Medicare post cataract and the Optical Shop

[specs4you]

Being new to working in a strictly Optical shop (no Dr. in house)
No not a chain store.........a ma pa store......delightful...as a sidebar...

I am stumped and not sure the same rules apply to Medicare patients who are
post cataract. Will they be reimbursed from us and /or do they have to go back
to their surgeon's office for the proper codes and I.D. number since we are not
a provider? They ask all the time and we feel bad that we cannot tell them how
to go about this and we want to be as accurate as possible and helpful.

Any ideas? I remember working for an O.D. who was a provider and a Medicare biller
that it had certain perameters IOL, timeframes betweent he two eyes etc.

Help please?

[braheem24]

Fill out the following:

http://www.cms.hhs.gov/cmsforms/down...0s-english.pdf

under describe illness write "V43.1" and put the dates of the cataract surgery. include a receipt from you with the V codes (V2020, V2203, etc) everything else is self explanatory.

Check here: http://www.cignagovernmentservices.c...ntactinfo.html to see where Lala land patients submit thier forms.

put a stamp on it and give it to the patient to send in, Do not send it in yourself otherwise they will call YOU instead of medicare wondering when their reimbursement will arrive.

[obxeyeguy]

Don't forget your surety bond. I believe you need this whether you accept assignment or not.

[Johns]

Don't forget your surety bond. I believe you need this whether you accept assignment or not.

Oh well...I guess I'm not the detail oriented kind of guy I should be...

[wel52]

Fill out the following:

http://www.cms.hhs.gov/cmsforms/down...0s-english.pdf

under describe illness write "V43.1" and put the dates of the cataract surgery. include a receipt from you with the V codes (V2020, V2203, etc) everything else is self explanatory.

Check here: http://www.cignagovernmentservices.c...ntactinfo.html to see where Lala land patients submit thier forms.

put a stamp on it and give it to the patient to send in, Do not send it in yourself otherwise they will call YOU instead of medicare wondering when their reimbursement will arrive.

I was under the impression that this form could only be used "once in a lifetime" for any type of Medicare reimbursement. If they use it for one eye, then it would not be available to use for the other eye, or anything else that might come up in the future...sort of Medicare's way of making sure the patient goes to a participating provider...any comments?

[a1vo]

I was under the impression that this form could only be used "once in a lifetime" for any type of Medicare reimbursement. If they use it for one eye, then it would not be available to use for the other eye, or anything else that might come up in the future...sort of Medicare's way of making sure the patient goes to a participating provider...any comments?

Don't forget your surety bond. I believe you need this whether you accept assignment or not.

Form 1490S can be used once per MediCare patient.

With this form, you do not need to be an "in-network" provider (i.e., no surety bond needed). You take $$ directly from your patient and he/she get the "reimbursement" directly from Medicare.

[a1vo]

Fill out the following:

http://www.cms.hhs.gov/cmsforms/down...0s-english.pdf

under describe illness write "V43.1" and put the dates of the cataract surgery. include a receipt from you with the V codes (V2020, V2203, etc) everything else is self explanatory.

I never know the time limit to use this from. I assume within 1 year from the date of the cataract surgery is OK. Anyone know what is the time limit to use form 1490S?

[rbaker]

Stop wasting taxpayer money. Repeal this benefit from Medicare and private insurance plans. there is no need for this so called benefit today.

Please get your hand out of my pocket.

[finefocus]

Oh, by the way, did you do an ABN (Advance Beneficiary Notice)? And a "Detailed Prescription" (the doctor signs off on every line item, every lens option, et.)? If you take assignment (the original poster almost certainly doesn't) you have to do lots and lots of paper. Oh yeah, almost forgot the "Delivery Receipt", where the patient formally acknowledges receipt of the glasses. Medical practices, who cannot afford any interruption of Medicare payments, have many hoops through which to jump!

[DragonLensmanWV]

Stop wasting taxpayer money. Repeal this benefit from Medicare and private insurance plans. there is no need for this so called benefit today.

Please get your hand out of my pocket.

But if they do you'll be shouting about how they're cutting back Medicare to screw seniors by the Obama administration.