VSP insurance billing?
Posted in Optical by admin | December 15th, 2008
Deidre W asked:
I used to do insurance billing for an optometrist, who also did my eye exams as well. When I first started there, I still had Vision Service Plan from my previous employer. My contact lenses are considered medically necessary because of my strong RX, however, I am very easy to fit for contacts because my RX has been stable for a few years, and I have no other problems. We had several other patients who also had medically necessary contacts, but most were more difficult to to fit. However, he was billing for the same amount of money for me as he was for people who required several follow-ups and multiple pairs of trial lenses in various RX’s. This seems unethical. Should I have reported this to VSP? I had no previous billing experiance prior to this, so I didn’t think anything of it at the time.
Please don’t answer if you have no actual knowledge of insurance billing practices. Thanks.
He was billing the actual lenses for about $200 more than he would bill the same lenses for if someone did not fall into the Medically necessary catagory. The same exact lenses. Also, when people had double coverage, and wanted non-prescription sunglasses, he would have us order a pair of glasses with RX lenses, then when they got there, he would take out the RX lenses and put plano tinted lenses in them. On occasion, he would have us bill VSP as the primary insurance when another company was in fact the primary insurer.
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I used to do insurance billing for an optometrist, who also did my eye exams as well. When I first started there, I still had Vision Service Plan from my previous employer. My contact lenses are considered medically necessary because of my strong RX, however, I am very easy to fit for contacts because my RX has been stable for a few years, and I have no other problems. We had several other patients who also had medically necessary contacts, but most were more difficult to to fit. However, he was billing for the same amount of money for me as he was for people who required several follow-ups and multiple pairs of trial lenses in various RX’s. This seems unethical. Should I have reported this to VSP? I had no previous billing experiance prior to this, so I didn’t think anything of it at the time.
Please don’t answer if you have no actual knowledge of insurance billing practices. Thanks.
He was billing the actual lenses for about $200 more than he would bill the same lenses for if someone did not fall into the Medically necessary catagory. The same exact lenses. Also, when people had double coverage, and wanted non-prescription sunglasses, he would have us order a pair of glasses with RX lenses, then when they got there, he would take out the RX lenses and put plano tinted lenses in them. On occasion, he would have us bill VSP as the primary insurance when another company was in fact the primary insurer.
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Tags: Glasses, insurance billing, Rx Lenses