Terms & Conditions

We appreciate your selection of our practice for your medical or cosmetic needs. Our practice is dedicated to providing personalized, quality care, and we look forward to it. To help make your visit with us as efficient, complete and comfortable as possible, please complete and return our patient forms prior to your appointment. Please arrive 15 minutes before your appointment time. As a respect to our patients, we will do our utmost to see you promptly. Please expect your appointment to take between 30 and 60 minutes, depending on the reason for the visit and if additional tests are required.

What you’ll need for your first appointment
A completed New Patient Packet.
Review our COVID-19 Protocol and Privacy Notice
List of all medicines, vitamins and nutritional supplements.
Eye glasses or contact lens as well as contact lens case.
Copies of previous operative reports if you have had eyelid surgery.
Copies of medical records or special tests, including the actual CT or MRI scans, if you have a complex medical problem.
If a procedure is recommended, it will be scheduled for a return visit.

For medical appointments, please bring the following (if applicable):
Photo ID
Insurance card
Primary physician referral (when required)
Your eye glasses or contact lenses

For cosmetic consultations, please bring the following (if possible):
Old photographs of yourself
Operative reports of previous cosmetic surgeries

Photographs
It is standard of care, that photographs will be taken of you prior to and following initiation of most clinical treatments and/or performances of any surgical procedure. These are a must, as they help in judging response to treatment and in pre-operative planning of the surgery.

About Insurance
While we will do everything we can to work with the insurance companies, we do not know and cannot certify what professional or operating room services will be covered by your insurance. We will contact your insurance company to describe your conditions and provide supporting documents to get authorization if that is required. Please note that authorization by insurance does not guarantee payment. You should also check with your insurance carrier about coverage before proceeding with surgery. Unfortunately, the patient is ultimately responsible for payment of services after 90 days of service regardless of the insurance claim status, approval or denial.

About HMO’s
Some insurance plans require pre-authorization prior to the office visit. If this is required by your insurance plan, please obtain authorization from your primary care physician before your appointment and bring it on your day of visit as we are not permitted by the HMOs to see their enrolled patients without prior authorization.

About Copays, Coinsurances and Deductibles
Your insurance plan determines the amount of copay, coinsurance and deductible. We are required by your insurance carrier, and by law, to collect all copays, coinsurances and deductibles. These are remitted at the time of service, including surgery. We will do our best to collect the correct amount. However, this is an estimate until we receive a Remittance Advisory or Explanation of Benefit from your insurance carrier after services have been rendered and claims have been processed. You will be refunded if we over-collect or billed if we under-collect. Please be sure to check your insurance plan for in or out-of-network provision, which may affect the amount of your copay, coinsurance and deductible. Any outstanding balance not paid in full after 90 days of service will be turned over to a third party for collection.

In addition to the examination there may be diagnostic tests (i.e., visual field test, tear duct probe and irrigation, CT and MRI scan, lab, etc) and photographs taken as part of the complete evaluation. These are performed, when necessary, to help in the diagnosis and management of the medical conditions. As a results, there may be additional out-of-pocket costs, as dictated by the insurance plan. It is not possible for us to foresee all possible tests prior to the consultation or be able provide the costs of the work-up, as different plans have different allowable for the same service.

About Allowable versus Fee Schedule
Allowable is the amount the insurance plan has pre-determined that it will pay for a certain service. Each insurance plan, including ones under the same insurance company, has different allowable. This is typically negotiated by the employer with the insurance plan. The allowable is the amount that the office gets paid and is also the amount the patient is responsible for if deductible has not been met or if the insurance plan denies payment. This amount may not be altered by the office without breach of contract with the insurance company. For this reason, we are not allowed by the insurance company to waive or discount deductible.

Fee schedule is a list of rates of all services that a practice use to bill insurance company. Many patients inquire why is the fee schedule different from the allowable. A practice typically has one fee schedule set to be inclusive of all insurance plans it participates in. Our fee schedule is 1.5-2 times the allowable of Medicare rate, which may be less than, more than, or equivalent to the allowable rate of your plan, to include the highest allowable of all our participating plans. Of note, in-network patient is not responsible for the fee schedule, and only for the allowable.

Payment Plans
We do not have payment plans. In extreme circumstances, we will do our best with patients to device a reasonable payment plan. This is on a case-by-case basis. Payment plans, however, are available for medical services only and not cosmetic services.

Cosmetic Consultation Fees
There is a cosmetic consultation fee of $125 that is applicable to future treatments or products. Fees for cosmetic surgery are determined by the extent of services needed to meet the patient’s goals. $1000 non-refundable deposit is required to hold a surgery date. The remaining balance is due two weeks prior to surgery. This fee is non-refundable for cancellation within one-week of surgery date, with the exception of medical emergency. More details of this policy are provided in our cosmetic quote.

Rescheduling and Cancellation
Appointment needs to be confirmed within two business days of the appointment. We require a $100 deposit to reschedule a late cancellation or a no-show appointment.  After two no-shows, we require a valid credit card on file to reschedule and charge the full amount of the appointment if a third no-show occurs.  We reserve the right to discharge patient from the Practice after three total late cancellations and/or no-shows. Cancellation is considered late if it is requested less than two business days of the appointment.

Other Fees
There is a $30 fee for completion of each forms for DMV, SDI, FMLA, etc.