no frame only on davis plans?

[Arturo Rios Jr]

my office manager said davis wont authorize a frame only claim....THIS CANT BE TRUE.

I'm calling in the morning asap but I had to get this out of my head. I will admit i'm only used to using eyemed but this makes no sense.

its an opthalmic frame she wanted a lens that wasnt available from the davis lab. I thought I handled the issue perfectly and she happily paid retail for the lenses. this is a winfall in my opinion.

[jpways]

The short answer is in the provider manual, it does not have the prohibition that most other insurances (like VSP and Eyemed) of a frame only without prescription lenses, but neither does it explicitly allow this claim type.

However, I still believe that you are correct in this, as I've done this in the past. Here's what I base my opinion on: from the patient rights (pages 20-21 of the manual) part 5, I have implied the benefit submission that you are talking about. And, I have submitted several claims doing this. The other information that I used to imply this benefit is that you can submit a provider supplied frame and patient supplied lenses, and we are reimbursed our frame allowance.

As an aside many plans that allow for medically necessary contact lenses (MNCL), when I have submitted a MNCL claim I reimbursed my U&C for that and the frame benefit is still available for submission (Which I have done a few time).

I hope this helps.