Ordering Eyeglasses with VSP Medicaid

VSP Medicaid plans may require you to add modifier codes and dispensing fees to your order. Some orders may also need to be routed to a particular lab. For specific information, refer to the VSP Medicaid Provider Reference Manual on VSPOnline at eyefinity.com.

If you have questions or are not enrolled and licensed by Medicaid, email VSP Provider Network Development at providernetworkdevelopment@vsp.com.

The following dispensing fees are required for some VSP Medicaid orders. We recommend you set up and price them in Other Items Setup for each of your offices:

* Sv Dispensing Fee
* Bf Dispensing Fee
* MF Dispensing Fee

To order eyeglasses with VSP Medicaid:

  1. On the top menu bar in Encompass, click Patients and select Search/Add patient.
  2. Enter the patient's information and click Search.
  3. Select the patient from the search results list.
  4. On the left side menu, do one of the following:
    • Click Material Orders and then, under Create an Order, click Add Eyeglass Order.
    • Click Eyeglass Order.
  5. Build the eyeglass order, using VSP Medicaid for the insurance and a Medicaid contracted lab for the lab.
  6. In the Order Review screen, select VSP Medicaid as the Insurance.
  7. Click Calculate Benefits.
  8. Click Override, if necessary, to edit the amounts.
  9. Enter the Patient Responsibility and Patient Copay.
  10. Enter the Insurance Reimbursement amount.

    11. If you leave the Insurance Reimbursement amount at $0.00, the claim will be marked Non-Receivable.

  11. Click Save.
  12. Click the Add/Review link.

    The Add Modifiers and Dispensing Fee window opens.

  13. Select up to four Modifier Codes for each item, if necessary.
  14. Select the Dispensing Fee, if necessary.
  15. Enter an amount for the dispensing fee, if necessary.
  16. Select up to four Modifier Codes for the dispensing fee, if necessary.
  17. Click Save.
  18. Complete the order as you normally would.