Balancing Medical and Vision Plans – Review of Ophthalmology

Managing Medicare, vision and medical plans without compromising patient care can be complicated. Here’s help.

This article answers the following questions:

• What is a “vision plan”?
• Will Medicare provide the same benefit as a vision plan for a routine eye exam?
• Is it possible for a Medicare patient to have a separate vision plan?
• If a patient has both medical and vision insurance, which is primary?
• Where is the reason for the visit documented?
• If a medical diagnosis is found in addition to the refractive diagnosis, should we also code the medical diagnosis?
• When a patient comes for a routine exam and pathology is found, may we bill the medical plan?
• Which plan is responsible if a patient needs urgent, sane day medical and/or surgical care?
• Is it ever possible to bill both medical and vision insurance?
• Do vision plans provide a “routine” eye exam for diabetics?
• Are there ways to reduce confusion with patients on this subject?
• How should we handle the patient who asks our staff to modify a claim to avoid personal responsibility?

This article was published in Review of Ophthalmology’s Medicare Q & A column, which is written by Corcoran’s Vice-President, Donna McCune, CCS-P, COE, CPMA. To view the entire article in Review of Ophthalmology, click on the link below:

http://bt.e-ditionsbyfry.com/publication/?i=114484

See page 22.