Hello all,
Have a quick question we ran into today. pt has EM, and has a PAL OS and SV balance OD. Entry and billing doesnt seem to allow diff lens styles. Am I missing something? Don't want pt to have to pay full PAL cost if only getting one.
Second option is to only order one eye, and edge SV in house, but still seemingly not able to just order 1 lens on EM order form online.
Thanks in advance for any assistance.
Best,
AA
Order 2 Progressives
I would enter as progressive "other" option and then price accordingly for one PAL and one SV lens.
Have I told you today how much I hate poly?
Disabuse yourself of the notion of:
a. billing single lenses to VCPs
b. "balance lenses" with VCPs.
I believe that this falls under an exception to the rules where this claim has to be done as a "private" job. Where you do the lab work privately and then bill Eyemed using a CMS-1500 form, making sure to supply the invoices with the claim. If this was me, I would still call Eyemed provider relations to make sure that I was remembering this correctly. But, I know I've had to do this several times in the past and at least one of those times was a case like this. There is a fax number to submit the claim to, but I have to hunt for it on Infocus everytime I need to do this. You will be reimbursed as if you did private lab work even if you are using a network lab, but I would check with Eyemed to make sure that you can edge both lenses in your own lab, if you have that option.
For the record the other cases I can remember having to do this on are one patient that fell outside of the acceptable ranges for the online submission system, it was a +8.00-8.75x167 that kicked me out. And the other case was an iseikonic job that I needed to do 2 different materials on.
Last edited by jpways; 01-04-2017 at 08:48 AM.
A sad state of affairs when a third party stands between you and your customer.
They're not our customers.
They're VSP or EyeMed "members". They joined the club.
They have special membership benefits.
We have oh-so-willingly decided to extend VSP or EyeMed's benefit confabulations to their members, for the pay that they've confabulated for us. We're contract labor.
They've outsold us. They've taken people off the market before we have had a crack at them.
In a perfect nutshell! Thanks Dr K!Originally Posted by drk
To the OP:
Stop wasting time trying to figure this out. Bill for a PAL pair. Or - if you just LOVE to loose money - waste inordinate amounts of time, trying to figure out the mathematical gymnastics of their claim system, write out a 1500 form, find, copy, redact as needed, and mail all your invoices to them. All for less money than if you just bill normally. You're not saving the patient any money of course, because your labor costs have gone sky high, and all for even less than their already pathetic disbursement to you in the end.
Why?!?!
I can't add to Ulleann's rep at this point, because mean Steve won't let me.
Thumbs up!
This!!!
We sell pairs only or they can find another sucke--um---another provider who will. Your bookkeeping will be a nightmare otherwise.
There are currently 1 users browsing this thread. (0 members and 1 guests)
Posting Permissions
Reply With Quote
Bookmarks