Montgomery Eye Center (ASC)

Estimate of Costs

• Montgomery Eye Center, LLC provides, as a practice, a personalized estimate (with charges specific to your anticipated procedure) to each patient prior to surgery.
• Estimates or updated estimates shall also be provided at the request of the patient, prospective patient, or legal guardian within 7 business days from the receipt of the request.
• Actual costs may exceed the estimate.
• Please contact your health insurer or HMO for anticipated cost sharing responsibilities.

Itemized Statement

• Montgomery Eye Center, LLC shall provide an itemized statement upon request of the patient or legal representative within 7 business days after patient discharge or 7 business days after the request, whichever is later.

Other Charges

Services may be provided in this health care facility by the facility as well as by other health care providers that may separately bill you.
Such as:

• Surgeon Fees—Billed by the Surgeon
• Pathology Fees—Billed by laboratory
• Anesthesia Fees—Billed separately by the surgery center
• Assistant Fees—Billed separately by your physician