If your invoice looks like the image below, please visit this website to pay your ophthalmology/MD bill. If you have any questions regarding this invoice, please call 346-214-2039.

If you have an invoice that does not look like the image below, you probably have an optical bill to pay. To pay your optical bill, please call 713-558-8768. 

If you have any billing questions, you can connect with our Billing Department. The Billing Department will receive your email and contact you soon to assist you. Thank you for your patience and for choosing Houston Eye Associates. 

 

SAMPLE ONLY

 

 

 

Welcome to Houston Eye Associates. We are here to meet all your eye care needs. We are pleased to offer you fully comprehensive eye care with physicians trained in each subspecialty of ophthalmology. Below are some helpful resources for your upcoming appointment. Please don’t hesitate to contact our office if you have any questions. To make an appointment, please call 713-668-6828.

Dr. Sushma Yalamanchili, M.D. will no longer be seeing patients at Houston Eye Associates effective November 30, 2022. If you were referred to Dr. Yalamanchili by another HEA physician, we recommend that you contact that HEA physician for a new referral. If you need assistance with reviewing your record and help in identifying your next steps, please contact Erin Chittum at (713) 668-6828 ext. 2454. Your medical records will be maintained by Houston Eye Associates. They will be kept confidential and available to the Houston Eye physicians. If you choose to transfer to another physician that is outside of Houston Eye Associates, then you will need to contact our Medical Records Department, sign a medical records release, and give them the name and address of the physician where you want the records sent. This will be done at no cost to you. If you have any questions, please contact the Medical Records Department at (713) 668-6828.

Dr. Marlene Morales left Houston Eye Associates effective April 8, 2023. Dr. Morales recommends that her patients follow up with one of her partners at Houston Eye Associates. To make an appointment, please ask the front desk or call (713) 668-6828. 

Dr. Dolores Diaz left Houston Eye Associates effective December 31, 2022. Dr. Diaz recommends that her patients follow up with one of her partners at Houston Eye Associates. To make an appointment, please ask at the front desk or call (713) 668-6828.

Dr. Shipra Agrawal left Houston Eye Associates effective June 30, 2023. Dr. Agrawal recommends that her patients follow up with one of her partners at Houston Eye Associates. To make an appointment, please ask at the front desk or call (713) 668-6828.

All medical records are maintained by Houston Eye Associates for seven years or until the patient is 21 if the patient is a minor.  All medical records are kept confidential and available to the Houston Eye physicians.  

If you have questions about our patient portal, call 713-668-6828 extension 2912. 

If you have questions about our surgery center's patient portal, call 832-553-7166. 

Houston Eye Associates complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.  Houston Eye Associates does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Houston Eye Associates:

• Provides free aids and services to people with disabilities to communicate effectively with us, such as:
  • Qualified sign language interpreters
  • Written information in other formats (large print, audio, accessible electronic formats, other formats)
• Provides free language services to people whose primary language is not English, such as:
  • Qualified interpreters
  • Information written in other languages

If you need these services, contact Molly Free at mfree@houstoneye.com.

If you believe that Houston Eye Associates has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Molly Free, Human Resource Vice President, 2855 Gramercy St., Houston, TX,  77025; mfree@houstoneye.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Molly Free, Human Resources Vice President, is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services

200 Independence Avenue, SW

Room 509F, HHH Building

Washington, D.C. 20201

1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

 

ATTENTION:  If you speak English, language assistance services, free of charge, are available to you.  Call 1-713-668-6828

 

ATENCIÓN:  si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.  Llame al 1-713-668-6828

 

CHÚ Ý:  Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn.  Gọi số 1-713-668-6828

 

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-713-668-6828

 

주의:  한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.

1-713-668-6828번으로 전화해 주십시오.

 

ملحوظة:  إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان.  اتصل برقم 1-713-668-6828 (رقم هاتف الصم والبكم:

 

خبردار: اگر آپ اردو بولتے ہیں، تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں ۔ کال کریں 713-668-6828-1

 

PAUNAWA:  Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-713-668-6828.

 

ATTENTION:  Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement.  Appelez le 1-713-668-6828.

 

ध्यान दें:  यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं। 1-713-668-6828 पर कॉल करें।

 

توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با 1-713-668-6828 تماس بگیرید.

 

ACHTUNG:  Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.  Rufnummer: 1-713-668-6828.

 

સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો  1-713-668-6828.

 

ВНИМАНИЕ:  Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.  Звоните 1-713-668-6828.

 

注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。1-713-668-6828まで、お電話にてご連絡ください。

 

ໂປດ​ຊາບ: ຖ້າ​ວ່າ ທ່ານ​ເວົ້າ​ພາ​ສາ ລາວ, ການ​ບໍ​ລິ​ການ​ຊ່ວຍ​ເຫຼືອ​ດ້ານ​ພາ​ສາ, ໂດຍບໍ່​ເສັຽ​ຄ່າ, ແມ່ນມີ​ພ້ອມໃຫ້​ທ່ານ. ໂທ​ຣ 1-713-668-6828.

Thank you for trusting your medical care to Houston Eye Associates. When you schedule an appointment with Houston Eye Associates, we set aside enough time to provide you with the highest quality care. Should you need to cancel or reschedule an appointment please contact Houston Eye Associates as soon as possible, and no later than 24 hours prior to your scheduled appointment. This gives us time to schedule other patients who may be waiting for an appointment.

Please carefully review our Appointment Cancellation/No Show Policy below:

We, at Houston Eye Associates, understand that sometimes you may need to cancel or reschedule your appointment. However, please understand that when a patient does not show up for a scheduled appointment, it creates an unused appointment slot that could have been used to care for another patient. To be fair to all of our patients, Houston Eye Associates adopted the following policy:

1. Please cancel your appointment at least 24 hours in advance, when possible. This allows us to accommodate other patients who are seeking an appointment.
2. If you do not cancel your clinic appointment 24 hours in advance and do not present to the office for your appointment, this will be documented as a “No-Show” appointment and you will be charged $45. Please note, the cancellation fee amount is at the discretion of the physician. 
3. If you do not cancel your surgery appointment 24 hours in advance and do not present to the office for your surgery, this will be documented as a “No-Show” appointment and will be charged $200.

 

You may contact Houston Eye Associates at 713-668-6828 to cancel your appointment.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item.

You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. 

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance, and/or deductible.

 

 What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn’t in your health plan’s network.

“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You’re protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

 

Applicable State balance billing information may be found at the bottom of this notice.

 

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

 

If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.

Applicable State balance billing information may be found at the bottom of this notice.

 

When balance billing isn’t allowed, you also have these protections:

You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities

Generally, your health plan must:

• Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
• Cover emergency services by out-of-network
• Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket

If you think you’ve been wrongly billed, contact

Centers for Medicare & Medicare Services (CMS)
Website: https://www.cms.gov/nosurprises/consumers
Phone: 1-800-985-3059

    Visit Centers for Medicare & Medicaid Services No Surprises Act for more information about your rights under federal law.

ATTENTION: If you need language assistance services for the interpretation of any form, it is available to you, free of charge.  Call 1-713-668-6828.