Minors
Our practice does not treat minors without the presence of a parent(s) or guardian(s). If the patient is a minor (under 1 8 years of age), the parent(s) or guardian(s) are responsible for full payment and will receive the billing statements.
Divorce Decrees
Somers Eye Center is not party to any divorce decree, so any outstanding balance is still the responsibility of the patient or the legal guarantor of the patient, in the case of a minor.
Special Form Fees
If you require any special forms to be completed (for example; FMLA, Work Comp or Disability) by a physician, the patient/guarantor will be responsible for the $25.00 fee related to the service.
Medical Record Copies
Your medical record is the property of Somers Eye Center. If you would like to request a copy of your medical records for yourself or to be mailed to another provider, please contact that provider to obtain the proper Medical Records Request form.
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Somers Eye Center may charge a reasonable cost-based fee pursuant to 45 CFR 164.524. The fee schedule is as follows:
- Clerical fees - $18.50
- First 250 pages - $0.50 per page
- Each page over 250 - $0.45 per page
- Postage - Varies
While filing the insurance claims is a courtesy we extend to our patients, all charges are strictly your responsibility from the time services are rendered. Therefore, it is often necessary for you to inquire and explore your benefits with your insurance carrier. We do realize that temporary financial problems may affect timely payment, but if such problems do arise, we encourage you to contact our billing department promptly for assistance in the management of your account at 816 842-2015.
Somers Eye Center believes that a good patient-to-physician relationship is based upon understanding and good communication. Thank you for reading and understanding our "Patient Financial Policy". We appreciate the opportunity to provide you with your eye care. Your assistance and cooperation will be most appreciated.