to one and a half hours. If you have any time restrictions you might want to reschedule your appointment.
Initial Evaluation by Ophthalmic Technician: You will be taken to an assessment area where your vision will be evaluated. Once in the exam room, the ophthalmic technician will review your medical history and check your eye pressure. Other tests may be performed based on your primary complaint and past medical history. The technician will use eye drops to dilate your pupils. Dilation is necessary to completely examine your eyes, especially the retina. Then you will be moved to our dilation waiting area while the drops take effect.
Ophthalmologist’s Exam: When your pupils are fully dilated, your eyes will be thoroughly examined by the doctor. Depending on the nature of your problem, we may perform additional tests on the day of your initial examination and, in some cases, treatment may be initiated.
Because you will have temporarily blurred vision in bright light after dilation, you may prefer someone drive for you after the examination. Your pupils and vision will return to normal over the next 24 hours.
Please do not hesitate to ask any questions about the results of your examination or the treatment recommended by the physician. Your diagnosis and all possible treatment will be completely explained to you.
Check Out: Our receptionist will advise you of payment. We file all major insurance claims including Medicare and Medicaid, and accept cash, check, Visa, MasterCard, and other credit plans that we can offer you. You will be asked to provide payment for co-pays, deductibles and uninsured services. Please review our Payment Policy for further details.
Thank you for choosing Cataract Consultants for your ophthalmic care. We are committed to providing you with quality and affordable health care. Please assist us in achieving these goals, by complying with our payment policy. Payment is due at the time the service is rendered. It is the patient’s responsibility to verify insurance and determine the status of coverage (co-pay & deductible) prior to their visit. We will be glad to file insurance claims however, the patient is ultimately responsible for payment if their private insurance (excluding Medicare & Medicaid primary) company denies payment.
- Forms of payment: Cash, Check, Master Card, Visa, or various Credit Plan Options.
- Co-Pays & Deductibles: All Medicare, Medicaid, and other insurance plan co-pays are payable upon Check-Out. It is the patient’s responsibility to know their portion payable at the time of service.
- Self-Pay: Payment is expected at Check-Out. If you are not prepared to cover your exam, we can offer you coverage through various credit plan options.
- Medicare: We accept assignment and will file all Medicare claims. At the time of service, the patient is responsible for 20% of the Medicare allowable fee, plus the deductible and any service charge not covered by Medicare.
- Medicaid: A current copy of the Medicaid Card is required prior to treatment. If the Medicaid Card is not brought to the visit, then the patient will be rescheduled.
- Worker’s Comp: Worker’s Compensation authorization must be obtained prior to the appointment, otherwise we cannot treat the patient.
- Private Insurance & Managed Care: If you participate in a plan which we accept, then we will be happy to file your insurance for you, otherwise payment in full is your responsibility.
- Refraction Fee: Part of your evaluation is the refraction which helps determine appropriate surgical options. Medicare and most insurance plans DO NOT cover this fee. The fee for this service will be collected upon Check-In.
Other Forms: For any insurance forms or dictated letters from our doctor, the fee is $25.00 per form and they will be ready in 3-5 business days.
Other Information: Any check returned to our office for non-payment will generate an additional processing fee of $30.00. We can assist you with setting up a credit plan in order to pay an outstanding balance. Accounts turned over to a collection agency will also incur a $50.00 administrative fee as well as nay additional fees associated with that effort, including court costs. Thank you for your understanding.