Lifetime Optometry's Financial Policy

Your clear understanding of our Financial Policy is important to our professional relationship. Therefore, we wish to clarify the following points.

I acknowledge that I am fully responsible for all costs incurred during my treatment at Lifetime Optometry.
Payment is due at the time of service.
I understand that as a service, Lifetime Optometry will file my insurance claims, but they do require a copy of my insurance card to insure accurate information for processing.
I understand that my insurance is a contract between me and the insurance company and Lifetime Optometry is not a party to that contract. If my insurance company does not pay in a timely manner (60 days), I will be responsible for payment of the charges incurred.
I agree to pay Lifetime Optometry (in full) within 30 days of notification of nonpayment by my insurance carrier.
I understand that I will be responsible for services deemed "not medically necessary" by my insurance company.
Parents and guardians are responsible for full payment on unaccompanied minors.
I agree that payment of insurance benefits be made on my behalf to Lifetime Optometry for any services furnished me by Lifetime Optometry.
I understand that collection agency may be used to collect unpaid balances. I further agree to pay any and all legal and collection costs on my account.
I understand there is a $20 service fee for all returned checks.
I have recieved a copy of Lifetime Optometry's Privace Practices for review and to keep for my records.