CONTACT LENS INFORMATION



CONTACT LENS INFORMATION

Contact lenses are a medical device that can only be dispensed by prescription. They must be regarded with the same cautions you would use for prescription drugs, which include prescription expiration dates and follow-up visits when recommended by your eye doctor.

Why you need a contact lens exam each year and what is involved:

Over time, all eyes go through gradual changes in size, shape, and physiological requirements (such as tear production and oxygen needs). These changes can affect the fit of the contact lens and the health of the cornea. A contact lens exam includes a thorough evaluation of your vision, your cornea (where the lens sits), and your lids as well as additional evaluations over and above a routine eye exam. Therefore an annual contact lens exam must be performed to determine if your current lenses are still fitting properly, and whether a different design, material or size of contact lens is better for you. New contact lenses are developed frequently and we want you to have the safest, most comfortable lenses available. The doctor will also determine if you have or have developed any conditions that might make the wearing of contacts inappropriate or hazardous.

What you should know and what you need to tell us about your insurance:

While contact lens exams are very important to the health of your eyes, most insurances do not cover any contact lens service or material. Unless you provide written evidence on the day of service that your insurer will reimburse us for contact lens services or materials, you are required to pay in full on the date of service/order date. Please note:

1. Cosmetic contact lens services and/or materials ARE NOT A COVERED BENEFIT under VISION INSURANCE PLANS OR BROWN & TOLAND MEDICAL GROUP (BTMG) or any insurance company that is administered through BTMG. We will not bill them for contact lens service or material.

2. With authorization and verified coverage for contact lens services and/or materials, we will bill VSP Signature and Signature Choice Plan, EyeMed, or Medical Eye Services.

3. Most vision insurance plans require you to decide whether you want to use your benefits for glasses OR contact lens services, not both. Please let our staff know how you would like to utilize your benefits.

Fees:

Prices include up to 3 months of follow up care

Renewal:

Spherical soft contact lens renewal $85

Astigmatic (toric) soft contact lens renewal $115

Rigid Gas Permeable contact lens renewal $115

Monovision/BiFocal/Multifocal contact lens renewal $115

Keratoconus or other complex contact lens renewal $350

New fit or change:

Spherical soft contact lens evaluation/fitting $115

Astigmatic (toric) soft contact lens evaluation/fitting $140

Rigid Gas Permeable contact lens evaluation/fitting $185

Monovision/BiFocal/Multifocal contact lens evaluation/fitting $140-$260

Keratoconus or other complex contact lens evaluation/fitting $500

Additional Fees:

Training for insertion & removal of contact lenses $45

Follow up visits after 90 days $55

Prices do not include the price of the contact lens material.

I have read and understand the above information and agree to comply with these policies.

Signature: ____________________________________ Date: _________________

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