VSP® In-Office Finishing Program
Program Guidelines
In-office finishing is available for single vision, stock lenses purchased from the Plexus OptixTM Single Vision Stock Lens Catalog on eBuy for your VSP Signature Plan®, VSP Choice Plan®, VSP Advantage PlanSM, CVC and Additional Pair patients.
The program excludes the following:
- Orders from other practices—you can only finish lenses from patients seen at your practice; you may not finish work for other VSP Network providers.
- Lenses not purchased from Plexus Optix, Inc. through eBuy at eyefinity.com.
- Lenses surfaced or altered by any lab (uncuts).
- Charity care claims (Sight for Students®, American Red Cross, and VSP Mobile Eyes®)—these orders must be submitted to a VSPOne™ Optical Technology Center.
- Lab-supplied frames—only frames supplied by the doctor or the patient are eligible for the program.
- AR coating applied at a lab—only pre-coated stock lenses are eligible for the program.
- Custom coatings.
- Lab applied coatings (Mirror and Ski Coats).
- Lab applied scratch coatings (VSP lens enhancement code QS: Scratch Resistant Coating B—other Approved Coatings).
- Products not specified in the Plexus Optix Single Vision Stock Lens Catalog.
- Any Rx that doesn’t meet the VSP minimum prescription requirements.
Lens Purchasing and Ordering
You should purchase single vision stock lenses through eBuy at eyefinity.com or call Plexus at 844-753-9870 for VSP In-Office Finishing claims.
Claim Submission
Online
Claims must be submitted electronically through eClaim at eyefinity.com or through a practice management system that’s integrated with Eyefinity.
- Select In-Office Stock Lenses in the Lens Finishing section of the Lab Invoice screen.
- Select Single Vision.
- Select the appropriate Material.
- Choose the appropriate lens from the menu.
- Select VSP IOF Program from the Select Lab dropdown.
- Choose either Doctor Supplied or Patient Supplied from the Frame Supplier menu.
- Complete all other required fields and submit the claim.
Paper
Claims for the VSP In-Office Finishing Program must be submitted electronically; paper claim submissions aren’t eligible.
Documentation Standards
Your patient records should accurately document VSP In-Office Finishing Program claims as billed. Patient records must clearly indicate the materials supplied and how and when the order was completed, including the frame manufacturer and model, lens purchase details, prescription, lens materials, lens enhancements, date of lens finishing, date received by patient, and any other relevant data. The VSP Doctor Service Report is not considered adequate documentation.
You must charge patients for all copays and non-covered lens enhancements.
In-Office Finishing Doctor Redos
The following redo policies and procedures apply to VSP In-Office Finishing Program single-vision stock lens orders. You’re responsible for the cost of all redos. Your patient should not be charged for redos resulting from a prescription change or errors made by office staff or in office labs.
VSP In-Office Finishing Program Doctor Redo Requirements and Limitations
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Requirements – A patient is entitled to a redo when one of the following requirement(s) is met: |
Limitations – You may deny or charge for a redo that falls within the following limitations: |
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Power changes (not including changes resulting in plano lenses) Axis changes Errors in transcription (not including transcription errors involving tints, photochromics, coatings, or frames) Change in materials (e.g., glass to plastic, plastic to polycarbonate, plastic to high index plastic, or glass, etc.) Changes in base curves |
Change made by the patient in the frame size, shape, or style Addition or change made by the patient in tint or coating Materials lost, broken, or damaged by the patient |
VSP In-Office Finishing Program Doctor Redo Requirements and Limitations
Redos on Lens Enhancements
Important!
Lenses covered by a manufacturer’s warranty (e.g., defects and scratch warranties) are not considered a redo. Please refer to the Terms and Conditions in the Plexus Optix Single Vision Stock Lens Catalog.
On qualified first-time doctor redo prescriptions, lens enhancements ordered on the original prescription will be covered on the first-time doctor redo.
Important!
Ordering additional covered lens enhancements not supplied on the original prescription is not a valid reason for a redo, but if there’s another reason to remake an order, you may include additional lens enhancements on the new lenses.
Adding a lens enhancement that was not on the original prescription should be administered as follows:
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Covered Lens Enhancements |
All Other Lens Enhancements |
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Don’t charge the patient.* Submit a copy of the invoice with a First Time Redo Verification form for reimbursement of the added covered enhancement. *There’s no charge to you or your patient for adding a covered lens enhancement unless the covered lens enhancement can’t be added to the original order (e.g., two options that can’t be combined like photochromic and solid tint). Enhancements or materials that can’t be added to the original order are a private transaction between you and your patient. Note: Ordering additional covered lens enhancements as the only reason for a redo doesn’t meet VSP’s requirements. Refer to the First-Time Doctor Redo Requirements and Limitations section to ensure there’s a valid reason for the first-time redo. |
Charge the patient either the patient copay or 80% of your U&C according to their plan type. |
Redos sent to contract labs
If lenses must be remade into a style or with lens enhancements not available through the VSP In-Office Finishing Program, you are responsible for covering all lab costs.
Other Redo Questions
For other questions on IOF redos, call VSP at 800.615.1883.
Reimbursement
Refer to the VSP In-Office Finishing Stock Lens Catalog for a complete list of materials, lens enhancements, and services and their reimbursement amounts. A few important items to note:
- The In-Office Finishing reimbursement per order will be the cumulative total of all associated lens enhancement fees (In-Office Finishing Fees). If there are no associated lens enhancements or the cumulative total of the fees is less than $10, the reimbursement for that order will be $10.
- Reimbursements cover your cost for the lenses. You won’t be reimbursed for taxes on In-Office Finishing payments for services or materials.
- You’ll receive your In-Office Finishing fee in addition to your base lens dispensing fee and any applicable doctor service fees for lens enhancements provided by your office.
Important!
Lens Enhancements not listed in the VSP In-Office Finishing Stock Lens Catalog are not included in the program and can’t be finished in your office. Payment for these services and materials, including frame and lenses will be denied.
Explanation of Payment
Your reimbursements under the VSP In-Office Finishing Program will be included in your VSP Explanation of Payment (EOP). The claims detail will appear as it does today, with a new IOF message code, IF. The In-Office Finishing section outlines your VSP In-Office Finishing Program reimbursements associated with claims submitted under the program. Payments will be included in your VSP check or EFT total.