COASTAL BEND EYE CENTER AND AMBULATORY SURGICAL CENTER OFFICE POLICIES FOR PATIENTS

THANK YOU FOR CHOOSING COASTAL BEND EYE CENTER.  WE UNDERSTAND YOU HAVE A CHOICE IN HOW TO RECEIVE EYE CARE AND WE ARE GRATEFUL THAT YOU HAVE PLACED YOUR TRUST IN OUR CARE.

We have written this policy in order to help you navigate our office to allow us to provide balanced customer service for you and our other patients.

Our core values:  We believe healthcare is a calling and that we are called to provide excellent care for the eyes of the Coastal Bend region of Texas.  We accept patients regardless of socioeconomic status or disease condition.  Many of our patients are disabled.  Some have low vision due to serious disease of the eye.  Some have need for urgent care to prevent more profound loss of vision.  In addition, our physicians provide leadership in our local, state and national medical community.  Our physicians serve “on call” for medical and surgical emergencies at local area hospitals.  We desire to provide convenient care with great customer service to all of our patients.  In our mission to prevent blindness: we prioritize being available to our patients in a time of need over being the fastest provider of an eye exam.  We desire to provide great value to all of our patients.  In our mission to prevent blindness: we prioritize quality of care over being the least expensive provider of an eye exam.

Team Based Care:  We believe we provide better eye care by having a team.  Doctors are people who can not be an expert for every problem, can not be in every location, and can not be available 24-7.  A single doctor can only see a limited number of people in a day.  We will do our best to schedule your appointment with a doctor who can best meet your needs.  Exams for glasses and contact lenses, and some exam visits for medical problems will be performed by a Doctor of Optometry who has been carefully selected as a member of our team.  Urgent visits will be provided by the most available provider, who can elevate your care to a specialist if needed.

Office hours:  Our main office at 900 Morgan Avenue is open Monday through Friday, 8:00 to 5:00.  Satellite offices have variable hours depending on patient needs and provider availability.

Appointments:  We see patients by appointment only.  Same day appointments are usually available for urgent or sudden illness.  We do everything in our power to see a patient who arrives in our office needing to be seen.  Patients given same day appointments may expect increased waiting times in the office.

After Hours and Emergencies:  For a serious emergency, go to the nearest emergency room or call 911 right away.   Many eye emergencies can cause permanent vision loss.  If you are in pain, or if your vision is decreasing suddenly: you are having an emergency that needs treatment to prevent vision loss.  People who have recently had surgery on the eyes should be especially vigilant, and notify the emergency room physician to discuss the case with the ophthalmologist on call.

Our doctors maintain privileges and share call at Christus Spohn Shoreline Hospital and South Texas Surgical Hospital in Corpus Christi.  We can see you in the emergency room if requested by the emergency physician.  We also maintain friendly relationships with the excellent physicians associated with Coastal Bend Urgent Care, TLC Medical Centers, and Physicians PrimER.

Cancellations:  Please call within 24 hours if you are unable to keep your scheduled appointment.  This allows us to provide that time slot to another patient.

Appointment times as arrival times:  We ask patients to arrive at the office at the time of their scheduled appointment, not before. We anticipate the need to fill out paperwork, perfect insurance authorizations and referrals before going to the exam room.   There is some natural variation in the time it takes to provide any given service.  Our patients will take different amounts of time to complete tasks, and have different and sometimes unanticipated health care needs.  We accept emergency patients from hospitals, other physicians and our existing patients.  Sometimes duty calls our doctors to see patients in the hospital late at night, early before or even during then work day.  In addition to the usual frustrations found in any surgeon’s office, Ophthalmology exams have built in a time consuming step of waiting for dilating eye drops to work.  We strive to transit patients through our office in two hours or less.  Please accept our apology in advance because we cannot always meet that benchmark. 

Running on time:  We respect that your schedule is busy and that your time is valuable.  Please let us know if you have waited more than 15 minutes so we can be sure you are properly checked in.  Remember that we are running several different schedules.  If someone who arrives after you is called before you, they might be here for a test or seeing a different provider.

Eye Exams:  Our principal service is providing eye exams.  Physicians have no ability to diagnose an eye problem on the phone.  We cannot make any diagnosis or recommendation based on a conversation in the waiting room.  We certainly cannot treat any condition you do not bring to our attention by telling us all of your symptoms and allowing us to examine you.

Please do not ask the doctor to speak to you on the telephone or in the waiting room before an exam.  We welcome the opportunity to answer all of your medical questions in the exam room, after the exam.  If you have an urgent need to speak with the doctor, prepare yourself for an eye exam and come on in.

Please help the doctor provide great care by participating fully in the pre-exam work up with our excellent ophthalmic technicians.   If we are unable to collect all of the information we need, we cannot fully answer your questions.

Please bring a trusted friend or family member into the exam room with you.  It is very helpful to have a second pair of eyes and ears with you to help remember and fully understand your conversation with the doctor. 

Refractions.  Refraction is the process of determining the eye’s refractive error, or need for corrective lenses.  The refraction is in particular needed for a patient experiencing blurred vision, or if we detect a decrease in visual acuity on the eye chart.  The refraction allows us to determine if decreased vision is due to need for glasses, or if a medical problem is to blame.  A refraction is needed if you are considering cataract surgery, or if you want a prescription for eyeglasses.

The refraction is an essential part of a complete eye exam, however Medicare and most medical insurance do not cover it.  The refraction fee is in addition to any copay or deductible set by your insurance carrier.  The refraction fee is due at the time service is provided.  If you believe your insurance will pay, we will happily submit the charge to them.  However, we cannot release a prescription for eyeglasses unless the account balance is paid.

Eyeglass Prescriptions:  Please let us know before your exam if you want a new prescription for eyeglasses.  The refraction is most accurate if performed before we disrupt your tear film with eye drops and pressure checks, and before we dazzle your vision with bright lights.  This helps us provide a more accurate prescription for glasses.

Contact Lens Prescriptions:  Please let us know if you want a prescription for contact lenses before you schedule your exam.  Only certain members of our team perform contact lens exams, so plan ahead. 

The contact lens prescription is more complex than an eyeglass prescription and is a separate billable service in addition to the refraction.  The contact lens fitting fee is in addition to any copay or deductible set by your insurance carrier.  Contact lenses are fit by trying different lenses on the eye and assessing vision and comfort.  Sometimes multiple visits are needed.

Contact Lenses:  Contact lenses constantly disrupt the corneal epithelium, putting the eye at risk for complications that can profoundly reduce sight or cause loss of the eye.  Contact lens wearers agree to:

• Never sleep in their contact lenses.
• Remove and clean contact lenses every day according to instructions.
• Dispose of contact lenses at appropriate intervals, or if they are damaged or become uncomfortable.
• Come for an exam immediately if the eye becomes red or painful, or if the vision decreases.

Dilated Eye Exams:  A comprehensive eye examination involves using eyedrops to dilate the pupil.  Dilating the pupil makes it possible to view a much wider area of the retina, allowing us to detect diseases that are the leading cause of blindness, including cataract, diabetic retinopathy, macular degeneration and glaucoma.  The National Institutes of Health recommens a dilated eye exam periodically for all people, and every year for people over the age of 60.  People with conditions like diabetes, glaucoma and macular degeneration should also have an annual dilated exam.  In general, we require a dilated exam for all new patients.  We also require a dilated exam before we schedule any procedure or surgery.

Eyedrops that dilate the eyes will make the vision blurry, especially for reading.  The eyes will also be sensitive to light.  The effect of the drops lasts for four to six hours.  Please bring a driver or arrange alternative transportation for your eye exam to reduce the risk of accidents.  If dilating the eyes would prevent you from having safe transportation home, please notify us so we can reschedule your exam.

Prescriptions and Refills: 

• The best time to get a prescription refill is at your appointment.
• In general prescriptions need to be authorized by the doctor, who is likely in an exam room, and has other patients who are tired of waiting.
• We strive to process called, faxed or electronic prescription refill requests within 1 week.
• If you need to call for refills, please don’t wait until you run out.
• We do not call in new prescriptions without an exam, but we will happily see you. 
• We do not call in prescriptions after hours, but we will try to get a sooner appointment if you need help. 
• We do not prescribe narcotics for chronic use, or call in prescriptions for narcotics. 
• Please don’t wait at the pharmacy or optical shop for your doctor to call.

Equal Opportunity:  Coastal Bend Eye Center affords equal employment opportunity to all individuals regardless of race, creed, color, religion, gender, national origin, ancestry, age, marital status, veteran status, disability, medical condition, gender identity or sexual orientation.  In addition it is the policy of CBEC to provide excellent medical and refractive eyecare to  patients, regardless of race, creed, color, religion, gender, national origin, ancestry, age, marital status, veteran status, disability, medical condition, gender identity or sexual orientation. 

Limitation of physician-patient relationship.  Coastal Bend Eye Center provides refractive, medical and surgical eye care services.  We strive to provide comprehensive eye care, but may at times refer a patient to specialists outside our practice for certain eye conditions. 

As a patient of Coastal Bend Eye Center, you agree that the physician-patient relationship with Coastal Bend Eye Center physicians is limited to conditions that they treat.  Patients with systemic medical conditions agree to seek care from their Family Practice or Internal Medicine physician for the care of those problems.  This includes systemic medical conditions that affect the eyes or vision.  Coastal Bend Eye Center may at its discretion help arrage referrals.  You agree to take responsibility for arranging any care provided elsewhere.  It is the patient’s obligation to establish their own relationship with appropriate physicians.

As a patient of Coastal Bend Eye Center, you agree Coastal Bend Eye Center provides care by appointment only, during limited hours and location.  You agree that information posted on this website, which may change, is the only notice we will provide to you regarding office hours and locations.  Coastal Bend Eye Center’s physicians may at their discretion take emergency call at area hospitals, and may make arrangements for provision of emergency care with physicians outside our practice.

As a patient of Coastal Bend Eye Center, you agree the physician-patient relationship is limited in duration.  You agree that the physician-patient relationship is terminated by mutual agreement three months following the most recent exam, or one year following a surgical procedure.  Termination of the physician patient relationship concludes Coastal Bend Eye Center’s obligation to provide medical care, but not Coastal Bend Eye Center’s obligation to maintain medical records, the patient’s obligation to pay for medical care previously received, or the patient’s obligation to pay for administrative expenses incurred after the conclusion of the physician-patient relationship .  You agree that this is the only notice we will provide regarding termination of the physician-patient relationship.  Patients in good standing may reestablish care at Coastal Bend Eye Center at any time by scheduling an appointment.

Dismissal:  If you are “dismissed” from the practice, it means you can no longer schedule appointments, get medication refills, or consider us to be your doctor.  You have to find a doctor in another practice.

Common Reasons for Dismissal:

• Failure to keep appointments, frequent no-shows
• Noncompliance, which means you won’t follow physician instructions about an important health issue.
• Abusive or inappropriate behavior with staff or physicians.
• Failure to pay your bill.
• Loss of therapeutic relationship.

Physicians and patients require a therapeutic relationship in order to provide quality care.  Negative or positive emotions experienced by the physician or patient may interfere with care, may cloud medical judgement, and may prevent a patient from receiving the best of care.

Friendship, family or business relationships, romantic feelings, anger, disappointment, disagreement and distraction can all cause loss of a therapeutic relationship.  A patient who is considering any administrative or legal action against a physician has likely lost their therapeutic relationship with that physician, and would best be served by seeing a different provider.  Avoidance of transferance and countertransferance that interfere with medical care is an important principle of Medical Ethics. 

As a patient of Coastal Bend Eye Center, you agree that dismissal for loss of therapeutic relationship is not intended to be disrespectful, demeaning, insulting or humiliating.  You agree dismissal does not constitute any form of punishment or retaliation.  Physicians who dismiss patients for loss of therapeutic relationship do so for the benefit of the patient, so the patient may receive unbiased care elsewhere.

Dismissal Process:  We will send a letter to your last known address, via certified mail, notifying you that you are being dismissed.  If you have a medical emergency within 30 days of the date on this letter, we will see you in the Emergency Room or Hospital.  After that date, you must find another doctor.  We will forward a copy of your medical record to your new doctor after you let us know who it is and sign a release form.  In the event we are called to see you in the hospital or emergency room after being dismissed, you must still find a differnt doctor for outpatient care.
 

FINANCIAL POLICIES

Promise to pay:  You promise to pay in full for all:

• Services we provide to you,
• Items we provide to you including eyeglasses and contact lenses,
• Credit we extend to you for the purpose of billing your insurance,
• Interest charges and other fees or charges such as returned check and late payment fees plus,
• Collection costs and attorney fees as allowed by law.

No Insurance:  We happily see people who do not have insurance.  We may at our discretion offer a prompt pay discount for people who pay in full at the time of service.  If you are unable to pay in full at the time of service, please inquire about payment arrangements or financing options that might be available to you.  

Medical Insurance:  We accept most forms of major medical insurance, Medicare, and Medicaid.  You as a patient accept final responsibility to pay for all services performed, including non-covered charges, deductibles, and copayments or coinsurance.  In most cases, medical insurance plans do not cover refraction fees, contact lens fitting fees, or optical materials.

Vision Insurance:  We accept many forms of vision insurance.  Vision insurance may cover a portion of refractive eye exams for glasses, contact lenses, and optical supplies.  You, as a patient, accept final responsibility to pay for all services performed, including non-covered charges, deductibles, and copayments.  In most cases Vision Insurance does not cover exams for medical problems, such as visual problems that cannot be corrected with eyeglasses, painful conditions, red or irritated eyes, or exams related to medical conditions like diabetes.  Our ophthalmologists are Medical Doctors who will bill you for medical services provided.  By providing a copy of your medical insurance, we can reduce the likelihood that you receive an unwanted bill.

Verification of Benefits:  As a courtesy to you, we may verify insurance benefits before your visit and may assist in obtaining necessary referrals and authorizations.  You as a patient accept final responsibility for knowing your insurance benefits, knowing whether our physician is on your plan, and obtaining referrals and authorizations needed for payment.  You as a patient accept final responsibility to pay for all services performed, including non-covered charges, deductibles, and copayments.

Filing insurance forms and accepting assignment:  As a courtesy to you, we will file primary insurance forms in our office.  In order to do this, we require accurate information from you.  Please bring your current insurance card and photo ID to each visit.  

At the time of service, you will be responsible for all fees that are not covered by your insurance, including co-insurance, deductibles, and non-covered services or items received.  We strive to be as accurate as possible in calculating your responsibility, but with so many variations in policies and fee schedules we are not always exact.  You may receive a statement from our office for any balance due.

Auto Accident:  If your injury is the result of an auto accident, you are required to pay for services and then collect from the auto carrier.  We will not file your insurance, but will provide you with a receipt, to do so.  

Liability injury:  If your injury is a result from another party’s negligence, you are required to pay for and then collect from the responsible party.  We will not file your insurance, but will provide you with a receipt, to do so.

Return Checks:  There will be a charge for any check returned by your bank for any reason.  The returned check fee is $30.00

Disability, Insurance Forms, Attending Physician Statements, FMLA:  There will be a charge of $50.00 for the completion of medical forms . Payment is due at the time you pick up these forms.  Please allow 7-10 days for the completion of these forms. 

Medical Records:  We will provide you a copy of your medical records upon request and for a fee.  You will need to sign a letter of release prior to having them copied.  Please allow up to 20 days for this request to be processed.

Non Medical Legal Services:  Our doctors are experts in our fields who desire to spend their professional time providing medical services to help improve people’s vision.  Our staff members are also experts in what they do, and we need them in our office performing their duties.  We have no mechanism to bill any third party payor for non-medical legal services.  Medicare and Medicaid do not pay for non medical legal services.  Non medical legal services may include but are not limited to:

• Expert testimony whether provided under any agreement or to comply with any subpoena.
• Certification of medical records to comply with any subpoena duces mecum.
• Counseling regarding any legal matter.
• Preparations for legal proceedings including meetings with defense attorneys, prosecuting attorneys, or mediators.
• Travel time required to provide legal services, including nights and weekends away from home or office.

You agree to pay all fees for non medical legal services provided related to your care at Coastal Bend Eye Center.  You agree to pay in full within 30 days:

• regardless of the reason for the testimony,
• regardless of whether the testimony is requested by you,
• regardless of whether the testimony is favorable to your cause,
• regardless of the outcome,
• and regardless of any cause of action you may have against Coastal Bend Eye Center, its physicians, its associates, and its employees. 

Our fee for non-medical legal services is $2000 per physician hour, $500 per non-physician staff member hour and any expense incurred.

Limited ability for insurance appeals:  If your insurance does not pay for a service, we may help you appeal if we believe you have a good case.  Our staff cannot submit multiple appeals on your behalf, or submit appeals that we do not believe are likely to be successful.

Statements:  If you receive a bill from us, it is because we believe the balance is your responsibility.  A bill may come several months after the date of service, depending on how long it takes for your insurance to make a final determination.  Please contact your insurance company first if you believe there is a problem.  If you cannot pay your entire bill, please call to make payment arrangements.

Collections:  You agree to pay any balance due, in full, within 30 days of the statement mailing date.  Accounts that are not paid within 30 days begin our in house collection process.  Late payments incur a fee of $30 per month.  If your balance becomes 65 days old, your doctor will be notified and you may be subject to dismissal from the practice.  You agree to pay any collections costs or legal fees incurred.

Changes to this Notice:  We reserve the right to change this Notice at any time, along with our polices and procedures.  We reserve the right to make the revised or changed Notice effective for existing patients, and patients agree to office polices as reasonably changed. We will post a copy of the current notice, along with an announcement that changes have been made, as applicable, in our office. When changes have been made to the Notice, you may obtain a revised copy by sending a letter to the Practice Administrator at the address listed below or by asking the office receptionist for a current copy of the Notice.

Complaints:  If you believe that your rights as described in this Notice have been violated, or if you have questions, comments or concerns you may file a complaint with the Practice at the following address:

Coastal Bend Eye Center
Attn: Practice Administrator
900 Morgan Ave.
Corpus Christi, TX 78404

To file a complaint, you may either call or send a written letter. The Practice will not retaliate against any individual who files a complaint. You may also file a complaint with the Secretary of the Department of Health and Human Services or the Texas Medical Board. In addition, if you have any questions about this Notice, please contact the Practice’s Administrator at the address listed above.

Revised Sunday August 31, 2015