Process these orders as you would under the main plan (e.g., Signature). Vision Service Plan (VSP) is an affordable insurance plan that specifically covers vision related needs. Call Member Services at 800-877-7195. Prescription Lenses You must have a contact lens procedure code (92326, 92310, 92311, 92312) recorded in an exam record or on a fee slip with contact lenses in order to receive the correct out-of-pocket calculations. Cigna orders will indicate a Choice benefit type and require special procedures if accompanied by comment codes L020 or L098. * Enjoy a higher frame allowance when you purchase a featured frame brand. Orders VSP will pay you your base lens prices and Choice/Advantage Plan option fees for material ordered and supplies to VSP doctors. VSP doctors are located in retail, neighborhood, medical and professional settings. Essentials Plan orders are generally submitted to your lab through Eyefinity. Additional Pair plans offer an additional pair of glasses under the same plan as the first pair. American Red Cross charity claims are only billable through a VSPOne lab. If you are a participating National Medicaid Plan lab, charge according to the National Medicaid Plan Fee Schedule. Orders submitted through eClaim must be processed and completed per your normal means, but billed as a private order. If your patient changes his or her mind and wants to select other products, simply update the order or fee slip and recalculate the out-of-pocket expenses. Billing Under these circumstances, process the order, but bill the doctor privately for your services. From within the Eyewear Order, Soft Lens Order, Hard Lens Order, or Fee Slip windows, click, Review the out-of-pocket calculations with the patient. To determine your private add-on price, deduct your lab’s private price for the base lenses from your private price for the material ordered. The VSP Signature Plan is a premier full-service plan that offers the lowest costs, a focus on health, and real provider choices. All American Red Cross orders must be processed through any VSPOne lab. Enhance your plan even further by adding one of these supplemental benefits. Doctors are informed if a patient has interim benefits through a comment code. Paper orders will be submitted to your lab with a Materials and Interim Benefits Pre-Certification Request form attached. … If you choose to see a doctor who is not in the VSP Signature network, your out-of-pocket costs will likely be higher and you must submit the itemized receipts to VSP … The Advantage Exam Plus with Allowances Plan was designed for the health plan market. Total Cost for Service. SM. Employee and City premium rates are subject to change each year in January in accordance with contract renewals. 3 Benefits through a VSP Preferred Provider Exam Services • Members receive 20% off an eye exam if needed • Optional: An eye exam may be added to the ProTec Safety Plan for an additional cost. Get a $120 frame allowance toward the purchase of any frame brand, or get a $160 frame allowance on a featured frame brand. PROVIDER CHOICES YOU WANT. Interim Benefits are an optional VSP WellVision® enhancement that provides coverage for services and materials obtained when a member is not eligible for services or materials under their regular plan. Please notify the doctor before processing these orders. Date of Service on or after 01/01/2015: New VSP Exam Plus Savings Plan The new Exam Plus Savings Plan combines VSP’s low-cost covered-in-full Exam Plus benefit along with the enhanced value of the Vision Savings Pass program, offering VSP members a competitive national fee schedule, guaranteed pricing on lens enhancements, and discounts on frames and contact lens exams. 63826 VCCL 7/20 . Orders Please refer to the patient’s option information for coverage. The name Vision Service Plan and the registered logo(s), service mark(s), and trademark(s) owned by Vision Service Plan or any of its subsidiaries or affiliates, and the contents of this site may not be used in any advertising or publicity, or other use without the prior explicit written permission of Vision Service Plan (VSP). Doctors are required to obtain authorization from the VSP Provider Services Support Line for orders submitted through Eyefinity. VSP will pay you for materials supplied to VSP doctors. VSP doctors are located in retail, neighborhood, medical and professional settings. Orders Provider Choices VSP Elements is a new covered-in-full program that supports the pediatric vision essential health benefit under the Affordable Care Act (ACA). If you are a participating California Medicaid lab, it is advisable that you contact the doctor to verify that the order does not require the use of a PIA lab. VSP's Standard Option plan comes with a $120 or $160 frame allowance. VSP is packaged with medical or dental coverage on a joint Orders Choice/Advantage Plan orders are generally submitted to your lab through Eyefinity. If you receive an Elements order, void the order back to the doctor. If you are not a participating National Medicaid Plan lab and would like to be included on the list of labs agreeing to charge according to the fixed fee schedule, please contact Plexus Optix at plexusoptix@vsp.com for further information. VSP Proprietary 8/11 VSP Signature Plan® The VSP Signature Plan is a premier full-service plan that offers choice, flexibility, and maximum value through a VSP Preferred Provider. Billing Billing Interim Benefits may be covered for an exam, frame, and an additional pair of lenses, including elective contact lenses. You have the right to contact VSP at 800-877-7195 to request a printed directory. Orders It is the doctor's responsibility to check the patient's aid code before sending Medi-Cal orders to a lab. You are responsible for … Sight for Students charity claims are only billable through VSPOne Columbus. The Signature Plan uses set fees for prescriptions and offers a choice of approximately 80 options. Save on eyewear and eye care when you see a VSP network doctor. (SIGNATURE ENHANCED) AND VSP. Signature plan C with a $15 exam copay and $30 materials copay These VSP plans are only available to groups headquartered in one of the following states: CA, CO, GA, IA, IL, IN, KS, MI, MN, MO, NC, NJ, NV, OH, OK, SC, TN, TX and WV. Orders Call VSP member services at 800.877.7195 for assistance. All other brands or marks are the property of their respective owners. Pricing VSP Orders. Doctors are instructed to order Exam Plus with Allowances Plans orders from your lab on a private paper order form or through Eyefinity. This important and unlimited plan goes beyond routine eyecare and provides additional coverage for medical and urgent eyecare services including supplemental medical coverage for specialty eyecare services and conditions such as pink eye, and other urgent eyecare needs. Please follow the same instructions as the Choice/Advantage Plans, Single Vision, Bifocal, and Trifocal lenses designed for computer use. For more information, please call VSP at 1.800.877.7195, or visit them online at www.vsp.com. VSP Choice Preferred Providers • 41,000 access points nationwide. VSP will pay you for the materials and/or services you provide on Repair orders. Their eye exam co-pay $15 and there is a co-pay of $25 for prescription glasses. The balance for our glasses after our VSP coverage was only $55 for all three of us! Billing The program provides vision exams and glasses to uninsured children across the country. If your lab receives a VSP Materials Invoice form with a copy of a Gift Certificate attached or an eClaim order with Lab Comment Code(s) L096 or L097, notify the doctor that you cannot bill VSP for the materials. For product support, check out the Support Community. VSP, WellVision Exam, and VSP Choice Plan are registered trademarks, and VSP Laser VisionCare Program is a service mark of Vision Service Plan. Billing ... ©2012 Vision Service Plan. If you receive an order with “ProTec” indicated in the Benefit Type box, please return it to the doctor unless it includes Comment Code L099. If an ophthalmic lens does not have an option (for example, a coating), mapped, then. $276.32. Here are the options for you to structure your plan contribution levels. Vision care: Part of any balanced healthcare picture. If you receive an order with Medi-Cal in the Benefit Type box, you may process it and bill the doctor privately or according to the National Medicaid Plan Fee Schedule. VSP Network Providers are offered ongoing Cultural Competency education and training. Orders are identified by the word “Repair” indicated in the Benefit Type box. Signature Plan orders are generally submitted to your lab through Eyefinity. Bill doctors on a private invoice for Medicaid orders. For example, if a doctor orders a pair of progressive lenses and your private price for the progressives is $100.00 and your private price for bifocals (base lens) is $30.00, charge the doctor $70.00 for the add-on ($100-$30=$70) as well as the bifocal fee listed on the Advantage Exam Plus with Allowances Plan fee schedule. VSP will pay you your base lens prices and Choice/Advantage Plan option fees for materials ordered and supplied to VSP doctors. VSP Choice Plan ... towards the cost of laser vision correction surgery. Featuring Otis & Piper™ Eyewear a collection of frames designed specifically for children. Orders for CVS lenses are identified by “CVC” in the benefit type box. All VSP contract labs participate in the Signature Plan, which offers competitive prices to VSP members and groups. You can recognize a Plano plan by the word "Plano" in the Benefit Type box. If your lab receives a VSP Materials Invoice form with a copy of a Gift Certificate attached or an eClaim order with Lab Comment Code(s) L096 or L097, notify the doctor that you cannot bill VSP for the materials. photochromic, sunglasses, and plano lenses), Patients must be currently eligible to receive lenses to obtain materials, Coordination of benefits is not permitted, If an “S” appears in the tint position on a patient’s plan grid, he or she may receive a rose or pink #1 or #2 tint or a rose or pink tint that does not exceed 20% absorption—these patients may elect to incur the extra cost of obtaining another color as long as the absorption level remains within the 20% limitation, If an “N” appears in any grid position, the option is not allowed and payment for materials will be denied. The name Vision Service Plan and the registered logo(s), service mark(s), and trademark(s) owned by Vision Service Plan or any of its subsidiaries or affiliates, and the contents of this site may not be used in any advertising or publicity, or other use without the prior explicit written permission of Vision Service Plan (VSP). Compare VSP's Signature and Choice vision plans and get a quote today! $1,000 (less any amount paid for supplemental testing) per member every two years . Return the VSP Materials Invoice form and the copy of the Gift Certificate to the doctor’s office or void the order through Eyefinity unless the doctor indicates an urgent need. Billing Bill doctors privately for Access and Access Indemnity orders. This calculator takes the guess work out of determining the patient’s out-of-pocket expenses on the Rx windows and calculating the patient’s benefits on the Fee Slip window! Doctors are instructed to order Medicaid orders from your lab on a private paper order form or through Eyefinity. Once your benefi t is eff ective, visit vsp.com for details. My husband, daughter, and I all went to the doctor and got eye exams and new glasses. The state contributes $8.64 (or it is part of the Coben allowance), the equivalent of the Basic Plan cost. This program was designed to provide eye exams and prescription eyewear to people who have lost their glasses during a disaster or other emergency and are not currently eligible or covered for new services and materials through a vision insurance plan. If you are a participating Advantage Exam Plus with Allowances Plan lab, charge according to the Advantage Exam Plus with Allowances Plan Fee Schedule. Billing $20 … All Sight for Students orders must be processed by VSPOne Columbus. The VSP Choice/Advantage Plans are a modified version of the VSP Signature Plan. VSP gives your clients and their employees the vision care they want: low out-of-pocket costs, savings on eyewear and more. Billing Date of Service on or after 01/01/2015: These high quality plans are versatile and cost competitive. Employer-Paid Options for Signature Plan • Option 1: Employer contributes 100% for employees and dependents. • Option 2: Employee contributes some level of premium. All information is provided in real time so that you can help patients decide what products are right for them before they make their final purchases. For a complete proposal or for a network access report, please contact your VSP Representative. VSP seems to be a campaign to funnel business to specific retailers and then over-charge because most people will not question the cost of the glasses. The City Offers Two Vision Plan Options Through Vision Service Plan (VSP) VSP Signature; VSP Choice; Cost. These high quality plans are versatile and cost competitive. Orders submitted through eClaim must be processed and completed as normal, but billed to the doctor privately. Or get 20% off from any VSP doctor within 12 months of your last WellVision Exam Contacts • 15% off cost of contact lens exam (fitting and evaluation) Laser Vision Correction • Average 15% off the regular price or 5% off the promotional price. Click. Your provider can charge a maximum of $60 for the fitting and evaluation. The Access and Access Indemnity Plans provide discounts to patients for basic materials and services. Cigna vision plans differ from VSP’s Choice Plans. On paper orders, the doctor will write “Medicaid” and include the patient’s authorization number. VSP has enhanced their premier full-service, VSP Signature Plan, to … VSP funds a vision care program through the American Red Cross. Coverage with Costco is avaliable only with the VSP Premier Plan. Process and complete these orders per normal procedures. Orders If you receive and process a charity order, bill the doctor on a private invoice. Billing The State of California has mandated that certain Medi-Cal orders be completed by Prison Industry Authority [PIA] labs. totaling indirect costs such as legal fees, judgments, and the cost of training replacement workers. VSP’s CVC Plan is intended to provide materials to patients who work extensively at a computer. VSP will pay you your base lens prices and Signature Plan option fees for materials ordered and supplied to VSP doctors. The online directory is updated more frequently than printed directory. The Medicaid plan offers low-cost vision coverage to patients. Single Vision, Bifocal, and Trifocal lenses that differ from the patient’s dress wear by 0.50 or more diopters. VSP will not pay unauthorized labs for materials provided under this plan unless accompanied by Comment Code L099. Elements claims are only billable through VSPOne Columbus, Ohio. Orders Return the VSP Materials Invoice form and the copy of the Gift Certificate to the doctor’s office or void the order through Eyefinity unless the doctor indicates an urgent need. The VSP Signature Plan is a premier full -service plan that offers choice, flexibility, and While it is possible to have this type of surgery covered by VSP, there are some caveats and requirements in place which you must follow. To determine your private add-on price, deduct your lab’s private price for the base lenses from your private price for the material ordered. Signature network doctors is available at www.messa.org or www.vsp.com. $774. The Price Order window provides cost estimates and patient out-of-pocket charges for all products, including lenses and frames, sold to patients participating in the Signature, including Additional Pair; VSP Choice, including Additional Pair; Exam Plus; and Exam Only plans; in addition to the VSP Signature Choice plan. Orders Plano benefits provide a frame and plano lenses to members of certain groups. Guaranteed Lowest Out-of-Pocket Costs Our Member Promise guarantees that employees are completely satisfied with their eye care and eyewear from VSP network VSP Proprietary 8/11 VSP Choice Plan® The VSP Choice Plan is a premier full-service plan that offers choice, flexibility, and maximum value through a VSP Choice Provider. Any item not listed on that fee schedule should be billed to the doctor according to your private add-on price for that product. The VSP Choice/Advantage Plans are a modified version of the VSP Signature Plan. VSP Signature & VSP Choice Plans Below is a summary of benefits available through VSP’s Signature and Choice Plans. VSP Preferred Providers • VSP has 44,000 access points nationwide. VSP Signature Plus Plan Each member on your plan can personalize their benefit with ease. Primary EyeCare PlanSM Photochromic LensescopayPlastic $62 single vision or $76 multi-focal copay Supplemental coverage for non-surgical medical eye conditions, such as pink eye and other urgent eyecare - $20 per visit As a VSP member you can access language interpreter services at no cost. Sight for Students is a program developed and funded by VSP. Under these circumstances, process the order, but bill the doctor privately for your services. VSP will pay your lab for materials for ProTec orders with this comment code. Orders Billing One such need is Laser-Assisted Stromal In-situ Keratomileusis (LASIK). VSP’s Repair Plan allows a patient’s frames or lenses to be repaired or replaced. These high quality plans are versatile and cost competitive. Complete the order and send this form to VSP for Payment. Orders and Billing VSP Signature Plan The Signature Plan is a premier full-service plan with choice, flexibility and maximum value ... VSP will pay 75% of the cost for approved low vision aids, up to the maximum of $1,000 (less any amount paid for supplemental testing) per member every two years Billing Choice/Advantage Plan orders are generally submitted to the lab through Eyefinity. If the order does not contain one of these comment codes, process it as you would a Signature or Choice Plan order, according to the benefit type indicated. Bill doctors on a private invoice for orders with comment codes L020 or L098, otherwise, bill according to your Signature or Choice Plan methods. Orders Bill doctors on a private invoice for Exam Plus with Allowances Plan orders. • VSP will pay 75% of the cost for approved low vision aids, up to the maximum of . The services or materials covered and the criteria for approving interim benefits may vary by group. Orders The coverage provided for the State of California is either VSP Choice or VSP Advantage Plan. Billing It’s essential to check for eye health risks associated with improper wearing or fitting of contacts, because if left untreated they can affect the overall health of your eyes. Due to the cost of eye care without insurance, my family has neglected going to the eye doctor. Signature network doctors is available at www.messa.org or www.vsp.com. The Essentials Plan is a modified version of the VSP Signature Plan. If the patient changes his or her mind, perform the following steps: Update the Eyewear Order, Soft Lens Order, Hard Lens Order, or Fee Slip window as needed. VSP reimburses doctors directly for these orders. Orders If you receive a VSP Materials Invoice and CMS-1500 form for a Medicaid order, return them to the doctor and proceed with the job as you would a private order. As a VSP® member, you get personalized care from a VSP network doctor at low out-of-pocket costs. ***The Employee Monthly Contribution refl ects your contribution to the Premier Plan cost. The Price Order window provides cost estimates and patient out-of-pocket charges for all products, including lenses and frames, sold to patients participating in the Signature, including Additional Pair; VSP Choice, including Additional Pair; Exam Plus; and Exam Only plans; in addition to the VSP Signature Choice plan. VSP Signature Plan ® Premier Coverage ... Other LASIK procedures may be performed at an additional cost to the member. Providers Choices Please notify the doctor before processing these orders. VSP Laser VisionCare discounts are only available from VSP-contracted facilities. Billing With VSP Signature With VSP Choice With other insurances Without insurance VSP Signature Plan' VSP Choice Plan' hdependent Sears@ Eye Care Providers Pearle Vision' The research2 conducted by Service Excellence Group, Inc. compared the same, popular, eyeglasses at independent doctors and retail chains. The Standard plan covers a comprehensive eye exam, as well as prescription glasses or contact lenses, with very reasonable co-pays. * Deductible applies to a complete pair of glasses or to frames, whichever is selected **Lens option member costs vary by prescription and plan chosen. lens options, from the same VSP doctor on the same day as your WellVision Exam. V ALUE AND SAVINGS YOU LOVE. Any item not listed on that fee schedule should be billed to the doctor according to your private add-on price for that product. If you choose to see a doctor who is not in the VSP Signature network, your out-of-pocket costs will likely be higher and you must submit the itemized receipts to VSP … Call VSP member services at 800.877.7195 for assistance. Lens coverage on CVC orders includes the following: The materials listed below are excluded from CVC benefits, although certain group exceptions may occur. Billing Orders VSP will pay your lab for materials provided. Doctors are instructed to order Access and Access Indemnity orders from your lab on a private paper order form or through Eyefinity. The ProTec Safety plan provides members with safety lenses and a frame. If you are not a participating Advantage Exam Plus with Allowances Plan lab and would like to be included on the list of labs agreeing to charge according to the fixed fee schedule, please contact Plexus Optix at 916.851.4900 or email us at plexusoptix@vsp.com for further information. Estimated Annual Savings: $497.68**. Near Variable Focus Lenses (VSP lens enhancement code IA or IL) are covered, Patients are covered for eyesizes up to and including 60 mm, Dress wear glasses in lieu of computer glasses, Two pairs of single vision lenses in lieu of bifocals, Non-covered lens options (e.g. ProTec orders must be processed at a participating ProTec lab. Choose the upgrade that’s right for you: •$250 frame allowance, or •Fully covered premium or custom progressive lenses, or •Fully covered light-reactive lenses, or •Fully covered anti-glare coating, or •$200 contact lens allowance. Patients are eligible if it has been at least 12 months since their last exam and there is a significant change in prescription. Plus, take advantage of Exclusive Member Extras for additional savings. Doctors are instructed to order materials from your lab on a private paper order form or through Eyefinity when comment codes L020 or L098 appear. Choice/Advantage Plan orders are generally submitted to your lab through Eyefinity. VSP reimburses doctors directly for these orders. If the benefit type is not Plano, but 0.00 is indicated in the sphere field, please call VSP at 916.851.4900 to verify that the patient is eligible for Plano lenses. VSP Network cost* VSP offers a variety of Individual Vision Plans depending to meet each customer's eye care needs. 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