Patient Information

Office Policies

Review the Following Office Policies

We offer the following information in order to familiarize you with our practice. Please take a moment to read through our policies. We look forward to assisting you with your eye care needs.

What to Bring

When coming to Rock Hill Eye Center for your appointment, please remember to bring the following:

  • Photo ID
  • Insurance Cards
  • Prescription Medications
  • Physician Referral (if your insurance requires it)

Patient Forms

For your convenience, we have our required patient forms available for you to download, print, and complete.

Patient Visit Requirements

All established patients need to arrive 15 minutes prior to appointment time and bring your current insurance cards and a list of your current medications. You will be asked to verify your information on file at check in to ensure that the information is accurate, especially if it has been three or more years since your last visit.

If this is your first visit, we need additional information and time to properly check you in.

Patients with Physical or Mental Limitations

Patients with physical or mental limitations must be accompanied by a family member or caregiver throughout the entire exam.

Medical Necessity

Please be aware that your medical insurance will only cover what they deem to be medically necessary. Insurance companies have their own policies as to what services they will cover. While your physician may feel it is necessary to perform a service, your insurance company may not agree. We cannot guarantee a service will be covered, but we will be happy to discuss an estimated charge in the event you may choose to pay out-of-pocket for the visit.


You are responsible for obtaining any authorizations or referrals required by your insurance company. You will need to check your insurance policy to see if you need an authorization or referral in order to see a specialist. If you do not have a required authorization, you may be responsible for your visit or may want to reschedule your appointment.

Patient Responsibility

Self-pay patients and patients with insurance co-pays are expected to make payment on the day services are rendered. If you are not prepared to make payment the day services are rendered, you may be asked to reschedule your appointment.

Signature Requirements

A patient must be at least 16 years old to sign several of our required forms. Minors under 16 years of age must be accompanied by a parent or legal guardian (with proof of guardianship). Forms may be signed before the day of visit by parent or legal guardian. Relatives are not considered legal guardians unless it has been stated by the court system.

Past Due Balances

Any past due balances will be due at the time of your routine eye exam. If your exam is not medically necessary and you have an outstanding balance which you are not prepared to pay along with the current exam, you will be asked to reschedule your appointment until after the outstanding balance is paid.

Returned Check Policy

When paying for your visit with a personal check and the check is returned for any reason, the check will be re-deposited one more time. After that, you are responsible to come into the office and pick up the check and pay the check amount plus a $30 fee in cash. If this happens, you will also not be able to pay for future visits with a personal check.

Refund Policy

It is the policy of Rock Hill Eye Center to collect the patient’s financial responsibility prior to services being performed. The amount collected is based on information obtained from the patient’s insurance carrier. At times, the information obtained from the carrier may be incorrect and a refund will be due to the patient. Rock Hill Eye Center will refund patients as soon as possible once the overpayment is identified.

Cancellation Policy

When it is necessary to cancel an appointment, please call no later than 24 hours prior to your appointment time. This allows us enough time to offer the opening to another patient.

Late Arrivals

If a patient arrives 15 minutes late for an appointment, they may be asked to reschedule, which will be left to the physician’s discretion.

Minors In Office

Please monitor your children at all times. While we appreciate our patients of all ages, we cannot permit running, screaming, or jumping around in the office due to the advanced age and low vision of some of our patient population. Also, please do not allow your children to climb or walk on the furniture.

Telephone In Office

As a courtesy to our patients, we have placed a telephone in the front lobby. This phone does not permit long distance calls and is here for the use of our patients being seen.

Emergency Care

Our practice offers 24 hour emergency care coverage. In the event of an emergency, call our office at 803-328-0168 and our answering service will contact the physician on call. You will receive a call back from our physician, who will instruct you what to do.

Additional Patient Information

Initial Visit

Rock Hill Eye Center always welcomes new patients. Here is some information that you will need to know prior to your first visit.

New Patient Forms

Prior to your visit with the Rock Hill Eye Center, please gather the following information and forms to facilitate your check in and examination process.

Payment Info

LorRock Hill Eye Center accepts a variety of medical insurance carriers and payment options. See which option works best for you.

Contract Carriers/Accepted Insurance

Rock Hill Eye Center accepts a variety of medical insurance carriers. Contact us if you have a question regarding whether we accept your medical insurance.

Please allow 24-48 business hours to be contacted regarding your appointment request. We look forward to seeing you soon.

* If this is a medical emergency, please call 911 or go to the nearest emergency room.

Have a Question?

Talk to our Staff

  • This field is for validation purposes and should be left unchanged.