Bill the doctor on a private invoice.
If the clip-on is not priced separately from the frame (e.g., a frame’s wholesale cost, including a clip-on, is $69.95), and can only be ordered with the frame, write the entire cost of the frame and clip-on in the frame cost box on the order form or note on eClaim. If the clip-on is priced separately from the frame (e.g., the frame’s wholesale cost is $45.85 and the clip-on’s additional wholesale cost is $29.95), it cannot be included under the frame allowance. The doctor will order the clip privately.
If an adapter is within the mask so that lenses can be edged and mounted as with any other frame, do not charge additionally for this, unless additional lens enhancements are ordered. Lenses that are glued to the mask are not available for use with VSP benefits.
Lens Enhancement Code SR
This lens enhancement is charged for single and double faceting. Bill the doctor on a private invoice for specialty sculpturing, (e.g., Multi-Facets lenses, Bill Brock Facets, etc.).
There is no payment or charge for frosted lenses. This service is considered part of your base lens prices.
When a prescription is ordered with lens enhancements that apply to only one lens, doctors will submit a Post Authorization form along with the lab order to VSP for reimbursement. Doctors should clearly indicate which lens enhancements are for one lens only in the Special Instructions areas and in Box 19 on the CMS-1500 (formerly HCFA-1500) form or noted in eClaim.
If the lens enhancements are not covered by the patient's plan, the patient will be charged only half the VSP patient lens enhancement price. VSP will charge the doctor back for only half the lab fee. Labs will receive the whole lens enhancement fee reimbursement but must supply the other half lens enhancement at no charge if the doctor orders a second lens before the patient’s benefits expire.
For Single Lens Orders, see below.
Modified lens shapes are not available through the VSP Lens Enhancement System and should be handled on a private basis between the lab and the doctor.
No fault-warranties are not available through the VSP Lens Enhancement System and should be handled on a private basis between the lab and the doctor. The lab may charge private fees for no-fault warranties.
Don’t charge the doctors for replacement nose pads. The addition of adjustable guard arms and pads and zyl build-ups is a private transaction between you and the doctor.
Lens Enhancement Codes RM, RN
Charge lens enhancement code "RM" with plastic lenses supplied with a 61mm eye size or greater. Charge lens enhancement code "RN" for glass lenses supplied with a 61mm eye size or greater. Use the eye size stated by the frame manufacturer to determine if the oversize lens enhancement is applicable.
Lens Enhancement Code SH
Use lens enhancement code "SH" for press-on bifocals.
Lens Enhancement Code SH
Lens Enhancement code "SH" is for press-on, or fresnel prisms only. Lens configuration prisms (ground-in prisms) are included in your base lens prices.
Private label products are not available through VSP.
When a single lens is ordered instead of a pair of lenses, labs are reimbursed for a complete pair of lenses. If only one lens is ordered and a second lens is needed within 12 months, provide the second lens at no additional cost.
If a lens enhancement is requested on a single lens order, please refer to Half Pairs above.
Lens Enhancement Code ST
Bill this code for orders that require slab-off.
Lens Enhancement Code TA
This lens enhancement code is systematically applied when a single vision lens with a bump is ordered.
Lens Enhancement Code SV
Use lens enhancement code "SV" for UV coating on lenses that do not have inherent UV inhibiting properties. Materials and lens enhancements that naturally block UV light include mid-index plastic, high index plastic, polycarbonate, trivex, photochromic, and polarized lenses. Can be billed in conjunction with UV Protection Backside code "BV."
Per ANSI Z80 standards, "Manufacturers of lenses who claim specific ultraviolet attenuating properties shall state the average percent transmittance between 290 and 315nm (UVB) and between 315 and 380nm (UVA)." Please note that blocking wavelengths above 380nm interferes with the visible spectrum and may affect the color of the lens.