VSP special lens allowance and Ipseo Eyecode

[DrHass]

Hello,

So I've recently installed a visioffice in my practice and I'm trying to wrap my head around billing these Eyecode lenses to VSP.

VSP does not cover the eyecode so if the patient wants an Ipseo eyecode lens you have to use what VSP calls the SLA and get it from a private lab, VSP reimburses you.
So far no problem, it's relatively easy to figure out what VSP and the patient pay with the formula.

What I don't understand is how do you handle other lens options that VSP would otherwise cover. The Ipseo is only available with AR. so let's say the patient wants an Ipseo with AR and Transitions, do you have to handle the whole thing thru SLA or does VSP somehow handle the AR and transition component like normal?

Has anyone done this?

-Steve

[Uncle Fester]

No. Years ago after several very frustrating events our Doc's and bookkeeper do not want us to do any vsp job under special lens options.

Perhaps someone else had more positive outcomes.

Kind regards and welcome to Optiboard!

[B101875]

When I have done lenses that one part is not covered. All parts are not covered. But when in doubt Call VSP.

[Java99]

No. Years ago after several very frustrating events our Doc's and bookkeeper do not want us to do any vsp job under special lens options.

Perhaps someone else had more positive outcomes.

Kind regards and welcome to Optiboard!

This was my past experience as well. At that office we ended up just doing a straight discounted job as it wasn't covered. Don't know how kosher it was, wasn't my call.

[DanLiv]

VSP Special Lens procedure:"Charge your patient 80% of your U&C fee, minus the lens allowance (Signature and Choice plan allowances listed below) and your scheduled lens dispensing fee. Options normally covered for your patient aren’t considered a covered option under the Special Lenses calculation."We’ll reimburse you for the lens allowance, in addition to your scheduled lens dispensing fee and other fees that may apply."The net effect is private lab eyewear at a 20% discount off U&C. It's actually fantastic for everyone involved if your patients are ok with the expense.

[AustinEyewear]

Hello,

What I don't understand is how do you handle other lens options that VSP would otherwise cover. The Ipseo is only available with AR. so let's say the patient wants an Ipseo with AR and Transitions, do you have to handle the whole thing thru SLA or does VSP somehow handle the AR and transition component like normal?

Has anyone done this?

-Steve

Haven't done it, nor have we called VSP, but its our opinion it all or nothing. Since lens is only available with A/R already on, submit the whole reimbursement under SLA.

Did you get to the bottom of this yet?

[DrHass]

Haven't done it, nor have we called VSP, but its our opinion it all or nothing. Since lens is only available with A/R already on, submit the whole reimbursement under SLA.

Did you get to the bottom of this yet?

According to VSP on the covered options I charge the pt the VSP pt fee for my U&C whichever is lower, which obviously is the VSP pt fee.

So you do well on the eyecode but AR, Transitions etc not so well... in the end you do better then selling them an "N" but its more of a paperwork burden.

[B101875]

I learend something this week. Use the Unity pal. If you can. That will let you do alot of free up grades w/ out the charges.