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

Unconfirmed appointments may be released to other patients.

 

Deposits

Some appointments require a deposit to hold your time.

• Deposits are applied to your visit.

• Deposits are nonrefundable if you cancel or reschedule with less than 7 days’ notice, or if you do not show for your appointment.

• Deposits are forfeited for missed appointments.

 

Cancellation & Rescheduling

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

Cancellations or reschedules with less than 7 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

 

FEES & EXPECTED COSTS

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

Payment is due at the time of service.

• The evaluation starts at $284, which is always the patient’s responsibility and cannot be billed to insurance.

• Most patients require additional testing, so the total visit cost is usually higher than $284.

• We may provide a rough prediction of what you might owe, but this is not a final amount and may change after insurance processes.

• Your insurance determines your final cost only after the claim is processed, so you may owe more or less than expected.

• 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.

  • Missed appointments

  • Late cancellations

  • Outstanding balances​​

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 deposit to reserve your time.

• Deposits are applied toward the cost of your visit.

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

• Deposits may be transferred once if rescheduled with adequate notice; after one change, the deposit is forfeited.

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.

​

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.

​

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.

• $284 of every NeuroVisual exam is always the patient’s responsibility.

• 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.

• Some plans cannot be billed by our office. 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.

​

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.