POLICIES

 

Appointment Scheduling & Confirmation

Appointments are not fully confirmed until all required steps are completed, which may include:

• Completing required forms

• Providing a valid card on file

• Paying any required deposit

• Providing insurance infomation (if applicable)

Unconfirmed appointments may be released to other patients.

Appointments must be confirmed at least 48 hours in advance. Appointments that remain unconfirmed may be automatically canceled and released.

 

Deposits

Some appointments require a deposit to hold your time.

• Deposits are applied toward the cost of your visit.

• Deposits are nonrefundable if you cancel or reschedule with less than 7 business days’ notice.

• Deposits are forfeited for missed appointments.

• Deposits are not transferable after one reschedule.

• Deposits apply to scheduled clinical time and are not contingent on insurance coverage or claim outcome.

Deposits are required to hold extended specialty appointments.​

 

Cancellation & Rescheduling

We require at least 7 business days’ notice to cancel or reschedule appointments that require a deposit.

Cancellations or reschedules with less than 7 business days’ notice:

• Result in forfeiture of the deposit

• Do not transfer to future appointments

This policy applies regardless of reason, including illness or schedule conflicts.

 

Missed Appointments (No-Shows)

If you do not arrive for your appointment and have not canceled in advance:

• Your deposit is forfeited

• If no deposit was collected, a missed appointment fee will be charged to the card on file.

Reserved time is set aside specifically for you and cannot be billed to insurance.

 

FEES & EXPECTED COSTS

NeuroVisual evaluations are specialty medical visits and are not routine eye exams.

Payment is due at the time of service.

• ​Initial, Progress, and Annual NeuroVisual exams are billed to medical insurance when applicable.

• $284 of every NeuroVisual exam is non-billable to insurance and is always the patient’s responsibility.

• Some portions of NeuroVisual care are not billable to insurance. Additional non-covered charges may apply depending on testing, imaging, materials, or upgrades.

• If we are not billing insurance for your visit, prompt-pay fees apply.

• Insurance benefits quoted by our office are estimates only and are not guarantees of payment.

• Final patient responsibility is determined only after the claim is processed.

• You are responsible for deductibles, coinsurance, non-covered services, and any balance not paid by insurance.

• Fees are subject to change without notice.

• We accept cash, credit card, and HSA/FSA cards.

• If a balance remains after insurance processes, it may be charged to the card on file.​

No refunds are issued for professional services or materials.

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By scheduling an appointment, you acknowledge that the final amount you owe is determined after services are provided and insurance has processed the claim.

 

Deposits & Card Authorization

Some appointments require a $150 deposit to reserve your time.

• Deposits are applied toward the cost of your visit.

• Deposits are nonrefundable if you cancel with less than 7 business days’ notice or do not attend your appointment.

• Deposits are not transferable after one reschedule.

By providing a card or paying a deposit, you authorize our office to securely store that card and use it for charges related to your care, including:

• Patient-responsibility balances after services are provided and insurance processes the claim

• Missed appointment or late cancellation fees

• Services or materials you approve during your visit

We submit insurance when applicable, but your insurance determines your final responsibility. Any balance not paid by insurance may be charged to the card on file.

By paying a deposit, you confirm you have reviewed our Policies page and agree to these terms.

If you have questions about these terms, please contact our office before your appointment.

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Leaving an Appointment After Check-In

An appointment is considered checked in when staff provides intake forms or begins the check-in process, even if forms have not yet been completed or signed.

If you arrive for your appointment, are checked in, and then choose not to proceed with the visit — including leaving after reviewing fees, estimates, or recommendations — the appointment is considered used time.

• Deposits are forfeited

• Any applicable same-day appointment fee WILL be charged

• Insurance estimates do not obligate the office to alter fees or services

Choosing not to proceed after check-in does not negate the reserved appointment time.

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Insurance

Insurance is a contract between you and your plan. Our office is not a party to that contract.

• NeuroVisual exams are billed to medical insurance, not vision plans.

• ​We are out-of-network with vision plans. NeuroVisual evaluations are medical visits and vision plans do not apply.

• Before your visit, we may provide a rough prediction of what you might owe, but this is not a final amount. Insurance determines your final responsibility only after the claim is processed.

• You are responsible for deductibles, coinsurance, non-covered services, and any balance not paid by insurance.

• We cannot bill: Cigna, TriCare, Aetna, Humana, Molina, Apple, L&I, Ambetter, Medicaid, First Choice, Dual Complete, and others. If this applies, you may submit for reimbursement yourself.

• If your plan requires a referral and it is not obtained, you are responsible for the full cost of the visit.

By scheduling an appointment, you acknowledge that insurance determines your final cost and that you are responsible for charges related to your care.

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Exam Types & Scheduling

• Binocular Vision Dysfunction (BVD) / NeuroVisual evaluations require a deposit to schedule and are not routine vision exams.

• Routine vision exams are scheduled by phone.

 

Agreement

By scheduling an appointment or submitting a deposit with our office, you acknowledge that you have reviewed these policies and agree to them, including those related to fees, insurance billing, deposits, and card-on-file authorization.