- The Handel Vision Clinic is dedicated to providing our patients with the best possible care and service. It is important to us that you have a clear understanding of our financial policy. If you have any questions, please feel free to discuss them with a staff member.
PERSONAL PAYMENT OPTIONS
We accept MasterCard, Visa, Discover, Amex, cash, or checks. In the event that you do not have insurance or have made prior arrangements, payment is due at the time of service.
INSURANCE/ THIRD PARTY PAYORS
As a courtesy, we will bill your insurance company for the charges you incur. We will bill up to two insurance companies on your behalf. We will estimate your co-pay, which is due at the time of service. Please understand that any expected payment from your insurance is an estimate only and you are responsible for any portion not covered by your policy. Once the insurance is received, you will be billed for any unpaid portion that your carrier determines as “due from the patient”. In the event that your insurance plan determines a service to be a “non covered” service or product or denies payment, you will be responsible for the complete charge. Worker’s Comp claims are exempt from this rule.
We go to great lengths to try to determine your insurance coverage including our participation in your plan, and the amount of coverage your insurance company provides. We are provider for hundreds of insurance plans and therefore, it is difficult to obtain exact coverage. Ultimately, it is your responsibility to determine all matters relating to your insurance, including eligible providers, and your coverage. You are responsible for all charges you incur.
For all service rendered to minor patients, the adult accompanying the patient is responsible for the payment. A parent or legal guardian should be present for all patients under the age of 18.
There will be an additional charge of $35.00 for all invalid or returned checks. Also, any account that has not had any payment activity for 60 days or for which a payment plan has been arranged may be turned over to collections. In the event an account must be turned over to a collection agency, the patient is responsible for any additional fees incurred.
* Any credits below $3.00 will be left on your account. No checks will be sent.
I HAVE READ AND UNDERSTAND THE FINANCIAL POLICY OF THE HANDEL VISION CLINIC AND HEREBY AGREE TO ITS TERMS.
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.