Patient Information

Accepted Insurances

Our office accepts most insurance plans for our ophthalmic procedures including Medicare. We will file insurance claims for all insurance plans in which we participate. For all others, we will file your claim when payment is received. Below is a list of some accepted plans, if you do not see your plan listed please call our office to see if your plan is accepted. TriCare, Blue Cross/Blue Shield, United Healthcare, Cigna, Aetna, Humana, APIPA.

If you have questions about your Medicare coverage, call 1-800-MEDICARE (1-800-633-4227) to speak to a Medicare Customer Representative. You can also go to www.medicare.gov to find out more about Medicare coverage. Our staff is also available to help you determine whether the eye care you need is covered by Medicare. You can e-mail [email protected] who will reply within 48 hours, or call us at 520-326-4321.

Your out-of-pocket expenses for Medicare or private insurance will depend of the type of insurance you have, whether you have supplemental insurance and whether you have a deductible on your policy. We’ll be glad to process all insurance claims for you. We also accept cash, personal checks, Visa and Mastercard.

Financing Options:

CARE CREDIT

CareCredit is different from a regular credit card.   It helps you pay for out-of-pocket expenses not covered by medical insurance by extending special financing options that you can't get when using your Visa or MasterCard.  Pay for health, and wellness care at over 200,000 enrolled providers across the nation. Once you've applied, you can use it again and again at any location that accepts CareCredit.  With shorter term financing options of 6, 12, 18 or 24 months no interest is charged on purchases of $200 or more when you make the minimum monthly payments and pay the full amount due by the end of the promotional period.

Care Credit

WELLS FARGO

Promotional Financing: 0% APR for 24 months with equal payments*

Your vision correction procedure is more convenient than ever now, with Hodges Eye Care’s new financing program! You can enjoy a financing plan that allows you to pay for care over time, including special financing for 24 months, with approved credit. Take advantage of convenient monthly payments and an easy-to-use online bill payment option. You can apply for financing with a quick in-office or online application process.

Don’t let cost be a barrier in better vision any longer! Take advantage of our 24-month special financing program and discover why the view from here is always clear.

*The Wells Fargo Health Advantage® credit card is issued by Wells Fargo Bank, N.A.. Special terms apply to qualifying purchases charged with approved credit. The special terms APR will continue to apply until all qualifying purchases are paid in full. The monthly payment for this purchase will be the amount that will pay for the purchase in full in equal payments during the promotional (special terms) period. The APR for Purchases will apply to certain fees such as a late payment fee or if you use the card for other transactions. For new accounts, the APR for Purchases is 12.99%. If you are charged interest in any billing cycle, the minimum interest charge will be $1.00. This information is accurate as of 01/01/2019 and is subject to change. For current information, call us at 1-800-431-5921.

WELLS FARGO

Flexible Spending Accounts Can Make Laser Vision Correction Even More Affordable

Save up to 50% on laser vision correction.
Thousands of companies now offer their employees this versatile – yet underutilized – benefit, sometimes referred to as a “flex plan” or “cafeteria plan.” An FSA can save you hundreds of dollars on medical bills and can be used to pay for laser vision correction. Depending on your tax bracket, using an FSA to pay for vision correction could save you up to 50 percent. Contact us for more information.

Patient Forms

For your convenience, we have made a number of forms available for patients to download. If you are new to our practice, we encourage you to download and print out the new patient forms. Filling these out in advance of your first visit will minimize the time you spend in the waiting room filling them out when you get here. Other forms are informational. If your doctor has given you a form with specific information or instructions different from the information on these online forms, rely on the information given to you by your doctor, not on the online forms. If you’re not sure which forms you need, please call 520-326-4321 for assistance.

New Patient Forms

  • Patient Information
  • Medical History Form
  • Lifestyle Checklist
  • Refraction Waiver
  • Appointment/Cancellation/No Show Policy
  • Payment Responsibility / Privacy Practice Notice

LASIK Patient Information Forms

LASIK Patient Information Forms (Spanish)

Patient Questionnaire: Refractive Surgery

Patient Questionnaire: Refractive Surgery - SPANISH

Authorization to Release Medical Records

Policy and Code of Conduct