Many doctors have difficulty explaining fees and charging what they're worth. Pamela J. Miller, O.D., F.A.A.O., J.D., recommends when fitting a bifocal, toric or a custom lens to cover a disfigurement, it's essential that you're paid for your time and expertise.

Diagnostic lenses and longer initial evaluations and fittings are major

components of the fee. If the patient requires an over-correction, address the fee up front. If it's a new fit, a global fee -- encompassing the examination, contact lens evaluation, diagnostic lenses, instruction, lenses and follow-up visits -- may be most appropriate. If it's a refit or a modification, your fees should reflect the complexity and time you'll spend.

The more complicated the fit, the greater the fee should be. But remember, it's always appropriate to fit what best meets the patient's needs, allows the greatest comfort and maximizes vision.