Adults and Children (Age 10+) Health History Form
Click here to enter your information online – no printing necessary
Click here to print, complete and bring your form to your appointment
Children (Age 9 and below) Health History Form
Click Here to enter your information online – no printing necessary
Click Here to print, complete and bring your form to your appointment.
Shamrock Family Eye Care accepts a number of different medical and vision insurance plans. If your insurance plan is not listed below or if you are concerned about the eligibility of your insurance plan, please feel free to call our office. Each medical and vision insurance plan is unique and may offer different vision services to each of its members. We will attempt to verify all eye care coverage before your appointment.
We accept the following medical insurance:
- Blue Cross/Blue Shield
- United Health Care
- If you don’t see your insurance listed, please call us at 614.889.8331 to inquire
We accept the following vision insurance:
- Vision Service Plan (VSP)
- Humana (Insight Plan Only)
- Blue View Vision
- If you don’t see your insurance listed, please email us or call 614.889.8331 to inquire
Shamrock Family Eye Care is happy to provide multiple payment options to meet the needs of our patients.
We accept all major credit cards including:
We also proudly accept payments with:
Frequently Asked Questions About Insurance
Can I use my medical insurance to pay for my comprehensive eye exam?
Medical insurance will typically pay for medical eye services, assuming you have an associated medical complaint (ie pink eye, dry eye, allergies, diabetes, high blood pressure, etc). Approved medical testing will often require a specialist copay. If vision correction is required and prescribed during the same visit, a refraction copay will likely be required.
Do you know what eye health and vision issues my insurance will cover? Does my insurance cover vision?
Your insurance is a legal contract between you, your employer, and the insurance company. Because of the number of insurance companies and policies, we cannot be familiar with the eye care limits and exclusions of every plan. It is your responsibility to be familiar with your vision coverage and policy. We are not responsible for any uncovered eye care services performed in this office. If you are concerned about whether or not vision is covered by your policy, it is best to call your insurance company in advance to confirm coverage.
If I need to file my own insurance for eye care services, what do I have to pay at the time of my visit?
We require that you pay any co-payments at the time of your visit. When we receive payment from your insurance company, our office will reconcile the account. Once reconciled, Shamrock Family Eye Care will bill you for the remaining amount due or refund any overage.
What if my insurance reimburses me directly for my medical bills?
There are insurances where, due to contractual arrangements imposed by your insurance company, we may be unable to receive payment directly from the insurance company. In that event, we will ask you to pay for the eye care services in full, with your insurance reimbursement sent directly to you.
How many different insurance companies will you file with?
If you have coverage for the same eye procedure with more than one company, we will file the primary carrier only for direct reimbursement to us. You may file the others for your reimbursement.
Will you file my coinsurance?
Any secondary insurance plans not forwarded directly by your insurance company (such as Medicare) are your responsibility.
Can you get approval from my primary care doctor at the time of my appointment?
Any prior approvals for eye care services or referrals from other doctors must be received before services are rendered.
What if my insurance company has not paid and I start getting bills?
Within three months of filing any insurance, all unpaid balances will become your responsibility. You may then contact your insurance company for reimbursement.