Please Read This Entire Page Before your Appointment
We are excited to see you soon!
COVID 19 Update: We are committed to making your eye care experience as safe as possible during the COVID-19 pandemic. Masks are currently optional at both locations. If you are considered high risk, we recommend wearing a mask indoors. If you have any symptoms, or are not feeling well, please call our office to reschedule your appointment.
Notice of Privacy Practices
PLEASE COMPLETE THIS PRIOR TO YOUR EXAM
In order to ensure that we can see you promptly and decrease your waiting time, please fill out your vision and medical history form prior to your scheduled exam. This applies to both established and new patients. Also, please be sure to fill out our COVID-19 pre-screening located on the bottom of this form.
Please Bring With You
On the day of your appointment, please bring the following to help us serve you better:
- Your glasses that you currently wear, including over-the counter readers.
- Any old written prescriptions for your glasses and contact lenses.
- Boxes of contact lenses that you currently wear.
- A complete list of your medications and/or eye drops that you currently use.
After your eye exam, you may click on the link below to access your secure patient portal. It is usually available 2-3 days after your appointment date. This portal will contain your eyeglasses and/or your contact lens prescriptions.
Please call or email us if don't know your username and password or you need additional information after your examination.
Downtown Seaholm: email@example.com or 512-472-3937
Domain Northside: firstname.lastname@example.org or 512-861-1500
Office Policies and Services
Below, please find important additional information that you will need prior to your exam. You will be asked to sign forms before your exam acknowledging that you read and understand everything provided here.
COVID-19 Risk and Treatment
We are committed to making your eye care experience as safe as possible during the COVID-19 pandemic. Masks are currently optional at both locations. If you are considered high risk, we recommend wearing a mask indoors. If you have any symptoms, or are not feeling well, please call our office to reschedule your appointment.
Our Practice Financial Policy
We are dedicated to providing you with the best possible care and service, and regard your understanding of our financial policies as an essential element of your care and treatment. To assist you, we have the following financial policy. If you have any questions, please feel free to discuss them with our staff. For all services rendered to minor patients, the adult accompanying the patient is responsible for payment.
Unless other arrangements have been made in advance by either you or your health coverage carrier, full payment is due at the time of service. For your convenience we accept Cash, Debit, Check, VISA, Discover, MasterCard and American Express.
We have made prior arrangements with many insurers and other health plans. We will bill those plans with which we have an agreement and will collect any required copayment at the time of service. The copayment will be collected when you arrive for your appointment. In the event your health plan determines a service to be “not covered,” you will be responsible for the complete charge. In that event we will bill you, and payment is due upon receipt of that statement.
If you have insurance coverage with a plan with which we do not have a prior agreement, we will prepare and send the claim for you, on an unassigned basis. In this case, your insurer will send the payment directly to you. Therefore, charges for your care and treatment are due at the time of service. We will also bill your health plan for all services that we provide in the office. Any balance due or non-covered services is your responsibility and is due upon receipt of a statement from our office. There are two types of health insurance that will help pay for your eye care services and products. You may have both and our practice accepts both: Vision care plans (such as VSP and EyeMed) and Medical insurance (such as Blue Cross Blue Shield and United Healthcare).
Vision care plans only cover routine vision exams along with eyeglasses and contact lenses. Vision plans only cover a basic screening for eye disease. They do not cover diagnosis, management or treatment of eye diseases. Medical insurance must be used if you have any eye health problem or systemic health problem that has ocular complications. Your doctor will determine if these conditions apply to you, but some are determined by your case history.
If you have both types of insurance plans it may be necessary for us to bill some services to one plan and other services to the other. We will use coordination of benefits to do this properly and to minimize your out-of-pocket expense. We will bill your insurance plan for services if we are a participating provider for that plan. We will try to obtain advanced authorization of your insurance benefits so we can tell you what is covered. If some fees are not paid by your plan, we will bill you for any unpaid deductibles, co-pays or non-covered services as allowed by the insurance contract.
Patients without Insurance
If you do not have insurance, it is not a problem at all. We offer a "cash pay" discount on all our vision services. Please contact us to inquire further, so we can help you with your individual needs.
Cancellation Policy/ Not Showing Up for your Scheduled Exam
Effective March 4, 2019, a patient who fails to be present for a scheduled appointment or does not contact the practice at least 24 hours in advance of their scheduled appointment, will be considered a “no show” and will be charged a fee of $50.00. This fee will be charged directly to the patient, not the insurer.
Should you need to cancel your appointment, this must be done at least 24 hours before your scheduled appointment. This allows other patients, who may be waiting to see the doctor, to use the available appointment time. In addition, patients who have two no show visits will receive a warning letter that any additional no show appointments will result in their dismissal from the practice.
Patients who wish to request an exception (for extenuating circumstances) will be directed to speak to the Manager who will make the final decision on a waiver of the no show fee. We do realize that on occasion, circumstances change at the last minute, and will allow for extenuating circumstances.
Also, please note that arriving more than 15 minutes late will count as a ‘no-show’, and, while we may still see you, you will have to wait until there is a break in the schedule to be seen. The decision to see you at that point will depend upon the time and the schedule for the day. Patients who are assessed a no show fee must pay the fee at the time of their next visit.
Optomap® Retinal Exam
This non-invasive procedure allows your doctor to see a much broader and more detailed view of the retina than is possible with conventional methods. When reviewed, the scan becomes a permanent part of your medical file, enabling our doctors to make important comparisons should potential vision threatening conditions show themselves at a future examination. We strongly believe that the Optomap® Retinal Exam is an essential part of your comprehensive eye exam. We prescribe it for all patients once per year.
With every potentially life and sight threatening issue one can possibly imagine, the best form of combat is early detection. It is for this reason primarily that our Optometrists at Optique use the Optomap® as a method to screen and check the complete health of your eyes. The Optomap® is more convenient, taking virtually no time at all, versus dilation which adds about 45 minutes to your exam time and distorts your near vision for the rest of the day.
As part of your pre-test work up, we capture Optomap® images for review with your doctor during your examination today. The $39.00 screening co-pay for this procedure is generally a non-covered service unless being used to actively follow disease. Any question you have about the Optomap® Retinal Exam can be directed to your doctor when they review the images with you during your examination.
Optomap® VS. Dilation
- A high resolution photo-document of your retinal health for YOU to view as well as your doctor!
- Image is kept with your medical records, and transferrable to any doctor, anywhere.
- Your doctor can compare your current image to past images and detect ANY changes in your eye health, e.g., the size and shape of an “eye freckle,” or a retinal hole.
- It takes only minutes, and there are no side effects!
- The doctor uses special drops which dilate the pupils of your eyes. The drops take around 20-30 minutes to take effect. Your eyes stay dilated for 4-6 hours. You will experience sensitivity to bright lights and blurred near vision for as long as your eyes are dilated.
- The Optometrist then looks into your eye with bright lights and magnifying lenses, with a visibility of about 15º at a time. Then, the Optometrist articulates with words about what is seen in your eyes. This is what is kept in your medical record to monitor changes in your eyes throughout the years.
OCT Screening for Assessing Eye Health
OCT is a sophisticated scanning system that produces highly detailed images of the retina. It is often likened to an MRI or x-ray of the eye, but it does not produce any radiation. This scan allows our doctors to see detailed images of the retina (the inner most layer of the interior eye), which enables them to accurately detect, monitor and control changes to the retina. This procedure is currently the only one that shows in-depth images of the internal structures of the eyes. Other procedures, such as the Optomap®, only show the surface of these structures.
OCT and Early Detection of Eye Health Problems
An OCT scan can detect the early signs of macular degeneration, glaucoma, detached retinas and other eye disorders. This procedure only takes minutes, and the equipment never touches the eye or causes discomfort. This permanent record is very valuable in assessing the current health of your eye and for safeguarding the health of specific structures of your eye, such as the retina, optic nerve, macula, and blood vessels. It will also serve as an initial point from which to compare, as we follow your health in subsequent years. Glaucoma and retinal diseases tend to progress without any symptoms in the early stages. Age is a major risk factor for development of many eye conditions because they typically develop over the course of many years. We prescribe it for all adult patients aged 18 and over once per year.
The screening co-pay for this part of the eye exam is $60.00. Generally, this test will not be covered under your medical insurance or vision plan unless it is being used to actively follow a disease. Any question you have about the OCT scan can be directed to your doctor when they review the images with you during your examination
Contact Lens Evaluations
The contact lens evaluation is an additional exam over and above the routine comprehensive vision examination. Many insurance companies consider contact lenses (and their evaluation) an elective procedure, and therefore do not cover the additional fees associated with contact lens evaluation. Any fees not covered by an insurance company will be the responsibility of the patient. Fees are determined based on the complexity of the prescription and the fit of the lens.
Contact lenses are medical devices which must be prescribed yearly by your Optometrist. Wearing contacts increases your risk of eye infection or corneal ulcers that can lead to loss of vision. This risk increases if the contacts are worn for an extended period of time. You should remove your contact lenses and call your optometrist immediately if you suspect anything is wrong, have blurred vision or experience any unusual burning, irritation, redness, pain or watering of the eyes.
The following information is important to review prior to receiving your contact lens prescription.
The Centers for Disease Control and Prevention (CDC) makes clear,
“Contact lenses can provide many benefits, but they are not risk-free—especially if contact lens wearers don’t practice healthy habits and take care of their contact lenses and supplies. If patients seek care quickly, most complications can be easily treated by an eye doctor. However, more serious infections can cause pain and even permanent vision loss, depending on the cause and how long the patient waits to seek treatment.”
The CDC recommends the following for contact lens wearers:
- Schedule a visit with your eye doctor at least once a year.
- Take out your contacts and call your eye doctor if you have eye pain, discomfort, redness, or blurry vision.
- Understand that eye infections that go untreated can lead to eye damage or even blindness.
The Food and Drug Administration (FDA) indicates:
“To be sure that your eyes remain healthy you should not order lenses with a prescription that has expired or stock up on lenses right before the prescription is about to expire. It’s safer to be re-checked by your eye care professional.”
Symptoms of an Eye Infection include:
- Irritated, red eyes
- Worsening pain in or around the eyes—even after contact lens removal
- Light sensitivity
- Sudden blurry vision
- Unusually watery eyes or discharge
Your Yearly Contact Lens Evaluation
Your contact lens evaluation includes the following services (by both the Optometrists and staff):
- Assessment of candidacy for contact lens wear
- Determination of contact lens prescription
- Determination of lens of choice
- Special testing for accurate lens fit
- Insertion and removal training for new contact lens patients
- A contact lens diagnostic pair and starter contact lens solution kit at the time of the fitting
- One (1) emergency trial pair within 12 months of the initial fitting
- Contact lens related follow up care for a period of 60 days after the initial fitting
Our Contact Lens Policy
- Charges for evaluation fees are due in full at the time of the initial evaluation.
- All contact lenses must be paid for in full prior to being ordered.
- Progress checks that are not contact lens related are subject to normal office visit charges.
- Patients will be responsible for any non-covered contact lens related services.
- Professional fees for the complete eye exam and evaluation are not refundable.
- Patients are responsible for scheduling and attending any contact lens related follow up appointments in order to finalize the prescription. Patients’ prescription will not be released and contact lenses will not be ordered until the Optometrist has finalized the prescription.
- Contact lens prescriptions expire after one year in the state of Texas.
- We will exchange contact lenses purchased from us within one year if your prescription changes. Boxes must be resalable, i.e. factory sealed with no marks, writing, or damage to the packaging.
- You must have back up glasses in a current glasses prescription. We also recommend wearing sunglasses over your contacts to protect your eyes from UV damage.