Optometric

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GUIDELINES FOR OPTOMETRIST INVOICES

[pic] (Independent Optometric Corporate Franchises)

A. Invoice

B. “Summarized Sales Activity by Category” Report

C. “Service Summary” Report

Failure to submit all of these documents for each service period at each clinic at which the Optometrist has provided optometric services will result in delay for payment of the optometric fees.

If you have any questions regarding billing Image Optometry, please feel free to contact Image Optometry’s Accounting Department located at the Head Office. The Head Office phone number is 604-468-2609.

A. Invoice

The invoice generated and submitted by the Optometrist need only be a simple invoice. It must at least provide the information listed below.

1. The billing entity. This would be the name of the Optometrist or the name of the Optometrist’s optometric corporation.

2. The date that the invoice is generated.

3. The service period. This would be the time period over which the optometric services were provided. For example: 01 August 2009 to 31 August 2009.

4. The total amount owing. This should be broken down by clinic and then totaled.

The specific format of the invoice is left entirely to the discretion of the Optometrist. However, failure to include all of this information for each service period at each clinic at which the Optometrist has provided optometric services will result in delay for payment of the optometric fees.

B. “Summarized Sales Activity by Category” Report

The “Summarized Sales Activity by Category” Report is generated by the Optometrist through Image Optometry’s practice management software - - IFile. This report provides an overview of the type and number of all of the optometric services provided by the…...

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