The vision vs. medical conundrum – Ophthalmology Management
Patients, as well as staff, are often confused about whether an exam qualifies as a vision exam or a medical exam. Here are answers to some common questions.
This article answers the following questions:
- If a patient has both medical and vision insurance, which is primary?
- Does Medicare cover “routine” and “annual” exams?
- When a patient comes for a routine vision exam and we find pathology, may we bill the medical plan?
- Is it ever possible to bill both medical and vision insurance?
- What happened to the local codes that used to describe routine eye exams?
- How can we reduce confusion with patients on this subject?
- How should we respond if a patient asks us to modify a claim to avoid personal financial responsibility?
This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below: