I see Eyezen+ is now offered by VSP.
Anyone know how I can access a printable page to show the add on fee for Signature and Choice plans? I don't see it on the March 2013 Lens Enhancement Chart.
Is it a "Near Variable Focus" bifocal lens? If so A or B?
Last edited by Uncle Fester; 07-29-2016 at 02:27 PM. Reason: tweak...
my lab said its categorized as digital aspheric sv lens and found in the eyefinity single vision drop downOriginally Posted by Uncle Fester
"One should either be a work of art or wear a work of art" - Oscar Wilde
33 for signature for plastic
80 % u&c choice for plastic
"One should either be a work of art or wear a work of art" - Oscar Wilde
I just billed an Eyezen for VSP and it was completely covered in CR39. Also it took me a bit to figure out that she SH needed to be entered as the OC height!
That was for Signature
Was digital sv a covered option on that patients plan? I have not seen one completely covered yet but we have not fit many either.
"One should either be a work of art or wear a work of art" - Oscar Wilde
It didn't specify. It wasn't under the 'covered with additional co-pays' either. I was surprised, I even gave her a higher estimate, figuring it would be around 20% of the U&C.
I'm not sure if this is a bug or intentional, but a similar thing happens when polycarbonate is covered the corresponding B code (the digital codes) BD comes up as covered. I don't believe this works with any other material because of how the other codes are written, i.e. Trivex is BA+BB so if I'm correct BA is included in the basic plastic service option which is always covered but BB is under the digital/aspheric option on the service record report which I've never seen as a covered option.
Which brings up another thing that bothers me (though would be explained by the above theory), why BA is never on the individualized enhancement lens charges, but BB, BD, BH, and BJ are.
In answer to the original question the Eyezen is in the the product index as being BA in plastic.
Last edited by jpways; 08-01-2016 at 09:37 AM.
This thread is old and I'm new to VSP and this Eyezen lens has me confused. I'm hoping by now people have a good grasp on billing Eyezen lenses and calculating co-pays. For example, the patient has VSP Choice and Digital aspheric lenses are not a covered for free option. It's covered at 80% of UC. I just spoke with a VSP rep and she said that the patient get's it for free as a covered SV item. Our Essilor contact, who is the Vision Source managed Care specialist, said he disagrees and that the patient should pay the 80% of the difference between the SV non digital price U&C and our Eyezen non digital price U & C as the SV non digital is covered and it's the aspheric component that's not. And of course any material upgrade charges as well at 80%. So I called VSP back again and got a different answer, though she said just enter the order in and when done you will know how much to charge the patient (yikes! I'd like to know ahead of time what we were are doing). Then you throw in the fact that kids get poly for free and it's confusing, but I would assume they would still pay the digital aspheric portion...but how to calculate the copay to the patient - child and adult. We sell this lens quite a bit to our non VSP patients and they love it, especially the college students.
If anyone can share how they calculate how much a patient owes for an Eyezen lens for the Choice Plan and the differences in amounts for a child vs adult.
For examples - this is my understanding ---help and correction if wrong.
U&C SV = A
U&C Eyezen = B
B-A = C X 80% = what we charge patient for BA portion.
If it's eyezen 1-3 also charge the TA fee of $10
Poly and a child - the poly is for free but I would assume I would still charge the B-A = C x 80% calculation above for the BA charge.
Poly and adult copay = B-A=CX80% BA aspheric portion + $40 poly
What if a child wants hi index - how do I separate out the poly portion that would be free, or does it not matter and since it's an upgrade patient doesn't get any benefit of poly being free.
Please HELP!
At my last office we used EyeZen lenses quite a bit, so you're definitely in luck!
Your calculations aren't quite what's going on, but I see the angle you're coming from. The SV lens and EyeZen are not what VSP are breaking down, it's the Digital Aspheric lens surfacing, since EyeZen can only be digitally surfaced. There is no price difference between child vs. adult aside from Poly being covered for the most part, just Signature vs. Choice and the plan options listed for each individual.
Lets say that SV CR39 (A) cost $95.00 and an EyeZen digital surfacing costs $175.00 (B) we would have as follows (which is more or less what you broke down above)
B - A = $100.00 - 20% U&C
Therefore B = $80.00
I'm not sure where you're getting the $10.00 fee from, but I never charged an additional fee on top for any of my patients.
In order to separate out anything, you have to figure out what the base price is for SV CR39 (A) and you would compare that against whichever material you're using, lets say 1.67 (C) which would look as follows:
C - A = Upcharge for High Index
So at this point you should have
A. CR39 base rate
B. EyeZen surfacing rate
C. High Index Rate
If you're doing High Index, you do NOT separate out the charge for poly unless the patient is getting poly.
Hope that's helpful! Feel fee to let me know if you need any clarification. :)
It does help, thank you Rai.de.soleil The TA of $10 is for eyezen 1-3. VSP will do a chargeback of $8 so I am going to charge the patient the $10 copay, otherwise I lose $8. It's listed under miscellaneous section code TA. VSP did confirm that it's required for Eyezen 1-3 as it's the measurements necessary to make the lens what it is.
I am making strides towards understanding this. I appreciate all the input.
You're very welcome. VSP Choice can be a little confusing. Feel free to reach out if you have any other questions!
I know this is an older discussion.. I always come to the party late. But, am I correct that VSP wil allow Eyezen 0 at no charge, but we do charge the Aspheric design for 1-4? Also, I understand that the TA is 0 also ( for the Eyezen 0). I have a discussion going on with different buddies from different companies. I just want to pick other peoples brains too..
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