PATIENT INFORMATION FIRST VISIT On your initial visit, we will obtain from you a personal history regarding your present condition and past medical history.  The doctor will conduct a comprehensive ophthalmological examination based on your history.  The initial examination will usually last from 30-60 minutes.  Every effort is made to see you on time.  If needed, subsequent visits will be scheduled.  Please notify us within 24 hours of your scheduled appointment if you are unable to keep your appointment. We will make every attempt to confirm your appointment. You will need to bring the following information with you on your initial office visit: Your insurance card Any referral forms required by your insurance provider A driver's license or current picture identification A list of current prescriptions and over-the-counter medications you are taking, including supplements and vitamins, and there dose and frequency Pertinent information about your medical and surgical history Bring any pertinent x-rays or records you may have. CONFIDENTIALITY As our patient, your records will be held in the strictest confidence.  We will not release your medical records to anyone without your written authorization.  If you wish your records from our office sent to another physician, attorney, insurance company representative or another party, we will be happy to comply with this request after obtaining proper written authorization.  We will mail your records to the above-mentioned persons once this is completed.  We reserve the right to charge a fee for this service.   EMERGENCIES Should an eye emergency arise at any time please go to your nearest emergency room.  If you need to speak with the doctors urgently, please call our office at 202.331.1754   PRESCRIPTIONS If you should run out of your medications prescribed for you by our doctors, have your pharmacist call 202.331.1754 during regular office hours.   FEES AND BILLING Full payment is due at the time professional services are rendered.  Our office accepts cash, checks, MasterCard, Visa and money orders.  You will be responsible for paying any deductible at the time of service unless you can show that the deductible has been met. We participate with the following insurances:  Medicare DC Medicaid Blue Cross Blue Shield – Federal and Commercial Cigna – HMO & PPO Cigna Allied Health Aetna – HMO & PPO Mamsi MDIPA Optimum Choice Alliance PPO United healthcare Unicare NCAS NCPPO Mutual of Omaha Foreign Service Benefit Plan Guardian IMF PHCS Elder Health If your health insurance is not listed, please give us a call so that we can verify if your insurance is covered as an “umbrella” policy under one of the plans listed above.  Please understand that the refractive eye evaluation, needed to determine maximum visual acuity potential and to prescribe glasses, are an integral part of the ophthalmological examination, but are non-covered by most medical insurance programs and therefore you are responsible for that fee at the time of service. HOSPITAL AFFILIATIONS Dr. Bert Souryal and Dr. Reginald Barnes are on the active staffs of the Washington Hospital Center and the George Washington University Hospital

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