I work at an eye clinic alongside my boss / Optometrist and owner. Throughout the five years that I've been employed I've learned alot. Of course, each office / clinic operates differently and have different processes when it comes to their contact lens fitting / eye exams protocols / procedures.
By law, upon completion of an eye examination (comprehensive which in insurance terms is the same as a routine eye exam) you are to be given a copy of your spectacle Rx. This Rx is only for eyeglasses whether or not you ask for it. However, its NOT unusual, that the Optometrist or / Opthalmologist may hold off on finalizing a patient's Rx if he/she discovers or suspects a patient may have something such as an underlining health issue... corneal abrasions, chronic dry eyes, retinal detachment, corneal ulcer/scarring, uncontrolled diabetes, high cholesterol, etc. If so, the doctor will share these findings with the patient, the risks and educate... then make recommendations. Depending on the findings, risk, condition, the doctor may refer a patient out to see a Specialist for further evaluation... most times, the doctor will recommend a treatment plan... order the patient to follow it for a specific duration of time and then have the patient schedule a follow up appointment to come back. At that time the doctor will conduct another examination. Most times, the doctor will finalize the Rx... given that there are no other issues etc.
That is the FIRST part of an eye examination. If a patient wants a cl Rx, he/she will need to be fitted for contact lenses... which is the second part of an eye examination and can be done together... The cost of the contact lens fitting is NOT included with an eye examination. There is a separate fee...fees will vary and your out of pocket cost will depend i.e., new wearer / new patient vs. established patient / experienced wearer, the complexity of your prescription, the type of lenses, whether you have, will be using your vision insurance benefits. Vision insurance if in network with the clinic/doctor rendering the fitting... have a negotiated contract. The amount you pay for the cl fitting, if using your vision insurance cl benefits is the amount set by your plan.
Also, you as the patient have a right to inform or share with the doctor the contact lenses you've worn in the past, currently wearing or would like to get fitted for. HOWEVER, YOU ARE NOT THE DOCTOR AND ARE NOT LICENSED... understand that eyes DO change... a cl fitting is tailored to YOU. Just because you've always worn a specific line or type of cls from a brand, DOES NOT mean that they will always be it. Hence, this is why its called a "cls fitting". The doctor is the one with the professional experience and license to practice and will determine which contact lenses may be the better or best option based off of measurements obtained from the exam, your lifestyle, your preference in wear schedule, etc. New patients who have never worn cls before ARE REQUIRED to go through training with an experienced staff member... who will go over the risks, benefits, how to properly clean, insert, remove, handle/care for and store cls. Patients must be able to demonstrate ability safely and properly remove and insert the trial lenses / pass training before being given the opportunity to take them home to try out during the trial period... return for a followup... upon a satisfactory visual evaulation by the doctor and patient reports no issues during take home trial period... the doctor will then finalize the cl Rx and MUST give the patient a copy of it... UNDER THE EXCEPTION, the patient have paid the fitting fee(s) in full. If a patient is noncompliant, did not complete the fitting (didnt come back for follow up appointments) etc...Rx will most likely not be finalized and may have to pay additional fees, etc.
Lastly, the clinic/dr must provide patients who pay out of pocket for the contact lens fitting... complete the fitting their Cls prescriptions once finalized. They cannot withhold it from patients REGARDLESS if the patients decide to purchase through them or elsewhere. HOWEVER, if a patient uses his/her vision insurance benefits... some plans like Davis Vision CLEARLY STATE something along the lines of "A contact lens fitting is not a separate component of the contact lens benefit, a claim must include the contact lens fitting in conjuction with a purchase of contact lenses for reimbursement or payment to be considered. "
Yeah. In a case like that... the plan may indicate the cl fitting to be collected as $20. However, if a patient pays $20 for the fitting, but, does not complete the fitting / or do not purchase contact lenses through the clinic... Davis Vision (that specific) plan will NOT reimburse or pay the doctor/clinic the remainder of the cls fitting up to the allowed or contracted amt. If this is the case, the patient will need to cough up the amount of the cl fitting fee less any copay already collected or must purchase cls directly from the clinic before the clinic will release the final Rx.
P.S. Most offices DO NOT include PD measurements when they give patients their prescriptions... because:
- PD measurements are taken upon ordering and purchase of eyeglasses. If you only want the Rx but didnt make a purchase, your PD measurements were not taken. If you've purchased eyeglasses from that particular office/clinic/provider before... they may give it you if you ask; however, because changes in your eyes do occur overtime; some patients experience gradual changes over time, while others may experience drastic changes in a short period... PD measurements are customised and can change too and it depends on who takes your PD measurements. The measurements may differ in a situation such as: an inexperienced optical staff vs. trained and experienced optician, Optometrist, etc.
Its usually not a big problem if a patient has a mild or low single vision Rx. These patients can usually order just about any type of frames, whether fitted or oversized and might not run into issues... however, for those patients who have higher prescriptions, high astigmatism, presbyopia, etc. Many patients 38 years old and older who use to see just fine with single vision lenses begin to notice their Rx changing, having more trouble seeing or focusing on distant words or things... as well as having a bit of an issue reading a book or viewing text messages... calling for a different type of lens... like Antifatigue/sync lenses... as their vision continues to change they will eventually benefit from either lined bifocal lenses or no line bifocal aka progressive lenses which allows them to see near, intermediate and distant... for those type of lenses... accurate measurements (pd, segment height, and or optical center height, and the fit / size of the frames are all important!!!). Oversized frames can cause distortions and movements that make it very difficult for a person to wear or see... thus, causing headaches, blurred visual acuity, etc. Thats why PROFESSIONAL Optometrists, Opthalmologists, and experienced Opticians/Assistants, etc. who have the best interest of their patients at heart will NEVER encourage their patients or any patients who need lined bifocal / progressive and computer lenses to order online!!!! Its recommended to go into an actual optical store or office to purchase glasses in person... so measurements are done in person by a person and not by guess like online retailers do.