Like EyeMed, VSP is a special vision plan that is usually tacked on to a medical insurance.
Cigna Vision is covered through VSP.
We are not in network for VSP, but we can submit for out-of-network benefits with an authorization. If a patient has VSP out-of-network benefits, we take the VSP copay for the routine eye exam (plus any additional contact lens or retinal photography fees).
VSP is open Monday through Saturday, so please call for an authorization while the patient is in the office for the exam. If you cannot call VSP because it's after hours or Sunday, assume the patient has the out-of-network benefits. If patient doesn't know the VSP copay, check health insurance card or take an average copay of $20.
To find patients in the VSP system, we need the subscriber (not patient) name and DOB and the last four digits of the subscriber's social security number. Write all of this information on the superbill, along with the authorization number and VSP copay amount.
Call VSP at 1-800-877-7195. Press 1 for out-of-network providers. Ignore the following choices and press 0 to be transferred to a representative.
Tell the representative that you are checking for out-of-network benefits for a patient. Provide the subscriber's information. The VSP system can only search by subscriber, not by the dependent members on the plan. If you are calling after the day of the exam, ask that the authorization be back-dated to the day of the exam.
If the patient has out-of-network benefits, mark down the copay and authorization number on the superbill. (Without the authorization number, we cannot submit the claim.)
Be sure to get a copy of the patient's medical card, especially when they are using VSP.