SATISFACTION GUARANTEE
The Optometrists and staff at Maine Optometry want you to be completely satisfied with every aspect of your visit with us. If
you are not, please notify any team member within 14 days of receiving your exam, eyewear, or contacts and we will do what it
takes to make it right. Please see the time limits below.
LENS OR FRAME CHANGES
Your complete satisfaction is our goal! After evaluation by an optician, we will work with you to determine what solution
will best meet your needs and resolve any issues.
We allow a 60-day period from the date of purchase for remaking lenses or changing frames under this policy. Any
difference in price will be charged for upgrades. We cannot refund when changing to lower priced lenses, frames, or
options, but will provide the remake at no charge. We feel that a patient will know within 60 days if they are satisfied with
their glasses. However, we will always work with our patients to deliver the best quality and service at a fair price.
Generally, we do not encourage refunds, as we will do everything possible to ensure your satisfaction. Our labs cannot
cancel orders once in process. Cancellations will result in a 20% service fee.
EYEWEAR WARRANTY
All frames and lenses purchased from Maine Optometry are covered against manufacturer defects within one year from date
of purchase. Replacements under warranty are covered during the one-year time period from date of original purchase and
warranty does not start over at time of replacement. Lenses have a one-time warranty replacement for scratches within one
year from date of purchase.
Maine Optometry offers complimentary cleaning, adjustments, replacement nose pads, and minor repairs any time, at any of
our locations, for the life of your eyewear.
PEACE OF MIND PROTECTION PLAN
This protection plan covers eyewear in the event of accidental damage. The cost of the plan is $29.99. When utilized, there is a $25.00 copay for Frame replacement, a $25.00 copay for Lens replacement, and a $50 copay if replacing both. Children 12 and under will automatically have the plan added at no cost, however, copays will apply when utilized. The exchange period will be extended to 90 days (1 time only) when coverage is purchased. Copays will not apply for the 1-time exchange; however, any additional frame cost is the patient’s responsibility. The plan does not cover lost or stolen glasses; we must have the damaged eyewear back. The plan is limited to 5 redemptions in one year from the date of pick up.
CONTACT LENS RETURN POLICY
With regard to sales of non-specialty soft contact lenses, any unopened & unmarked boxes may be returned for a full
refund, or exchanged, within 60 days. All sales of specialty gas permeable (rigid) and hybrid (containing both rigid and soft
components) contact lenses are final. If, however, there are discrepancies between the doctor’s initial prescription and final
prescription, any changes for the actual prescription will be honored at no charge as long as enough time is given for the
lenses to be exchanged to be mailed and received by manufacturer within 60 days from time of order. All contact lenses
that need to be ordered will need to be paid in full before they are ordered.
PROFESSIONAL FEES
Within 60 days from the date of original exam, a complimentary Rx check will be performed if needed. From 60-120 days,
the refraction fee will be discounted 50% for this service. After 120 days, the full refraction fee will be charged for Rx
checks.
Patient Financial Responsibility and Cancellation Policy
Co-Payments: Your co-payment is due at time of service.
Self-Pay: Patients with no insurance coverage are expected to pay, in full, at the time of service.
Optomap® Retinal Imaging Fee: As a part of our standard of care beginning in 2023, we perform the Optomap® Retinal Imaging during all routine eye examinations. These scans provide an in-depth view of the retina and allow us to do a side- by-side comparison year over year. This information is crucial for us to monitor your eye health. Insurance typically doesn't cover the cost of advanced screenings, and a fee of $20.00 is due at the time of service. If the doctor determines a medical finding, the cost of these images will be billed to your medical insurance. Maine Optometry will provide this service free of charge for patients who are 8 years and under.
Outstanding Balances: Payment is due upon receipt of statement. Balances not paid within 90 days of the initial billing may be subject to a $15 per month late fee. In the event the account is past due after 90 days, the account may be sent to a collection agency.
Eyewear/Lens/Contacts Lens: Purchases must be paid in full at the time of order. We will gladly hold your order with a 50% deposit and the order will be placed upon receipt of full payment. Upon pickup, final cost of eyewear/lens may have a small balance due or credits due to variations of insurance company’s final rates.
Returned Checks: Checks returned for insufficient funds (NSF) will incur a $25.00 charge and we will automatically redeposit the check. If the check is returned a second time, another $25.00 service charge, plus the face value of the check will be charged back to the patient’s account and will be due immediately in an alternate form of payment.
Account Credits: Any credits on a patients account that are incurred will not be subject to automatic refund of $40 or below.
Medical Diagnosis: Please be advised that most insurance companies do not consider treatment for a medical diagnosis by an optometrist to be a Routine Eye Exam. These services will be billed to your medical insurance carrier and subject to their terms and conditions.
Cancellation and No-Show Policy: Patients are requested to cancel or reschedule their appointments at least 24 hours in advance to allow the practice enough time to reschedule the time slot. However, we understand that this may not always be possible and allow for one cancellation under 24 hours or one no-show within a 24 month period. The practice retains the right to refuse scheduling or dismissing patients from the practice that have incurred three or more violations of the policy within a 24 month period. New patients or patients that have not been seen in the previous 36 months that have two or more violations will be dismissed for failure to establish as a patient.
I hereby acknowledge that I have read and understand the above information.