EYE CARE INSURANCES

Perhaps nothing is more confusing than insurance, in general, and more specifically in eye care.

Let’s talk basics- First, let’s talk ADMINISTRATORS. An insurance administrator is a separate entity that agrees to handle the coding, pricing, and paying off claims for vision coverage, and in agreement with a medical insurance provider. These companies will generally work together nationally, that is the same two will be connected in NY to CA and everywhere between, but NOT ALWAYS, so when someone comes into my office with United Health Care and tell me they have Vision Insurance , I can fairly confidently assume they either have Spectera Vision or VSP (Vision Service Plan). If someone presents a Highmark BC card I will look for vision coverage under either Eye Med or Davis Vision.

Generally an employee with experience in dealing with these insurance issues will be able to tread these murky waters with only a little effort and there are often poker tells that reveal themselves in ID card prefixes or customer service phone numbers etc. but it takes a trained eye to spot the clues because it isn’t something most subscribers even know they have. If we had a dollar for every time we had someone argue with us over what their insurance is we could give free coatings to everyone.

I have Blue Cross they’ll say and we spot the clue, type in their info to Davis Vision and bingo, you have DV we’ll say and they’ll argue with you until you print out their benefits and hand them the DV print outs.

Sometimes a person will have vision coverage directly through their health plan however and sometimes they only have vision coverage under the medical part of their plans and therefore a medical condition must be related to their vision exam and benefits, like diabetes.

Some people have vision benefits through their union halls and often the local union hall will pay benefits directly to the member or provider.

These are all obstacles to identify understand and overcome and this is what we do, we work with people to identify their coverage, their administrator and their benefits.

Our office bills nearly every vision plan that is currently on the market today. From Teamsters to Carpenters to pipefitters and electrical unions and dozens of other national and local unions. We bill for most of the state of WV boards of Educations. Here are a partial list of some of the more common Insurances companies and administrators we submit claims to:

(*out of network claims)