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Patient Information

Thank You for Choosing Vita Park Eye Associates,

We Look forward to seeing you soon!

Staff at Vita Park Eye Associates

 Appointment Paperwork

Patient InformationsTo make your visit go as smooth and quick possible we ask that you come prepared to your appointment. Below you will find the necessary paperwork we require to be filled out annually for each patient, feel free to print off and bring in the filled out forms to help cut down your time in our office.

Exam Information  Patient Medical History Patient Information  Privacy Policy Release of Records

Insurance Cards

We are providers for many insurance plans; please check below for our list of insurances that we do participate with. However, the most accurate way to ensure that we are providers for your specific insurance policy is to contact your insurance company by calling the number on the back of your insurance card.

In order to correctly process and receive payment for your visit with us, we ask that you present your insurance card at each visit. As providers, we have only a specific window of time that we can process your claim for you, if we receive your insurance card after this specified time your insurance may not process your claim for payment.

We will accept an insurance card by fax to help expedite claims in situations such as this. Please feel free to contact our billing department at 920-887-1151 if you have any questions on insurance or claims processing within our office.


It is always best to check with your insurance company to

verify eligibility with our clinic prior to your appointment.

We will submit a claim for the insurances listed below; however, we can not guarantee payment by your insurance. You are responsible for any co-pays, coinsurance, deductible amounts, and/or non-covered amounts by your insurance.

Insurance payment is based upon your individual benefits; you will need to contact your insurance company for further details.


Medicare Part B

Senior Plans
  • Network Health Platinum Plus
  • Anthem / Medicare Advantage Plan
  • Dean Care Advantage
  • Humana Gold
  • PacifiCare
  • Rail Road Medicare
  • United Healthcare Group Medicare Advantage
  • AARP Medicare Complete
Medical Assistance / BadgerCare
  • Standard Medical Assistance
  • Dean Health
  • BadgerCare Standard Plus
HMO's / PPO's / Other
  • Dean Care
  • Quartz
  • Network Health
  • Humana* - Non HMO Plans ONLY
  • Anthem
  • WPS
  • Healtheos
  • The Alliance
  • WEA
We do not accept any vision plans/insurance.

 Further information for Medical Assistance Patients

If you do not see your selected Medical assistance plan on our list, then we are not providers for your insurance.

Please be aware that there may be co-pays for your office visit or for the purchase of glasses that will be collected at the time of service.

We are providers for Badger Care Core Plan, however, this plan does not have a vision benefit, and you can only be seen for a medical reason. This plan does not cover eyeglasses.


FinancingIn today's economy, we understand that finances are rough on everyone. For that reason, we accept and are preferred providers for many insurances. We also offer financing and payment options for those who qualify.

We want to work together to provide exceptional eye care to everyone.

For your convenience we take the following forms of payment: Cash, Check, Money Orders/Cashiers Checks, Credit Cards: Visa, MasterCard, Discover, American Express, or Care Credit.

Care Credit is a medical financing option that can be used for eye exams, cataract surgery, premium IOL lenses, glasses, sunglasses & contact lenses. This can also be used at other medical offices, for more information or to apply please log onto

At this time we take Credit Cards in the office or over the phone only.

Co-pays/Patient Payments

If your insurance requires a co-pay we will ask for this to be paid at the time of service. Any outstanding balances on your account will also be collected at that time unless a payment arrangement has been set up with our office.

In addition to co-pays, payment on any glasses or contacts will be due on the date they are ordered. If a contact lens fit & teach is required these charges are extra and will be due at the time of service as well.

If you have any questions on charges that you may incur at your appointment or any finance questions, please click below to learn more about our options or contact our Billing Department with any further questions.

If you have questions concerning your upcoming appointment

please feel free to call or email our office.


In todays economy we understand that finances are rough on everyone. For that reason we accept and are preferred providers for many different insurances. We also offer financing and payment options for those who qualify. We want to work together to provide exceptional eyecare to everyone.

Learn More