Champlain Ophthalmology strives to provide the best medical care in an expedient manner while keeping healthcare costs down for all of our patients. As such, certain guidelines are necessary as well as fees for services provided to you and your family.

Category Process Additional Fees
Scheduled Appointments All appointments should be made in advance of your arrival to the office, including sick visits. Late arrivals will be seen as time becomes available. If the patient load does not permit, it may be necessary to reschedule. No charge, aside from standard fees for services rendered.
Appointment cancellations 24 hour notice required. Multiple siblings or paired spouse appointments may no longer be possible after multiple no-shows No charge
MVA Forms Typically filled out during regular office visits.  We now participate with the MVA to submit forms electronically. If the form is required at another date, please drop off form with self-addressed, stamped envelope or arrange to pick up forms in the office. MVA Forms are unable to be filled out as you wait.  There is a 1 business day turn around. No charge for paper form at time of scheduled visit. $10 for electronic submission or if not day of service.
Non MVA Forms Make request in writing with stamped, self-addressed envelope or arrange to pick up forms at the office. Price varies depending upon complexity.
Refraction Services Glasses prescription $75 for a glasses exam if not covered by medical insurance.
Contact Lens Evaluation Meet with our contact lens specialist for a contact lens evaluation including fitting, insertion and removal training, and new prescription. Ranges from $100 to $200 depending on the complexity of the evaluation.
Co-pays and account balances Due at the time of the visit Price varies depending upon your particular insurance plan. There is a $20 fee added to your account balance for all returned checks.
Medical Record Transfers We are happy to assist in this manner according to HIPAA regulations. 73¢ a page, plus a handling fee and postage.

Payment is required at the time of service. For your convenience, we accept cash, check, Visa, MasterCard, and AMEX.

Insurance Coverage

Your insurance coverage is a contract between you and your insurance company and it is your responsibility to know the limits and benefits. Champlain Ophthalmology will assist your insurance company in processing your claim; however, you are ultimately responsible for the payment of your account. Due to variations in policies, it is your responsibility to check with your insurance plan to be sure they consider us as participating providers.

We will file insurance claims only for the plans in which we participate in at any given time. These plans currently include:

Aetna (Not HMO) Alliance Allied Benefits BCBS Federal
Coresource GEHA Great West Group Resource Inc
Guardian MAMSI MDIPA Medicare (HMO)
Medicare Railroad NALC NCPPO Onenet PPO
Optimum Choice PHCS United Healthcare

You should communicate directly with your insurance company to settle any disputes over claims and reimbursements. We appreciate your cooperation. Inquiries or concerns regarding your bills should be directed to our billing department at (301) 493-9600.