Spectera Introduces New Online Claim System

Spectera is introducing their new online claim system late October. Included in the new system is the ability for TSO offices to electronically file claims on eyewear materials.

Below are some of the features of the new Spectera system.

Online Claim Submission
• TSO offices will have the ability to file exam and materials claims online. Spectera will continue to accept paper claims, and use of EDI transmission as well.

Removal of Claim Authorizations
• If you typically verify eligibility when the patient calls to make an appointment, that’s good. Spectera recommends looking online again on the day of appointment to verify the member is still eligible.
• Dependent eligibility will be accessed the same as it is today, using the subscriber ID and dependent DOB.
• Providers will continue to be notified if a member has one of the 23 chronic health conditions that are monitored in Spectera’s Bridge2Health program.

Clearer Claim Statements
• A Provider Remittance Statement (PRA) will accompany each payment.
• The new statements will be available whether you receive checks or you are participating in Electronic Payment Services.
• Frequency of twice monthly payments will increase to weekly in 2014. Spectera will conduct training webinars for TSO prior to the new system release.

Please contact Ann Deen at cadeen@tso.com for more information.