EyeMed Reminder

Q: When calculating the patient out-of-pocket cost for PALs, do you take the discount prior to applying the patient’s allowance?

A: It depends on the authorization.  Most are done by taking the allowance off of the retail price and then discounting the balance by 20%, but there are also some out there that have you discount the U&C before taking off the allowance.  So the rule of thumb is to do whatever the authorization says.