Coordinating VSP Benefits

Patients are often eligible for benefits under two concurrent VSP plans. For example, a patient who has VSP benefits through her employer and her spouse’s employer may be eligible to coordinate those benefits and qualify for more services.

To coordinate VSP benefits

  1. Record the patient’s primary VSP insurance plan in the patient’s profile. See Setting Up a Patient’s VSP Insurance.
  2. Obtain an authorization for the patient’s primary VSP insurance plan. See Obtaining and Viewing VSP Eligibility and Benefits Details.
  3. Record the patient’s secondary VSP insurance plan in the patient’s profile. However, instead of recording the patient’s secondary VSP insurance plan as a VSP insurance plan, record the plan as Unknown Carrier/Plan by performing the following actions:
    1. From the Insurance tab on the patient’s profile, click New Insurance to add a new insurance plan.
    2. From the Carrier drop-down list, select the carrier name you use for VSP coordination of benefits (COB).
    3. From the Plan drop-down list, select the plan name you use for VSP COB.
    4. Record any additional necessary information and click Save.
  4. Manually add eligibility and authorization details for the secondary insurance by performing the following actions:
    1. From the Insurance tab on the patient’s profile, click the Eligibilities link next to the patient’s secondary insurance.
    2. Click Add Eligibility and record the patient’s eligibility information for the secondary insurance.
    3. Click Save.
  5. Record the patient’s order. See Creating VSP Orders.
  6. Apply the patient’s primary VSP insurance plan to the order. See Pricing VSP Orders.
  7. On the Order Pricing window, click Apply Secondary Insurance.
  8. Select the check boxes for the benefits you want to apply to the order. The products and services you select must match the products and services that the patient is authorized to receive.
  9. Click Calculate Benefits.

    The Additional Information window opens.

  10. Type the patient’s benefits information in the fields, and click Continue.

    The benefits are applied and are reflected in the pricing information.

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