Routine vision

We have partnered with Vision Service Plan^® (VSP) for routine vision examinations and hardware. VSP administers claims processing, member and provider calls for all routine vision benefits. You can reach them at 1 (800) 877-7195 or TDD 1 (800) 428-4833.

Regence MedAdvantage members must see a VSP Signature network provider to receive in-network benefits for routine vision services. The out-of-network allowed amount for routine vision exams is $45 after copayment. Members are responsible for balances above the allowed amount after copayment for out-of-network.

All claims with the following routine International Classification of Diseases 9th Revision, Clinical Modification (ICD-9-CM) codes as the primary diagnosis, as well as applicable routine vision hardware claims, should be submitted to VSP for claims processing:

Reminder: When the purpose of an examination is routine, preventive or wellness, make sure to include the appropriate routine diagnosis code in the primary position to assure proper claims processing. Medical diagnoses should not appear in the primary position for routine services. Claims submitted with a medical diagnosis inappropriately in the primary position may result in recovery of overpayment after the claim is processed.

All vision hardware claims are considered routine except for those listed in the table below. Claims for the following diagnosis codes will be covered under the member’s medical benefits:

If we receive a claim for a routine vision service, it will be denied with instructions to submit the claim to VSP for processing, if you are a VSP participating provider. If you do not participate with VSP as a routine vision provider, the member should submit a receipt to VSP for reimbursement, according to the assigned out-of-network allowed amount.

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