Here at opticXpress we always council our doctors to do their best to bill a patient's medical insurance vs. the patient's vision insurance whenever possible. Recently, Dr Augustin Gonzalez sent me this article he wrote that explains exactly why a doctor should do this.
"To my amazement, there continues to be plenty of confusion between eye care
professionals and patients about the role of vision plans and medical insurance. It is no wonder our patients are still more confused! Hopefully, the following information will help clear some of the confusion.
The proper usage of Vision Plans is indicated for refractive care. In other words Vision Care Plans are a pre-paid rider of your medical insurance that is intended to provide a service and a durable good at a reduced fee. It is limited to a refractive diagnosis with the doctor (optometrist mainly as ophthalmologist rarely take Vision Care Plans) performing a screening evaluation of the health of the eye and a full refractive evaluation of vision. Vision plans such as VSP, EyeMed, or Comp Benefits cover vision care diagnosis only, which is limited to the icd9 367.XX series of codes or what is commonly known as nearsighted, farsighted, and refractive astigmatism.
Many OD’s and in such many patients do not realize that Medical Insurance is the responsible entity to be used when a medical related eye problem is detected. Problems such as cataracts, dry eyes, infections, inflammation (even those cause by medical devices such as contact lenses), macular degeneration and complications from diabetes or high blood pressure are often found during the course of the eye evaluation. The management and medical decision process of these eye related medical conditions is not reimbursed by your vision plan.
Medical care involves those situations where during the course of the evaluation, a medical condition with a management decision is related to your eyes and there is a need for counseling, documentation, follow-up care, regular monitoring, prescription of medications or referral to a surgeon is indicate"
Call opticXpress today for more information on how we can help you properly use a patient's vision and medical benefits!
