Contact Lense Fitting Fee

Contact Lense Fitting Fee

Posted in the Optometry Forum

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Guillermo

Brea, CA

#1 Jun 6, 2007
I am probably one of those patients that only remembers to schedule an appointment to have my eyes checked only when I'm on my last pair of contacts and need to "re-fill". While I'm not against anyone making a buck,I feel that earlier in the day I paid an excessively high "Contact Fitting Fee" of $165 AFTER 15% Discount.

Today I learned a lesson; ask what the fees are before even making an appointment, as the shock came after all the service was provided and new contacts were on me.

I don't recall ever paying "Fitting Fees" in the past and the most I ever spent after an eye exam over what my double-coverage insurance covered was not more than $250 when I got contacts and glasses the same year. Today I paid $225 and that included the $165 in fitting fees.

This "fitting fee" made me look around and see if this is even legal and I found out that it is, at least under California Law; which specifies when the fitting of contacts starts and ends and for which it allows extra charges, "Fitting Fees". After all of this (including this email) I still feel that the fee was exessive and still have not found what an everage "Fitting Fee" is.

Should this fees be stated before the service is rendered? I think so.

Should anybody feel like they've just been taken (ripped off) for what seems like about 15 - 20 minutes work?

Perhaps I'm missing something but $165 Fitting Fee seems abit steep.

What is the general feeling about this?
Contacts

Lexington, KY

#2 Jul 16, 2007
I was also charged a fitting fee of almost 50 bucks. which IS steep to me. I was told I has an insurance co payment of 10.00 until I was walking out the door. I'm still trying to find out if its legal. I'm in Illinois. I feel like bait and switch was used on me
Brian

Cleveland, OH

#3 Aug 9, 2007
As I research this problem of high fees for fitting contacts - I am learning it is a great way for the doctors to screw the public. After you pay the fee -- they fit you for one brand of contacts that you must buy from them. So before you pay the fee - give them a list of brands from 1800contacts that you can buy on the internet - it is the law they have to give you the prescription(that used to be the old ggame to screw you)
good luck
eyedoctor

Salinas, CA

#4 Aug 19, 2007
contacts are a medical device. You feel they are just a peice of plastic that allows you to see. But as a doctor we see patients that have problems associated with contacts. some problems don't even give any symptoms till it is too late...corneal ulcer, conjunctivitis, corneal abrasions to name a few . these can lead to blindness. All this is in an eyedoctor's mind when they are fitting you with contacts. Only the few who are effected really realize what's involoved.
Marty OD

Glastonbury, CT

#5 Sep 16, 2007
The eye doctor is the one responsible for the fit of the lens, and the one you complain to if it's uncomfortable or can't see. My CL fitting fee covers the extra time (beyond a "routine" exam) I need to decide which lens I think will work best, put a lens on the eye (not private label, in my practice), let it settle a few minutes, evaluate the fit under the microscope, and determine if it's a good fit. If it isn't, we try a different one.(As mentioned above, the consequences of poorly fitting lenses can range from minor irritation to corneal ulcers and permanent vision loss.) It also includes one or more follow-up visits to ensure that my patients are happy with the lenses after a full days wear. The cost is greater for toric (astigmatism), bifocal and custom lenses, as they often take more time to fine-tune the fit and vision.
As far as buying lenses online, these days you can get most any lens online. I give my patients a copy of their CL Rx when I consider the fitting completed. My CL pricing is very competitive with online vendors, but the advantage my patients have when they buy from me, is me... if they run out of lenses or tear their last one and need a spare, we're there for them. If their Rx changes mid-year, we'll take back unopened boxes and exchange them for the correct power. If you got yours online, I'd encourage you to speak to the folks you bought your lenses from and see what they'll do for you.
As for you who feel we're just out to screw our patients, how do you expect us to keep the doors open if we don't charge for our services? If we were to do a fitting for free, and you buy your lenses somewhere else, how do we pay our staff? From your $10 copay? Or from the insurance reimbursements that average 50-60% of our usual fees?

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Brian

Cleveland, OH

#6 Sep 25, 2007
Interesting the comments from the eyedoctors. Of course every wants to get rich and feels their profession deserves premium prices. The last fitting fee was 175 dollars for about 8 minutes of the doctors time. How much thought did he put into this - it is questionsable. It is just a matter of time until the government gets involved.
5 years ago the fitting fee was 50 dollars and 5 years before this it was free when you got an eye exam that the insurance paid along with the 10 dollar copay.
So in 10 years the eyedoctors have found a new way to pad their income. They get the 150 dollar fee from the insurance - the 175 dollar fee for the fitting and also try to pork you on selling you their private label contacts.
In my informal survey I tried to find anyone that has gone back because the contacts didn't fit. I couldn't find anyone. Actually most people were surprised that they could even do this. If anyone had eye problems - they ended up getting billed to insurance.
I am sure that somewhere there are eyedoctors willing to live on their 200k a year incomes and do not have to screw the public. but like the CEO's of today -- they want all they can get - GREED is exactly what it is and the doctors should not paint it any other way!

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Brian

Cleveland, OH

#7 Sep 25, 2007
Marty - I feel so sorry for you that you can't seem to make ends meet on the 150 dollar copayment. As I sit in the office of my ex-eyedoctor He sees at least 6 patients each hour.
Their are 3 doctors in the office to share the secretary. So the office is bringing in around 18 patients an hour at a round 100 dollars each.
I think this more then covers the office expenses.
The 100 thousand dollar cars out front(under their covered carport) of the doctors is an indication of the poverty these doctors are living in. You mention return visits for free -
how many return visits do you really get for contact lense fitting problems.
How did eyedoctors survive when they lived on only the doctors fee. Where they living in poverty. I don't think so. This new exhorbitant fee is Greed Greed and more Greed. I hate government intervention but it is coming!

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Not Brian

Salinas, CA

#8 Sep 28, 2007
brian you are a total douche bag
DrC

Goshen, IN

#9 Oct 2, 2007
The described fitting fees seem terribly expensive. I do tier fitting fees based on how difficult the fit is. If the patient will require numerous visits/adjustments and material ordering it will undoubtedly be billed higher. Our general contact lens evaluation is around $30 if we are just accessing for Rx change or evaluating fit/damage. Fitting fees for situations that can extend into months run around $90 on top of the $30--usage is rare.
Optometrist

Phoenix, AZ

#10 Jun 11, 2008
I agree with DrC. We have a tiered contact lens service fee, over and above the "routine exam" fee. This is legal and standard and has nothing to do with ripping anybody off.
This fee can range from $25.00 to $200.00 in our office. It depends on what service is given and how complexity of the contact lens fit.
I prefer to call it a "contact lens service fee" because calling it a "contact lens fitting fee" makes it sound like the "fit" is the only service involved. Contact lens service includes determining the brand of contact lenses needed and prescription, assessing the patients eye health, evaluating the lens on the eye and dealing with any potential contact lens complications (and there are MANY, just check on the internet). One potential complication of contact lens wear is a corneal ulcer, which can cause blindness and loss of the eye!!
While most ordinary contact lens wearers do not experience serious complications, when it happens to you it doesn't feel "rare".
As optometrists, we are responsible to the patient to assure a safe, healthy contact lens fit. We deserve to be paid for this service.
If a patient has questions about contact lens service fees, these questions should be addressed at the time the appointment is made, not after you've seen the doctor. This type of miscommunication fosters resentment and confusion.
I advise you to ask for the fees up front. If the price is too high for your budget, call another office. You will defintiely find that good service and good care is not always "cheap".
Good luck!!
optometrist in CA

San Leandro, CA

#11 Aug 21, 2008
I read with interest the various posts, and felt I need to add my input. I understand the views of the patients on this board, however we are dealing with medical devices (as defined by Federal Guidelines), and we offer a service that we have until recently been giving away for free. Optometrists, unlike their other professionals have been too willing to do this for too many years.

How many of you have been to your personal Lawyer, CPA, Medical doctor for free? THEY BILL YOU FOR EACH SERVICE THEY PROVIDE. Even a phone call or email can result in an invoice!

Lets take this a little further......how many of you have been to your MD due to illness, waited for 30 minutes for 3 minutes of his/ her PROFESSIONAL time (PAYING FOR THEIR SERVICE), received a medicine (PHARMACY CHARGE) that caused side effects or was not effective. You then go back to see the MD (waiting 30 minutes for 1 minute of their time)(PAYING THE SAME AMOUNT FOR THEIR SERVICE AGAIN), get a new Rx and have that is filled (PHARMACY CHARGE). Does either the MD's office or the Pharmacy offer you anything for free the second time..........can you return the "faulty product" for full refund??? I DOUBT IT

WHY IS IT PEOPLE EXPECT OPTOMETRY TO OFFER THEM SERVICES FOR FREE, AS WELL AS REFUNDS ON PRODUCT THAT ALREADY BEEN OPENED??

I feel that people need to realise that what they wear in their eyes is not a commodity, but a medical device and thus worthy of proper professional payment.

This is an argument that will continue for a long time, but in our office we tell patients what their contact lens service agreement fee is and what it covers..........the next time they sustain an infection due to improper use of conatct lenses, they realise what a good investment that initial service agreement fee was.

Before people start replying to this post, please realise that there are ten of thousands "other guys" who do abuse their contact lenses, and get into trouble......who do they expect to fix them???.......You got it.....the optometrist.

One post referred to possible overcharging by optometrists. All I can say, is that how come an item that costs pennies from Home Depot, suddenly comes to many dollars from my handyman or plumber........I feel that if ever there should be a closer look at high fees, perhaps professionals in non medical fields should be afforded the same criticism that we seem to be receiving. When I question them....what answer do I get?...."You are paying for my professional skill"

Optometrist are medical professionals (who diagnose and treat a myriad of ocular problems, as well as diagnosing LIFE threatening illnesses), and deserve to be treated as such, and set fees according to their professional status inline with other preofessionals (MD'd, Lawyers, CPA's etc).
Sunshine

San Pedro, CA

#12 Aug 30, 2008
I also have tiered fees for complexity of the contact lens evaluation. The highest fees are for custom made lenses. The lowest is for disposable non-astigmatic lenses ($30). Even for the ones who paid me $30, I still see them for an unlimited number of visits, as the patient needs or requests, for up to three months. The average is about one follow up, but I have seen some as many as ten times at no additional charge. If someone has a problem six months in, I will see them for no additional charge also, because I feel the responsibility to do so. Most patients are very appreciative if this happens. Some patients actually try to pay, even though I tell them it's included. I had a patient who went to the emergency room and paid $800, because he could not get his contacts out of his eyes. I told him that if that ever happens again, I would do it for free. I've done that for tourists for free and they weren't even my patients. The majority of optometrists are in it to help people. If we were greedy, we would have gone to medical school.
Guillermo

Beverly Hills, CA

#13 Oct 2, 2008
From the Original poster:

It's been a while since I looked at this post and the response is interesting.

I did not return to the same office the following year.

I still think his "fitting fee" was out of proportion. And to clarify if not understood I did not get glasses that year in question in the original post. I never went back to see him and the contacts did not bother me.

The year after this incident I went to a different office and changed contacts as I was told these new lenses were better (a way to fit you with new lenses) and paid a fitting fee. This fitting fee was a lot more reasonable. I did end up goin back with problems with this new contacts and my insurance was billed again since I have emergency coverage (not out of pocket which is most important to me).

I said it then and say it again: I'm not against anyone making a buck.

Tiered fees if I understand them (different for every patient depending on their needs) I agree with.

As for those (not all but most) who cahrge a set fee to all patients with the promise of free re-visits I think it is a way to disguise the truth.

If you do it this was is because you profit the most this way. Hey, its legal so fine go ahead and continue doing it but don't make it sound like you are doing a service to the patient as some will benefit but not all.

I don't know the numbers but my guess is that most lense wearers do not come back with problems. Sure you come back for the follow up (5 mins at most) visit but even then I don't think you end up giving free service to 100% of you patients.

One of you said it before:
Patient: ask for the fee upfront.

But service providers it would not take much to post the fee or inform the patient of the fee upfront.

Again, its legal for now, but many people abuse legal means to maximize income, its the nature of the beast.
Sunshine

San Pedro, CA

#14 Oct 3, 2008
Just out of honest curiosity... Do you think that I should charge a patient for the return visits, since everyone pays the minimum $30 for the contact lens evaluation and some do not come back? Should I charge more to the ones who do come back? So far, I haven't been. Do you think we should calculate and prescribe contacts for free? If a return visit is medical in nature, and the patient perceives that it is related to the contacts, but it really is not, do you think that visit should be free to avoid misunderstanding and disappointment by the patient?
Sunshine

San Pedro, CA

#15 Oct 3, 2008
Oh, forgot to mention... Since you don't mind that the insurance paid for your return visit, does that mean that you don't care what people charge as long as you're not the one to pay? The fact that you have insurance does not guarantee payment to the doctor and as optometrists, we are notorious for writing off those charges and not billing the patient.
REPLY TO BRIAN

Henderson, NV

#16 Oct 3, 2008
This is to educate all of the patients out there who are not getting educated by their doctor's offices. Contact lenses, unless specified, are NOT considered medically necessary. Insurance companies consider them, in laymen's terms, a Want, not a Need. This is why patients with almost every vision insurance plan must pay out of pocket for their contact lens prescription. In turn, there is more to a contact lens evaluation than just picking numbers to correct your vision. More examination is required and usually a different prescription from the glasses is prescribed due to the lens sitting on your eye rather than you looking thru glasses further away. Doctor must check the health of they eye, make sure your current contact lens wear is allowing enough oxygen to the eye, and try out the newest and best technology out there for your eyes. While $165 is a steep price to pay, (I normally hear those numbers from opthamologist practices, OD's are usually around the $30-75 range), I am disgusted with the fact that people view these doctors as greedy when they have gone to school specifically for the healthcare of your eyes rather than a plethura of medical subjects as with a medical doctor who would charge astronomical amts for simple procedures, and only want to be reimbursed for the time and care that they put in. I am not an OD but I manage a practice in Nevada and Optometrists do not get the credit they deserve for the knowledge they usually give for free in the best interest of their patients. You just need to be educated.
Mary

United States

#17 Nov 3, 2008
I get what the Dr's above are saying. And that's fine. But WHY should I pay the fee over and over each year when the prescription is exactly the same, the brand is exactly the same, the fit is exactly the same? Sure if I change brands or something then I'll gladly pay the $50, but if nothing (and I mean absolutely nothing) has changed, then what exactly is being "fitted"??? It's just padding the bill if you ask me!
bear

Orange Park, FL

#18 Nov 7, 2008
One big problem I've had and what makes people mad is they see that their insurance card says $20.00 copay for contact eye exam and 150 toward contacts.. When I see that as a consumer I'm thinking, wow I don't have to fork out much to get my new contacts. Then, as others have stated at the end they hit you for a 75.00 fitting fee. At least I know when I got to the doctor I pay 20.00 ,like my insurance card says, even if he decides he wants to do an EKG. I not going to be surprised when I check out.
Why don't the eye doctors state this fee upfront? They know customers are going to shop for lower fitting fees till it gets to where one doc will advertise "free fitting Fees for contacts" Oops. wow,we had a great thing going while it lasted.
CA OD

United States

#19 Nov 9, 2008
We do state the fee up front. The difference in medical practices is that they make you return for that additional test or go elsewhere for it, and you end up paying your copay multiple times. Their reimbursements are much higher than ours, as well. When we do a contact lens exam, we do additional visits without charge.

When the prescription is the same year after year, how do we know that it is still the same? We know because we checked it again. How else would you know that it is okay to continue with those contacts unless we examine you? There are cases of people having serious problems with their eyes from having worn the same type of contacts for years. If you are still wearing the same thing for several years in a row, that means your doctor has not educated you on newer, healthier, clearer, contact lens options that continue to be developed on a continuous basis. It's fortunate that you can still wear the same contacts so far, but when a problem occurs, who do you blame? We take the responsibility of making sure your eyes are okay. When a patient does not wear contacts, we do not have to check for contact lens related eye issues, so we don't charge them for that. When you do wear contacts, you should be willing to pay th $30 to make certain that your eyes are okay to continue with contacts.

Most people spend more than that for a haircut and that doesn't last but six weeks. When my dentist takes x-rays, I don't complain that my teeth still look the same. When I go to my doctor for medication, I don't tell him not to charge me because I've taken that medication before.
Not Brian2

De Witt, AR

#20 Nov 24, 2008
Not Brian wrote:
brian you are a total douche bag
You must be an eyedoctor and a poor excuse for one for saying that to Brian

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