We are committed to providing you with a great customer experience and are happy to verify insurance eligibility and benefits. However, this is never a guarantee of benefits as some insurance companies arbitrarily select certain services that they will not cover and/or must be medically necessary. It is your responsibility to understand the scope and limitations of your insurance policy and you are financially responsible for all charges rendered whether or not paid by your insurance. We are happy to discuss insurance coverage in more detail with you regarding your specific vision and/or medical plan. Insurance
Blink Eyecare are providers for numerous vision/medical insurance panels. Your responsibility will be for any co-payment and other charges your insurance does not cover. Our office will help you receive your maximum benefits, if you have provided us with the necessary current insurance information at the time of examination, or before the time your eyewear is ordered. Otherwise, you will be responsible for all costs incurred. If your insurance plan requires a co-payment/co-insurance, you are expected to pay this at the time of service. If your insurance company has not paid the balance within 60 days of service, and it is determined that they will not be paying, you will have 30 days to pay the balance. Should the account be referred for collections, you will be responsible for collection fees and expenses.
If we do not accept your vision/medical insurance, then you will be responsible for all fees and charges that you incur. Payment is due the day of the examination unless prior arrangements have been made. Our office will provide you with an itemized statement that you can submit to your insurance company for reimbursement upon request. Uninsured Patients
If you do not have insurance for services provided, a 30% administrative discount will be given if the account is paid in full on the day of service. This applies to services only; glasses, contacts and other eyewear are not included. Payment
We accept cash, check, Visa, MasterCard and Discover. A $30.00 returned check fee will be assessed for any returned checks. We also accept Carecredit. Medical Services
For medical care, if you have not met your deductible, we will collect half of your balance at the time of service. You will receive a bill for the remaining balance after your insurance processes your claim unless other arrangements have been made. Refraction Services
During refraction, the Optometrist evaluates whether you would benefit from corrective eyeglasses. The refraction service is vital to calculating the most accurate prescription to help your vision. Medicare and most other medical insurance do not cover refraction as part of their medical policies. If you have a separate vision plan outside of your medical insurance, please let us know, as many vision programs will pay for the refraction. By signing below, I agree I have read the refraction policy and understand that this is considered a non-payable service by most insurers and I agree to pay the $65.00 cost at the time of service. Contact Lens Prescription Rule
This rule states that the patient must acknowledge receipt of their contact lens prescription. I understand and acknowledge that once my contact lens exam is completed and finalized within 90 days, I will be given a copy of my contact lens prescription in a paper format or digital. I understand that if I request an additional copy of my prescription that Blink Eyecare has 40 business hours to respond and provide me with a new copy. By signing below I acknowledge that I will be given a copy of my prescription once I am finalized. 92310 Contact Lens Exam Services
Contact lens exam services are not covered by most insurances. All contact lens follow ups must be completed within 90 days or a new exam will be necessary. If I choose to have these services and they are not covered by my insurance, then I understand that I am financially responsible.
- Single Vision Fitting: $80.00
- Astigmatism Fitting: $98.00
- Multifocal Fitting: $150.00
- New Wearer Fitting: $150.00
- RGP Single Vision/Toric Fitting: $150.00
- RGP Multifocal Fittings: $165.00
- Specialty Contact Lens Fittings: $200.00
We strive to provide you a truly custom product, tailored to your individual prescription. Therefore, frame and lenses are not-refundable. However, store credit will be honored within 30 days of being dispensed. 50% down payment is required to order glasses or contact lenses, the balance is due when they are dispensed. If the glasses/contacts are not picked up within a month then you will receive a statement and will need to pay off your balance within 60 days. Otherwise your account will be turned over to collections. Collections
Accounts with balances over 90 days old are considered “Past Due.” Our billing staff will make a reasonable attempt to notify you if your account has reached a “Past Due” status. It is important that all changes in your name, address, phone number, insurance, or employment be relayed to our office as it can affect the billing of your account. If we are unable to locate a patient, payment is not received, or satisfactory payment arrangements are not made, then an account will be referred to our collection agency. Should this occur the patient will be responsible for collection fees and expenses.
If you had eyewear purchased and the balance was sent to collections, you will not be able to pick up your eyewear until your collection balance has been paid off. Then any future orders will have to be paid in full to be ordered.
Once you have been sent to collections, we can no longer collect any fees/money. You will need to contact the collection agency and pay them. We will also not be able to see you for any future appointments until your previous balance has been paid off. Lack of Cooperation
We are grateful for all our patients and the opportunity to serve them. We appreciate your assistance in helping us complete our work in an efficient and accurate manner. We believe that all patients should be treated with dignity. We reserve the right to terminate a patient from the practice in those rare cases when a patient may be verbally or physically abusive, refuse to give necessary information, or is non-compliant with ocular instructions, treatment and advice, or in collections.
Read through our HIPAA Policy Form Here.