Payment is expected at the time professional services are rendered. A 50% deposit is required before materials are ordered; balance is due upon delivery of materials.
I have requested Marston Optometry to bill my insurance company for covered services on my behalf. I clearly understand that it is still my responsibility to make sure that the bill is paid in a reasonable time. If for any reason any portion of my bill is not paid by my insurance, I further agree to make arrangements for prompt payment of the bill.
I hereby authorize any insurance company to pay the proceeds of any of my benefits due me directly to Marston Optometry a copy of this can be considered as an original for insurance purposes.