Patient Forms

Please browse through our patient information listed below - including patient registration forms, medical record release forms, insurance and vision plan information and CareCredit financing information.

We participate with most insurance and vision plans, please call 434.385.5600 to confirm participation with your plan

Insurance and Vision Plans

Harman Eye Center and its affiliate offices participate with the following insurance companies and vision plans:

  • Aetna
  • Anthem HMO (at certain locations)
  • Anthem PPO
  • Cigna
  • Coventry
  • Davis Vision
  • EyeMed
  • Humana (PPO/PFFS)
  • Medicaid (at certain locations)
  • Medicare
  • Medicare Private Fee-For-Service (PFFS)
  • Medicare Railroad
  • Medicare Replacement Plans
  • Optima
  • Piedmont Community Health Plan (Commercial/Medicare Advantage/HMO)
  • Spectera
  • Superior Vision
  • TRICARE Standard
  • United Healthcare
  • VA Premier
  • Veteran’s Choice
  • Vision Service Plan (VSP)

Participation with insurance and routine vision plans may vary by office. Please call 434.385.5600 Ext. 3 if you have any questions or to confirm participation with your plan.

For any and all billing, statement, or balance due inquiries only, please contact 877.969.0392.  All other clinical related questions should go directly through your physician’s office line.


At all of our locations, we gladly accept Medicare and participate with most insurance and vision plans. As a courtesy to our patients, we will file both your primary and secondary insurance forms.

Sunbit Financing

Sunbit is the preferred buy now, pay-over-time solution of service providers and retailers fulfilling the needs of thousands of local communities.

– 90% of customers approved
– 30-second approval process
– Easy to use in-store, online, and on-the-go
– No awkward conversations. No hassle at the time of payment. Just more great experiences for everyone.

Harman Eye Center gladly accepts CareCredit for payment for services – for more information or to apply online, please visit

Help pay for your family’s vision care with the CareCredit healthcare card. Use your credit card to pay for:

  • Glasses and sunglasses
  • Contact lenses
  • And more


CareCredit is a healthcare credit card designed exclusively for healthcare services with special financing options.*

Whether it’s a routine checkup or a LASIK procedure, you shouldn’t have to worry about how to get the best eye care.

Wells Fargo Health Advantage

Your best you is closer than you think! With Wells Fargo, you’ll find the widest array of monthly payment options to help your reach your individual wellness, beauty, and performance goals. Wells Fargo allows you to move forward today without delay. Plus, with special financing options not available with other credit cards, you may find Wells Fargo is the better way to pay. With Wells Fargo, you can receive the care your physician recommends with flexible payment options that fit your lifestyle. Apply today so you can focus on looking, feeling, and being your best.