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Financial Policy Form

  • FINANCIAL POLICY

    We are dedicated to providing the best possible care for you, and we want you to

    completely understand our financial policies.

    1. Professional fees are due when services are rendered unless we are network providers for your plan. As a courtesy, we will file a claim to your primary insurance. WE DO NOT SUBMIT SECONDARY INSURANCE CLAIMS.
    1. When glasses or contacts are purchased through insurance, the balance is due in full when the order is placed.
    1. Insurance plans and coverage vary from year to year. You will be responsible for any services the insurance does not pay due to co-pays, deductibles or other patient responsibility. Payment is due upon receipt of a statement from our office.
    1. If you are insured by a plan that we do not accept, we will prepare an unassigned claim. This means the insurance will send payment directly to you, therefore our charges are due at the time of service.
    1. If your insurance does not pay the practice within 45 days, you are responsible for any balance due. If we later receive a check from your insurance, we will refund any overpayment to you.
    I have read and understand Family EyeCare Clinic’s financial policy and I agree to be bound by its terms. I also understand and agree that such terms may be amended by the practice from time to time.
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  • Date Format: MM slash DD slash YYYY

Dr Figler has enjoyed the many years of seeing patients at Family EyeCare Clinic and Kane and Figler Optometry and appreciated their confidence in his skills. The growth of his own practice in Slavic Village requires more of his attention located at 7211 Broadway Ave Cleveland, OH or call 216-641-0055 or visit his website broadwayoptical.net. We wish him the best of luck from the Family EyeCare Clinic.

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