TSO Network Update - July 2018

July 2018 z 25 Insurance & Third Party — Contact Cindy Huynh at Cindy@tso.com about Insurance & Third Party questions. Lens Enhancement Reference Tool Updates Effective June 6, 2018, the Lens Enhancement report tool on eClaim will be updated in an effort to bring you and your staff an easy-to-use reference guide when pricing lens enhancements. Updates will include revised charts, adding information such as Aspheric enhancements, and removing items such as doctor supplied enhancements and Low Vision. These items will still be available to reference in the Patient Record Report. Please note, the Lens Enhancement report tool is specific to your VSP patients’ coverage; reference this chart when pricing lenses to ensure your patients are getting the most out of their benefits. To access the “Lens Enhancement Charge” tool for your VSP patients, simply authorize their benefits through eClaim, then click on the “Reports” link and navigate to the tab located next to the Patient Record Report. VSP Lens Enhancement Changes In an effort to simplify the ordering process for you and your staff, and to align with market standards, elimination of 1,000 lens entries along with the following changes to the Vision Care Formulary will be implemented in the third quarter of 2018: • Increased reimbursement with NVF lens categories.Lenses in categories NVF A and NVF B will be moved into a new category, NVF. Reimbursement for lenses currently in the NVF B category will remain the same, and an increase of $6 in reimbursement will be provided for all lenses moving from NVF A. Please note, co-pays for your VSP patients using NVF A lenses will increase depending on their plan. • Aligning Progressives with the market standard. To reflect market prices and ensure your VSP patients continue to benefit from their plan, category F lenses Universal and Ultimate B, and Everyday lens, currently in category J, will be moved to category K. These changes will result in a lower co-pay and reimbursement for the limited number of VSP patients who choose these lenses. • Additional reimbursement for Single Vision Digital lenses with a bump. Lens enhancement code TA will be added for Single Vision Digital lenses with a bump (anti-fatigue), resulting in an additional $2 in reimbursement when processing your claims. Co-pays for your VSP patients will increase for these lenses. More details on the effective date and updates to the VSP Options Chart will be available in a future communication. Questions? Please contact providernetworkdevelopment@vsp.com. Beginning July 1, 2018, and continuing over the following 12-18 months, VSP will begin to cover standard progressive lenses for Signature & Choice clients, enabling VSP to win and retain business and gain more patients for VSP network doctors. VSP’s decision to make standard progressives available to more members does not affect reimbursements. Base service fees remain the same. Plus, when you dispense standard progressives, you will receive dispensing fees from VSP ($27 Choice, $20 Signature), like other covered-in-full lens enhancements. VSP data shows that when standard progressive lenses are covered, patients are more likely to move into the progres- sive category and out of bifocals, leading to a better experience for patients and greater revenue opportunities for doc- tors. Consider that clients with standard progressive coverage: • have a lower bifocal dispense rate of 7.8% vs. 10.5% for those without; • have a higher standard progressive dispense rate of 4.8% vs. 2.25% for those without. Ultimately, because there is no cost to the patient to upgrade to progres- sives, experience shows that patients will move into a higher category lens, resulting in happier patients and higher service fees for doctors. In support of the important role doctors play in choosing the lenses that are right for their patients, VSP does not plan to heavily promote this new coverage to members. Instead, marketing materials encourage members to talk to their VSP network doctor about the lenses that are right for them.