JANUARY 2018 CI OPTICAL SELECTION GUIDE HEALTH CARE AUTHORITY VISION PROVIDERS

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Brittany Hines
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1 JANUARY 2018 CI OPTICAL SELECTION GUIDE HEALTH CARE AUTHORITY VISION PROVIDERS

CI OPTICAL Since 1997, the Washington State Correctional Industries (CI) Optical Program has been training their offenders to produce high quality, cost effective prescription eyewear.

2 CI OPTICAL Since 1997, the Washington State Correctional Industries (CI) Optical Program has been training their offenders to produce high quality, cost effective prescription eyewear. Our high capacity optical production facility is designed to supply large volume contracts as well as small entities. Our state of the art production facility is complemented by a highly experienced civilian supervisory staff ready to serve your vision hardware needs. In addition to our prescription eyewear services, we also offer a line of premade reading glasses designed specifically for the correctional/ institutional environment. MISSION STATEMENT As a business, Correctional Industries is committed to maintain and expand offender work training programs which develop marketable job skills, instill and promote positive work ethics, and reduce the tax burden of corrections. VISION STATEMENT Transform lives and increase successful reentry through training and mentoring. EYE WEAR REQUESTS Agency policy may affect eligibility. Please contact the CI Optical Lab if you have any questions. Providers, please include legible Rx with complete information, i.e., frame name, color, eye size, DBL (skull or cable temples), and any applicable codes. Do not Fax POF orders; jobs start when patient s frame arrives, and please include Rx with frame. CI Optical does not sell or credit frames for patients to try out. CLOSEOUT FRAMES All discontinued/closeout frames are final sale and cannot be returned. Quantities on hand are limited and only offered while supplies last. CI OPTICAL CUSTOMER CARE Hours of Operation: 7:00 am to 4:00 pm Monday - Friday Closed for Washington State observed holidays CIOpticalCustomerCare@doc.wa.gov TOLL FREE FAX

3 WOMEN S FRAMES Cindy 49/18/140 Samantha 48/19/135 AMBER BLACK/WHITE COPPER PLUM Sarah 50/18/135 AMBER BROWN ROSE

4 UNISEX FRAMES Canyon 47/18/140 Omni 49/21/135 AMBER PEWTER BROWN Pound 50/19/135 PEWTER BLACK CHERRY MEN S FRAMES Bobby 52/16/140 54/16/145 TORTOISE BROWN FADE GRAY FADE TAN

5 CHILDREN S FRAMES Brooke 47/17/130 Casey 45/15/125 CHERRY COTTON CANDY Romper /17/125 44/17/130 Sawyer 48/15/130 CHERRY NAVY MAUVE (Not Shown) Tommy 41/19/130 BROWN GUNMETAL

6 GENERAL INFORMATION PRICING FOR QUALIFIED CLIENTS OF SENATE BILL 5352 Frame Pricing Standard frames $10.00 Safety frames $25.00 Specialty frames $60.00 Package Pricing Single Vision Base Package: Standard Frame $10.00 Left Single Vision $6.00 Right Single Vision $6.00 Total $22.00 Bifocal Base Package: Standard Frame $10.00 Left Bifocal $11.00 Right Bifocal $11.00 Total $32.00 Trifocal Base Package: Standard Frame $10.00 Left Trifocal $16.00 Right Trifocal $16.00 Total $42.00 Single Vision Specialty Package: Durable or Flexible Frame $60.00 Left Single Vision $6.00 Right Single Vision $6.00 Total $72.00 Bifocal Specialty Package: Durable or Flexible Frame $60.00 Left Bifocal $11.00 Right Bifocal $11.00 Total $82.00 Trifocal Specialty Package: Durable or Flexible Frame $60.00 Left Trifocal $16.00 Right Trifocal $16.00 Total $92.00 PRICING FOR QUALIFIED CLIENTS OF SB 5352 (Continued) Options Pricing Slab off prism, plastic (per lens) $20.00 Lenticular (per pair) $30.00 Press-on Fresnel Prism (per lens) $20.00 Prism over 3 Diopters - Add per Diopter (per lens) $1.50 Mid Index (per pair) $40.00 High Index (per pair) $50.00 Polycarbonate lens (per pair) $30.00 Progressive lens- Added to trifocal price (per pair) $75.00 Photochromatic (brown or gray) (per pair) $50.00 Polarized (brown or gray) (per pair) $75.00 Antireflective coating (per pair) $40.00 Fashion Tints: Tint - solid (per pair) $5.00 Tint - gradient (per pair) $6.00 Tint - double gradient (per pair) $8.00 U-V lens coating (per pair) $6.00 Tint and U-V (2 or higher) (per pair) $11.00 Non-allergenic frame coating $10.00 Pattern fee for patient's own frame (per pair) $20.00 WARRANTY It is the policy of Washington State Correctional Industries (CI) to provide its customers with products and services that conform to their specifications and quality requirements. CI's goal is to achieve a constant high standard of quality while maintaining economical operations. All CI optical products are covered by a limited warranty as follows: Lenses are warranted for 90 days against manufacturer defect only. Lenses are NOT warranted against scratches. Due to time, exposure to elements and concealed damage working with patients own frame can be unpredictable. CI Optical does not accept responsibility for any outside frames sent in. CI Optical frames are warranted for one year against manufacturer defect only. Reworks due to doctor or dispenser errors, or patient satisfaction, are provided at no cost for the first rework within the first 90 days of original order and are billed at 100% thereafter. This only applies to prescriptions filled under Senate Bill All physician requested reworks filled for non-provider billed prescriptions are billed to the provider at 100% of the HCA contract price. All lab errors are reworked at no cost to the provider. CI OPTICAL CUSTOMER CARE CIOpticalCustomerCare@doc.wa.gov TOLL FREE FAX CA011 (R 01/2018)

MARCH Vision Care. Kansas Specific Information. Table of Contents

MARCH Vision Care. Kansas Specific Information. Table of Contents Kansas Specific Information This document contains information specific to the State of Kansas. Please refer to the Provider Reference Guide for general information regarding plan administration. Table