Billing Policy

Billing Policy - Financial Policy Agreement – Signature on File - Authorization for Payment


​​​​​​​Medical or Vision Insurance Coverage

Medical or vision insurance coverage varies widely. It is your responsibility to understand what procedures and/or products are covered by your insurance. Rolling Hills Eyecare (RHEC) will make every attempt to contact your insurance carrier to verify eligibility and benefits. However, the eligibility and coverage information provided to us by your insurance carrier is subject to change during claims processing. Payment of claims is not guaranteed by RHEC or the insurance carrier.

For patients who have insurance that RHEC accepts directly, we will submit a claim for covered services and materials on your behalf. By signing below, you authorize the insurance company to make payment directly to RHEC. Any noncovered services or materials including co-pays will be your responsibility. To ensure prompt processing of your claims, we require that you provide us with all medical or vision insurance information and any additional personal information required for filing a claim at the time of your initial visit. You will also be required to provide your medical or vision insurance card(s) at every visit. It is your responsibility to notify us of any changes in your insurance status.

Your estimated copay is due at the time exam services are performed. A minimum of a 25% deposit is required to place an order for eyewear, with the remaining balance to be paid in full at the time of pick-up.


What will I be expected to pay at the time of service If I do not have insurance?

You will be provided a Good Faith Estimate before you receive services. Payment in full is required at the time exam services are performed. A minimum of a 25% deposit is required to place an order for eyewear, with the remaining balance to be paid in full at the time of pick-up.


How will I be billed?

We will send a monthly statement. You will be billed for the difference between the insurance company’s payment (if not paid in full) and the charges incurred for services and/or products. Balances are due in full within ten (10) days of receipt.

For your convenience, we may send electronic statements and payment reminders through text and/or email. These notifications include a secure link to pay your bill instantly. While standard message and data rates may apply, there is no additional fee for this service.

You may opt out of digital billing at any time. Please note that opting out will also unsubscribe you from all other electronic communications from RHEC, including appointment reminders


Office Policy

Cancellations - Refunds - Order Changes - Prescription Evaluation


Cancelations/Refunds

Eyeglass and Contact lens orders are started immediately. For this reason all sales are final, we are unable to cancel an order once it has been submitted. Due to the custom nature of eyeglasses and contact lenses, refunds are not possible. Professional service fees (e.g., examination, consultation, and diagnostic testing) are not refundable.


Order changes

For eyeglass orders RHEC offers a 1 time exchange within 60 days from the original order ready date. For contact lens orders RHEC will, at manager discretion, exchange unopened boxes for non refundable credit towards a new order. Boxes must be unmarked, like new, and not less than 1 year from expiration.


Prescription Evaluation

For Eyeglass Prescriptions: If you are not comfortable with the vision in your new glasses, we will re-evaluate your prescription and remake lenses ordered with RHEC at no charge within 60 days of your original exam (at the doctor’s discretion).

Contact Lens Evaluations: The evaluation fee covers the assessment of new or existing contact lens prescriptions, trial lenses*, training, and 90 days of follow-up care. If follow-up care is necessary beyond 90 days, an additional fee will apply, extending the evaluation care for another 90 days.

*Specialty Lenses: A non-refundable trial fee applies to specialty lenses, as these must be purchased specifically for the patient. This fee will be applied toward the final lens order.