Understanding Which VSP Plans Are Available for Automatic Calculations
Encompass automatically calculates doctor reimbursement and patient out-of-pocket charges for most VSP plans when you add the plans to orders in the Current Pricing screen. Use this list to figure out which plans and plan enhancements can be automatically calculated, and which need to be calculated manually. For more information on pricing orders and calculating VSP benefits, see Pricing and Adding Insurance to Orders.
Use these procedures only if your practice is VSP Out of Network. You can use e-Eligibility to obtain authorizations and patient information for all the listed plans, including those that are not available for automatic calculation.
These plans will be automatically calculated:
VSP Signature
VSP Choice
VSP Advantage
Additional Pair/Second Pair
CLEX
Covered Contact Lenses (CCL)
VSP EasyOptions
Essentials
Market Based Options/Flex Options
Exam Only
Exam Plus
Choice Exam Plus
Suncare
EFF (Enhanced Featured Frame Allowance)
Extra $20/Extra $40
Telehealth/Telemed
Medically Necessary Contact Lenses (NCL) - Out of network only
Safety/Protec Safety
You will need to manually calculate amounts for these plans:
Medicaid
Primary Eyecare (PEC)
Diabetic Eyecare (DEP)
Laser VisionCare (LVC)
Computer VisionCare
Safety/ProTec Safety (In Network Only)
CMA Plans (combined material allowance)
Flat Allowance Plans
Medically Necessary Contact Lenses (NCL) - In network only
Elements
Interim Benefits
KidsCare
Low Vision
Vision Therapy
Repair/Replace