CI Optical Selection Guide - Washington State Correctional Industries

WA S H I N G T O N S TAT E
CORRECTIONAL INDUSTRIES
M AY 2 0 1 6
CI OPTICAL SELECTION GUIDE
H E A LT H C A R E A U T H O R I T Y
VISION PROVIDERS
CI OPTICAL
Since 1997, the Washington State Correctional Industries
CI VISION STATEMENT
Optical Program has been training their offenders to
Transform lives and increase successful reentry through training
produce high quality, cost effective prescription eyewear.
and mentoring.
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
CI MISSION STATEMENT
highly experienced civilian supervisory staff ready to serve
As a business, Correctional Industries is committed to maintain
your vision hardware needs. In addition to our prescription
and expand offender work training programs which develop
eyewear services, we also offer a line of premade reading
marketable job skills, instill and promote positive work ethics,
glasses designed specifically for the correctional/
and reduce the tax burden of corrections.
institutional environment.
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.
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 — 888.606.7788
FAX — 888.606.7789
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TABLE OF CONTENTS
4
MEN'S FRAMES
Metal
Plastic
6
WOMEN'S FRAMES
Metal
Plastic
10
YOUNG ADULT FRAMES
Metal
Plastic
15
CHILDREN'S FRAMES
Metal
Plastic
20
SPECIALITY FRAMES
Metal
Plastic
22
SAFETY FRAMES
24
GENERAL INFORMATION
Pricing (SB5352 clients only)
Warranty
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MEN'S FRAMES
Icon
Pride
51/19/135 • 53/19/140
54/17/140
Spring Hinges
Spring Hinges
Antique silver
Black
black
brown
Brown
gunmetal
ZB008A
53/19/145  55/19/150
Spring Hinges
BROWN
GOLD
ANTIQUE SILVER
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MEN'S FRAMES
Nate
Matthew
48/18/135  50/18/135  52/18/140  54/20/145  56/20/145  58/20/150
54/17/140
Color not shown: BROWN FADE
grey
grey fade
olive
shadow
tortoise
Soho 1014
53/17/140
crystal/Black
black/red
black/blue
demi purple
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WOMEN'S FRAMES
Agnes
EQ201
52/18/135
50/18/140 • 52/18/145
Spring Hinges • Stainless Steel
brown
BROWN
lilac
PEWTER
rose
EQ202
50/19/135 • 52/19/140
GOLD
GUNMETAL
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WOMEN'S FRAMES
Maria
Metaflex 1029
53/17/135
51/17/140
Spring Hinges
Spring Hinges
brown
gold/pearl
burgundy
mocha/brown
violet
plum/pink
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WOMEN'S FRAMES
EQ303
Gracious
53/16/140
51/18/140
Spring Hinges
BLACK
black/blue
BROWN
black/violet
CHERRY
black/rose
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WOMEN'S FRAMES
Soho 108
Soho 1013
52/16/140
52/16/140
black/crystal
brown/brown
black/purple
brown/aqua
tortoise
wine/purple
Sunset
UL91
51/17/135
52/20/140
brown/orange
BROWN
grey/purple
PINK
olive/green
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Y O U N G A D U LT F R A M E S
ASAP
Cheerful
49/20/140
42/18/125 • 44/18/130
Spring Hinges
Spring Hinges
amber
black/silver
black
blue/silver
gold
brown/silver
Finale
Lucid
48/19/135 • 50/19/140
54/18/140
Spring Hinges
Spring Hinges
Antique Brown
black
antique silver
BROWN
gold
oRCHID
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Y O U N G A D U LT F R A M E S
SW312
Todd
49/20/140
46/18/135 • 48/18/140 • 50/18/145
Spring Hinges
Spring Hinges
Brown
Antique Brown
BLACK
ANTIQUE GOLD
GUNMETAL
MATTE BLACK
7724
Aurora
51/19/135
48/19/135
coffee
black
burgundy
brown
purple
burgundy
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Y O U N G A D U LT F R A M E S
Belong
Corvette
51/17/140
49/19/140
Spring Hinges
black/crystal
black
plum/crystal
blue
tortoise
lilac
Lindsay
Melissa
50/16/135
47/17/140
brown
black
burgundy
brown
violet
red
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Y O U N G A D U LT F R A M E S
Soho 1011
SW208
50/19/140
50/18/140  53/18/145
Spring Hinges
black/grey
BROWN
brown
GREY
purple
TORTOISE
SW 227
SW319
53/16/145
48/17/140
Spring Hinges
black/crystal
burgundy
plum
navy
tortoise
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Y O U N G A D U LT F R A M E S
SW 438
U-21
48/19/135
50/18/145
black
BLACK
brown
BROWN
Urban
51/17/140
Spring Hinges
BROWN/BLUE
Yale
46/19/135
crystal
black matte
crystal/black
navy/tortoise matte
black
tortoise matte
tortoise
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CHILDREN'S FRAMES
Hide & Seek
Junior
42/19/125 • 44/19/130
35/18/115 • 37/18/120 • 39/18/125 • 41/18/125
Spring Hinges
Spring Hinges
Brown
amber
Navy
blue
purple
rose
Pumpkin
40/16/120 • 40/16/C30 • 42/16/125 • 42/16/C35
Spring Hinges • Cable and Skull Temples Available
Antique Brown
blue
black
GOLD
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CHILDREN'S FRAMES
Kendall
Shortstop
45/17/130
43/17/120 • 45/17/125
Spring Hinges
Spring Hinges
black
black
brown
blue
Navy
ant brown
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CHILDREN'S FRAMES
Bashful
Bronx
42/16/130
46/18/130
Spring Hinges
Spring Hinges
black/crystal
black
blue/rose
brown/rose
burgundy/blue
tortoise fade
MP81
Peewee
38/15/140
36/14/115 • 38/14/120
Spring Hinges • Cable Temples
Spring Hinges
blue
BLUE
brown
BROWN
tortoise
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CHILDREN'S FRAMES
Solo Bambini frames on this page require prior authorization.
Itsy Bitsy
Teeny Weeny
30/13
35/14
Flexible • Safe
Flexible • Safe
Available colors:
Available colors:
100
101
102
103
103.1
104
100
101
102
103
103.1
104
Ice
Strawberry Ice
Pink
Turquoise Ice
Ice Blue
Blue
Ice
Strawberry Ice
Pink
Turquoise Ice
Ice Blue
Blue
105
106
107
108
109
110
105
106
107
108
109
110
Yellow
Watermelon Red
Green
Lavender
Denim
Root Beer
Yellow
Watermelon Red
Green
Lavender
Denim
Root Beer
111
117
Charcoal
Plum
ice blue
blue
strawberry ice
Toddler
yellow
40/15
Flexible • Safe
Rascal
Available colors:
43/16
100
101
102
103
103.1
104
Ice
Strawberry Ice
Pink
Turquoise Ice
Ice Blue
Blue
Flexible • Safe
Available colors:
105
106
107
108
109
110
100
102
103.1
106
109
110
Yellow
Watermelon Red
Green
Lavender
Denim
Root Beer
Ice
Pink
Ice Blue
Watermelon Red
Denim
Root Beer
111
117
111
115
116
117
Charcoal
Plum
Charcoal
Khaki
Orange
Plum
green
khaki
pink
orange
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CHILDREN'S FRAMES
Solo Bambini frames on this page require prior authorization.
Rookie
Scout
38/14 • 42/15 • 44/16
45/18
Flexible • Safe
Flexible • Safe
Available colors:
Available colors:
100
101
102
103
103.1
104
100
106
109
110
111
112
Ice
Strawberry Ice
Pink
Turquoise Ice
Ice Blue
Blue
Ice
Watermelon Red
Denim
Root Beer
Charcoal
Forest
105
106
107
108
109
110
113
114
Yellow
Watermelon Red
Green
Lavender
Denim
Root Beer
Red
Peony
111
117
Charcoal
Plum
denim
TURQUOISE ICE (38/14)
peony
plum (42/15)
Eagle Scout
50/20
Flexible • Safe
Available colors:
root beer (44/16)
Scout Master
55/22
100
102
109
110
111
112
Ice
Pink
Denim
Root Beer
Charcoal
Forest
113
Flexible • Safe
Red
Available colors:
100
109
110
111
112
113
Ice
Denim
Root Beer
Charcoal
Forest
Red
forest
ice
red
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S P E C I A LT Y F R A M E S
Specialty frames may require authorization.
Jim
Josh
54/18/140
49/18/135
Flexible Frame • Color not shown: GUNMETAL
Flexible Frame • Color not shown: antique blue
gold
black
satin brown
coffee
Jayme
Paige
41/18/120
46/20/135
Flexible Frame
Flexible Frame
LIGHT BROWN matte
Brown
NAVY
gunmetal
PLUM
wine
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S P E C I A LT Y F R A M E S
Specialty frames may require authorization.
Stan
All American
54/18/140
See Frame Sizing Below
Flexible Frame
Durable, Athletic Frame • Adjustable Strap • Colors not shown: See below
coffee
black
Not Shown: BLUE W/WHITE BRIDGE, BROWN W/TAN BRIDGE, WHITE, GRAY W/BLACK
BRIDGE, RED W/BLACK BRIDGE, RED W/WHITE BRIDGE
Eye Size
DBL
Temple
44
20 or 23
Adjustable
47
20 or 23
Adjustable
50
20 or 23
Adjustable
53
23
Adjustable
Eye Size
DBL
Temple
42
18, 20, 22
130, 135, 140, 145, 150
44
18, 20, 22
130, 135, 140, 145, 150
46
20 or 22
130, 135, 140, 145, 150
48
20 or 22
130, 135, 140, 145, 150
50
20, 22, 24
130, 135, 140, 145, 150
52
20, 22, 24
130, 135, 140, 145, 150
GOLD
Apollo
See Frame Sizing Below
Durable Frame
gunmetal
black
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SAFETY FRAMES
Specialty frames may require authorization.
SC 900
SP 83
52/14/140 • 54/14/145 • 56/15/150
50/20/140 • 52/20/145 • 54/20/150
Durable Z87 Rating • Available with Side Shields
Durable Z87 Rating • Available with Side Shields
Brown
Brown
grey
smoke
tan
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GENERAL INFORMATION
PRICING FOR QUALIFIED CLIENTS OF SENATE BILL 5352
PRICING FOR QUALIFIED CLIENTS OF SB 5352 (Continued)
Frame Pricing
Options Pricing
Standard frames
$10.00
Slab off prism, plastic
(per lens)
$20.00
Safety frames
$25.00
Lenticular
(per pair)
$30.00
Specialty frames
$60.00
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
Package Pricing
Single Vision Base Package:
Standard Frame
$10.00
Left Single Vision
$6.00
Progressive lens- Added to trifocal price
(per pair)
$75.00
Right Single Vision
$6.00
Photochromatic (brown or gray)
(per pair)
$50.00
Polarized (brown or gray)
(per pair)
$75.00
Antireflective coating
(per pair)
$40.00
Tint - solid
(per pair)
$5.00
Tint - gradient
(per pair)
$6.00
Tint - double gradient
Total
$22.00
Bifocal Base Package:
Standard Frame
$10.00
Left Bifocal
$11.00
Right Bifocal
$11.00
Total
Fashion Tints:
$32.00
Trifocal Base Package:
Standard Frame
$10.00
Left Trifocal
$16.00
Right Trifocal
(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
Pattern fee for patient's own frame
$10.00
(per pair)
$20.00
$16.00
Total
WARRANTY
$42.00
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.
Single Vision Specialty Package:
Durable or Flexible Frame
$60.00
Left Single Vision
$6.00
Right Single Vision
$6.00
Total
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 5352. 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.
$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
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CI covers all Solo Bambini frames for eligible clients when all the
following clinical criteria are met:
• The client is age four or younger.
• The provider has documented the reasons that the standard CI
Optical frames are not suitable for the client.
To receive payment, providers must follow the agency's EPA process.
See EPA #611.
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WA S H I N G T O N S TAT E
CORRECTIONAL INDUSTRIES
Department of Corrections
PO Box 41115
Olympia, Washington 98504
CI OPTICAL CUSTOMER CARE
CIOpticalCustomerCare@doc.wa.gov
TOLL FREE — 888.606.7788
FAX — 888.606.7789