Office Location Standards
VSP Vision Care is committed to high-quality, safe, and accessible office settings for our membership. Network doctors are required to meet or exceed all outlined doctor office location standards. To ensure compliance with these standards a site review is initiated upon reaching the established threshold of site quality complaints.
Americans with Disabilities Act (ADA) Accessibility Guidelines
- Facility site must meet city, county, and state building structure and access ordinances for persons with physical disabilities. A facility site includes the building structure, walkways, parking lots, and equipment.
- All facilities designed, constructed; or altered by, on behalf of, or for the use of a public entity must be readily accessible and usable by individuals with disabilities, if the construction or alteration was begun after January 26, 1992 (28 CFR 35.151).
- Any alteration to a place of public accommodation or a commercial facility, after January 26, 1992, must be made to ensure that, to the maximum extent feasible, the altered portions of the facility are readily accessible to and useable by individuals with disabilities, including individuals who use wheelchairs (28 CFR 36.402).
- Reasonable accommodations must be made to allow adequate access for persons with disabilities.
- Provide accessible pedestrian paths of travel (ramps, corridors, walkways, lobbies, elevators, etc.) between elements (seats, tables, displays, equipment, parking spaces, etc.).
- The minimum clear passage needed for a single wheelchair is 36 inches along an accessible route and may be reduced to a minimum of 32 inches at a doorway.
- Restroom and hand washing facilities should be wheelchair-accessible. If wheelchair-accessible handwashing facilities are not available within the site, reasonable alternative accommodations are provided such as alcohol-based hand cleansers, and wheelchair-accessible restrooms are located within the building.
For more information about the ADA, including ADA regulations, visit www.ADA.gov; or, www.access-board.gov.
Appointments and Accessibility
VSP requires network doctors to use an appointment scheduling process and system that allows appointments to be scheduled according to patients’ stated eye care needs within the timeliness standards established for VSP members. The intent is to ensure that patients are handled consistently and scheduled for appointments in a manner that recognizes the urgency of their eye care needs.
- Patents experiencing an eye care emergency should be seen immediately or referred to an appropriate alternative medical facility.
- Make every effort to see the patient at their scheduled appointment time. Patient wait time should not exceed 30 minutes.
- The site must have (or arrange for) a telephone triage, voicemail system, and/or answering service to provide routine, after-hours, and urgent/emergency eye care instructions, whenever office staff is unavailable to answer phone calls. Patients should receive a return call from this system for follow-up within a reasonable timeframe.
- Ensure a process is in place to follow up on missed and canceled appointments. Missed and/or canceled appointments and contact attempts must be documented in the patient medical record.
General Appointment Availability Standards
Routine Preventive Eye Care: Standard routine or preventive eye care scheduled within 30 calendar days.
Medical Eye Care: Medical eye care scheduled within 7 days.
Urgent Eye Care: If call is received during office hours, and the doctor determines the need of the member to be urgent, member should be seen within 24 hours.
Emergency Eye Care: When emergency treatment is necessary the patient should be seen immediately or directed to the most appropriate emergency facility for care.
Unscheduled Appointments: Evaluated (triaged) by a doctor to determine the severity of the condition and disposition of the patient. Patients who need to be seen immediately are to be accommodated.
Specialty Referral: Scheduled within 14 calendar days from the time the primary care provider requests the referral.
Check here for state exceptions to the above general appointment availability standards.
If a patient is unable to obtain a timely referral, the patient may call VSP at 800.877.7195 or the Department of Managed Health Care at 888.466.2219 for further assistance.
Clinical Office Standards
VSP network doctors are required, at a minimum, to have the following instrumentation necessary to provide eye care services at the comprehensive level, including and not limited to:
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- Equipment used to measure and assess patient health must be in proper working order and adequately maintained according to the manufacturer’s guidelines for the routine inspection, calibration, repair, and cleaning/sterilization of the equipment.
- Calibration, cleaning, and maintenance logs should be kept for all instruments and available for review.
- Use proper sterilization and decontamination of instrumentation and testing devices that come into contact with patients before each use. When possible, perform in front of the patient.
- Doctors and office staff are required to wash their hands, use single-use exam gloves, and/or use an alcohol-based hand cleanser before each patient. When possible, perform in front of the patient.
- Maintain diagnostic and/or therapeutic pharmaceutical agents in a secure location, according to the manufacturer’s storage guidelines.
- Contact lenses, contact lens solutions, therapeutic products, and pharmacological agents must be properly discarded on or before the manufacturer’s expiration date.
Complaint/Grievance Procedures
- Complaint forms, at least one telephone number for filing grievances, and a copy of the VSP complaint/grievance procedure must be available on-site and can be provided to patients promptly upon request.
- VSP Vision™, VSP Vision Care®, and VSP contracted providers comply with applicable Federal and applicable State civil rights laws and must not discriminate, exclude, deny benefits to, or treat people differently because of race, color, religion, national origin, age, disability, or sex (including sexual orientation and gender identity).
Refer to the Complaints & Grievances section of the VSP Provider Reference Manual for additional information.
Cultural Competency and Language Assistance
- Doctors and their office staff are responsible for ensuring clinical and non-clinical services are provided in a culturally competent manner and accessible to all patients.
- Network doctors must complete cultural competency training annually. Training must be current, documented, and available for review. VSP includes Cultural Competency training in the Training & Support section of VSPOnline.
- Interpreter services are made available in identified threshold languages specified for the site location.
- Provide 24-hour access to interpreter services for all members, including non- or limited-English proficient (LEP) members, either through telephone language services or interpreters onsite.
- Interpreter services for the hearing impaired are made available at no cost to the member.
Refer to the Patients’ Rights and Responsibilities section of the VSP Provider Reference Manual for additional information.
Insurance, Licensure, and Certification
- VSP requires network doctors to maintain malpractice insurance coverage with defined coverage limits.
- All required professional licenses and certifications, must be current and issued from the appropriate agency for practice, and available onsite.
Refer to the Insurance, Licensure, and Certification section of the VSP Provider Reference Manual for additional information.
Medical Records
- VSP requires medical records, including electronic health records (EHRs), to be maintained according to applicable state and federal laws and regulations.
- Maintain medical records and member information in a confidential, secured location that denies unauthorized access.
- Medical records should be easily retrieved by appropriate office personnel.
- Ensure storage and transmittal of EHRs preserve confidentiality and security and are compliant with state and federal guidelines.
- Medical records must be retained for a minimum of 10 years (42 CFR 438.3).
Refer to the Medical Record Documentation section of the VSP Provider Reference Manual for additional information.
Patient Privacy and Confidentiality
- VSP requires privacy and confidentiality be maintained for each patient and their health information according to applicable state and federal laws and regulations.
- Office personnel must regularly receive training on patient confidentiality. Training must be current, documented, and available for review.
- Patients have the right to privacy for examination and consultations.
- Protected Health Information (PHI) and Personal Identifiable Information (PII) must be securely maintained.
- Conduct patient interviews and personnel discussions in a manner that safeguards patient privacy and confidentiality.
- Ensure personal patient information is not discussed in front of other patients or visitors, displayed, or left unattended in reception and/or patient flow areas.
- Disclosure of patient PHI for purposes outside of treatment, payment, and healthcare operations requires patient permission.
Pharmaceutical Agents
- VSP requires pharmaceutical dispensing to be compliant with applicable state and federal laws and regulations. Pharmaceutical drugs may only be dispensed only by a physician or other persons lawfully authorized to dispense medications.
- VSP requires appropriate medication and pharmaceutical supplies storage and maintenance.
- For patient safety and risk management, medications should be secured and not left unattended in patient care areas.
- Prescription pads, medications, sample and over-the-counter drugs must be securely stored in a lockable space (cabinet or room) within the office/clinic to prevent unauthorized access.
- As a routine office procedure, with documented frequency and inspection, medications and other pharmaceutical supplies must be regularly checked for expiration.
- Expired medications and pharmaceutical supplies should be properly discarded on or before the manufacturer’s expiration date.
Physical Condition
- VSP requires network doctors’ office and clinic site locations to be maintained in a safe, clean, and sanitary condition.
- Provide a patient waiting area with adequate lighting and office furnishings that are clean and in a good state of repair.
- The physical appearance of waiting and exam rooms, floors, carpets, walls, furniture, and restrooms should be clean and well-maintained.
- Provide a clean, properly working restroom, which includes toilet and hand washing facilities, and appropriate sanitary supplies (toilet paper, hand washing soap, paper towels, etc.) for patient use.
- As required by law, maintain a smoke and pet-free environment.
Safety Requirements
- Site must meet city, county, and state fire safety and prevention ordinances.
- Site must be adequately equipped with fully charged and operable portable fire extinguishers that are readily accessible to personnel. Annual inspection tags should be affixed to the extinguishers indicating the month and year that the extinguisher was professionally inspected.
- Office personnel must regularly receive safety training for 1) fire safety and prevention and 2) non-medical emergencies procedures (e.g., site evacuation, workplace violence). Training must be current, documented, and available for review.
- Ensure adequate lighting in patient flow working and walking areas such as corridors, walkways, waiting and exam rooms, and restrooms to allow for a safe path of travel.
- Exit doorways must be unobstructed and marked by a readily visible “Exit” sign.
- Post diagrammed emergency evacuation routes in a visible location at all elevators, stairs, and exits.
- List emergency phone numbers in an accessible location(s) that includes:
- Local emergency response services (e.g., fire, police/sheriff, ambulance).
- Emergency contacts (e.g., office managers, supervisors, etc.).
- Appropriate state, county, city, and local agencies (e.g., local poison control number).
Infection Control
Adherence to infection control and prevention practices is essential to providing safe and quality patient care. VSP has adopted the recommendations of the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) as part of its network doctor office location standards. Use standard precautions to care for all patients across all settings where healthcare is delivered including:
Hand Hygiene
- Ensure healthcare personnel perform hand hygiene with soap and water or use alcohol-based hand cleansers before contact with each patient.
- Ensure that supplies necessary for adherence to hand hygiene are readily accessible in all areas where patient care is being delivered.
Contact Lens Care
In accordance with the Centers for Disease Control and Prevention contact lens information for eye care providers and public health professionals:
Clean contact lenses according to the manufacturer’s guidelines.
- Rub and rinse contact lenses with contact lens disinfecting solution according to manufacturer’s guidelines, including and not limited to multipurpose solutions and/or hydrogen peroxide-base systems.
- Use fresh cleaning or disinfecting solution each time lenses are cleaned and stored.
- Do not use saline solution or rewetting drops to disinfect lenses. Neither solution is an effective or approved disinfectant.
Contact lens storage
- Contact lens cases should be rubbed and rinsed with sterile contact lens solution (not tap water), emptied, and left open to dry between each use.
- Replace used storage cases at least once every three months.
Environmental Cleaning and Disinfection
- Clean and disinfect surfaces in the patient care environment and other frequently touched surfaces.
- Use proper sterilization and decontamination of instrumentation and testing devices that come into contact with patients before each use.
- Promptly clean and decontaminate spills of blood or other potentially infectious materials.
Bloodborne Pathogens Standard
In accordance with federal, state, and local regulations VSP follows the Occupational Safety and Health Administration (OSHA) standards for bloodborne pathogens. The current OSHA Bloodborne Pathogen Standard (29 CFR 1910.1030) can be obtained from the OSHA Publications Office, 200 Constitution Avenue, N.W., Washington, DC 20210, or through the OSHA website (www.osha.gov).