Federal Employees Dental and Vision Insurance Program (FEDVIP)

10-digit MEMBER ID Numbers FEDVIP:

As of January 1, 2022, VSP started issuing all FEDVIP members a 10-digit Member ID number. Practices should use this Member ID to authorize benefits for your FEDVIP VSP patients in place of their Social Security Number.

If a patient asks where they can find their 10-digit Member ID, they can simply log in to their vsp.com account as they normally would and navigate to their Member ID card. Their ID card will be updated with this new number, and they can print it at any time.

Materials

FEDVIP members with the VSP High Option plan are covered for TechShield^™ anti-reflective (AR) coatings and have a $20 allowance for non-TechShield^™ AR coatings. Review the Patient Record Report and the Patient Lens Enhancement Charges Report to calculate the correct charges, if any.

Lab Routing

Prescription eyewear orders for FEDVIP members are fulfilled through a nationwide network that includes VSPOne Optical Technology Centers and more than 50 other contract labs. Based on the materials requested, eClaim at eyefinity.com will display a list of labs available to complete your order. Orders will be routed according to the claim submission date rather than the date of service.

Coordination of Benefits (COB)

Some FEDVIP members may have routine vision coverage through their health plan.

If the member and provider participate in both FEHB and FEDVIP, the lesser of the contractual plan allowances will prevail. This means the office will need to calculate the cost to the member under each plan; the plan that has the least out-of-pocket cost to the member will be Primary.

Please confirm the health plan information with your patient and verify that the health plan will cover your services.

If the health plan covers:

Exam Only: Bill us as primary for materials. Coordinate benefits for the routine exam per the guidance above to ensure least out-of-pocket cost to the member. If the health plan is determined to be primary, submit a paper claim to us after you receive payment from the health plan, along with a copy of the health plan's explanation of benefits.

Exam and Material: Coordinate benefits for the routine exam and materials per the guidance above to ensure least out-of-pocket cost to the member. If the health plan is determined to be primary, submit a paper claim to us after you receive payment from the health plan, along with a copy of the health plan's explanation of benefits.

If the health plan doesn't cover your services, bill us as primary.

Reimbursements are based on the VSP Choice Plan secondary COB allowance. For more information, refer to the COB Between Health Plans and VSP Plans section of the VSP Manual.

Note:

If the federal employee’s health benefit (FEHB) plan is an HMO and you’re not a participating provider under that plan, then bill us as primary.

Authorizations

Eyefinity's eClaim will display messages when patients have routine vision coverage through their health plan, indicating that coordination of benefits may apply. The IVR system and faxed authorizations will have similar messages. These messages aren't available for practices using the Practice Management Interface software.

Glossary

Closed Network Access	Members must obtain medical services from network providers.
FEHB Plan Type	FFS and HMOs are the two FEHB plan types offered by the FEDVIP. Some FFS and HMO plans offer POS products, allowing the member to choose from a designated network of providers or non-network providers at an additional cost.
Fee-for-Service (FFS)	Health plan in which doctors receive a fee for each covered service. The plan will either pay the medical provider directly or reimburse the member for covered services after the member has paid the invoice and filed an insurance claim. FFS plans offer open network access, allowing the member to receive medical care from any doctor.
Health Maintenance Organization (HMO)	Health plan in which members receive care through a network of doctors in designated service areas. HMOs offer closed network access. Note: If the federal employee’s health benefit (FEHB) plan is an HMO and you are not a participating provider under that plan, then bill VSP as primary.
Open Network Access	Members can obtain medical services from in-network or out-of-network providers.
Point of Service (POS)	A product offered by HMO or FFS plans. With an HMO plan, the POS product allows the member to see providers who are not part of the HMO network, paying higher deductibles and co-insurances for their services. Members must file a claim for reimbursements.