Configuring Spectera Formulary Contact Lens Allowances
You can configure contact lens coverage allowances for Spectera insurance plans. From the Formulary Contact Lens Allowances window, you can perform the following actions:
- Add contact lens allowance amounts along with the corresponding quantity of disposable and planned replacement boxes allowed. You can add contact lens coverage allowances that apply to all plans or to specific plans.
- Edit the quantity of disposable and planned replacement boxes allowed for an allowance amount.
- Copy contact lens coverage allowances between plans.
- View a history of all changes made to contact lens coverage allowances.
- Generate a PDF report showing contact lens coverage allowances for all plans and individual plans.
- While the following procedures can be used for any insurance carrier, this functionality is intended for setting up formulary contact lens allowances for Spectera insurance plans.
- The contact lens coverage allowances that were previously set up for your company appear in the grid the first time you access the Formulary Contact Lens Allowance window.
This section explains how to set up contact lens coverage allowances.
Topics include the following:
To search for contact lens coverage allowances
- Open the Formulary Contact Lens Allowances window. See To open the Formulary Contact Lens Allowances window.
- To search for allowances that apply to a specific plan, select the plan name from the Plan drop-down list.
The Plan drop-down list is blank by default and the allowances that appear in the grid apply to all plans.
- To search for allowances that are currently inactive, select No from the Active drop-down list.
Yes is selected in the Active drop-down list by default and the allowances that appear in the grid are active. To view both active and inactive allowances, leave the Active drop-down list blank.
To add contact lens coverage allowances
- Open the Formulary Contact Lens Allowances window. See To open the Formulary Contact Lens Allowances window.
- To add an allowance for a specific plan, select the plan name from the Plan drop-down list.
If you add an allowance with the Plan drop-down list blank, the allowance applies to all plans.
- Click Add.
A second Formulary Contact Lens Allowances window opens.
- Enter the allowance values in the following fields:
- Allowance: Enter the allowance amount.
- Allowed Disposable Boxes: Enter the quantity of disposable contact lenses boxes allowed for the allowance amount.
- Allowed Planned Replacement Boxes: Enter the quantity of planned replacement contact lenses boxes allowed for the allowance amount.
- (Optional) To add the allowance as inactive, deselect the Active check box. The Active check box is selected by default.
- Click Save.
To copy contact lens coverage allowances
- Open the Formulary Contact Lens Allowances window. See To open the Formulary Contact Lens Allowances window.
- Click Copy.
The Copy Formulary Contact Lens Allowances window opens.
- From the Copy From Plan drop-down list, select the plan with the allowances you want to copy.
All allowances configured for the selected plan are copied. You cannot select individual allowances to copy to another plan.
- From the Copy To Plan drop-down list, select the plan you want to copy allowances to.
If the plans you are copying allowances between have the same allowance amount but different box quantities, the box quantities for the plan you are copying allowances to will be overwritten.
- Click Copy and click OK in the confirmation message window.
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