Vision Service Plan (VSP)
All charges are to be entered in the patient’s ledger on the day of services, regardless of whether the patient or insurance will pay. The patient’s vision or medical insurance may affect the amount the patient will pay at the time of their visit to the Clinic. The financial class field on the patient’s computer record should reflect the patient’s insurance and, in some instances, the Billing Department will append an insurance screen to the patient screen in the computer.
We service several different VSP plans
Medi-Cal (Blue Cross and Alameda Alliance)
Regional
State
Signature
Exam Plus with allowance
Signature Choice
Access
Advantage
Patient’s or insurance subscriber’s last four digits of Social Security number is obtained at the time the appointment is placed. Patient’s eligibility is obtained from VSP through their web page, http://www.vsp.com, or by telephone (800-615-1883). If the patient is not currently eligible for services, the front desk staff will inform the patient. Eligibility clearance will state exact coverage for patient. Patient co-payments/ overages will be collected at completion of first visit.
The non-Medi-Cal VSP plans have allowances for exam and materials. In general, they are usually an either/or benefit for contacts. If your examination is going to involve contact lenses, please be aware that there are two types of plans: “total” and “exam plus.” If it is a “total” plan, you MUST ORDER CONTACTS on the day you see them. If it is an “exam plus” plan, you do not have to order contacts on the same day. If you have questions, please ASK! DO NOT SEND PATIENTS TO CHECK OUT BEFORE VERIFYING THIS INFORMATION!!!!
The Medi-Cal plans allow for an exam and glasses every two years with no co-pay. They will also cover an office visit with no co-pay. Glasses are covered every two years for children under 21 years of age.
List a refractive diagnosis as the first/primary when billing VSP for a routine exam.
For medically necessary contact lenses, a separate authorization is required with Medi-Cal (Blue Cross and Alameda Alliance), Regional, State, and Value plans. The Insurance Department has the forms required, so please ask for one. A separate authorization is not required with the other plans. This benefit is only available to patients under 21 years of age.