NOTE: This manual remains the sole and exclusive property of VSP®. The information contained in this manual is confidential and proprietary, and the VSP network provider is granted a limited personal and nontransferrable license for use of the content of this manual during participation on the VSP network. The contents of this manual may not be used, copied, and/or reproduced for any other purpose, or disclosed and/or disseminated to any third party for any purpose whatsoever, without the prior written consent of VSP. If, for any reason, the manual recipient no longer participates on the VSP network, the doctor hereby agrees, and is directed, to immediately destroy this manual, all copies, and any and all amendments and addenda that may be issued by VSP from time to time.
advantage network manual Table of content
VSP Advantage Plan Lens Enhancements Charts
Client Details
VSP Advantage Plan Lens Enhancements Charts
September 1, 2024 VSP Advantage Lens Enhancements Chart
September 1, 2024 VSP Enhanced Advantage Lens Enhancements Chart
Client Details
The following client details apply to Blue Cross of Idaho True Blue and Secure Blue Medicare Advantage plan patients only (does not include True Blue HMO SNP). Refer to VSP Advantage Plan section for complete coverage details not listed below.
Note:
VSP currently covers the Blue Cross of Idaho Medicare Supplement plan members under a Choice Exam Plus plan coverage. This will not change.
Lenses
Spectacle lens coverage under the VSP Advantage Plan is designed to provide necessary lenses covered in full, including single vision, bifocal, trifocal, or lenticular lenses in plastic or glass. You’ll receive your Advantage Plan lens dispensing fee for covered lenses.
Lens Enhancements
Members are covered for standard progressives, scratch coating and UV protection. If a patient chooses a covered lens enhancement, you’ll receive the Advantage Plan covered service fee.
If your patient selects a non-covered lens enhancement, charge the patient according to the VSP Advantage Network Lens Enhancements Chart.
Lab
All orders must be sent to VSPOneTM Columbus. In--office finishing equipment or stock lenses may not be used.
Only in an emergency situation may a private lab be used. See Using Non-Contract Labs for more information. If a non-contract lab is used for an emergency situation, the non-Genesis frame allowance would apply.
Covered Frame
Frames from the Altair® Genesis collection is covered for patients and will be lab supplied though VSPOne™ Columbus. You’ll receive a $19 frame dispensing fee. To ensure correct frame dispensing payment, enter both wholesale and retail frame amounts and choose lab supplied frame option. Genesis frames are fully covered when a complete pair of prescription glasses (lenses and frame) is ordered. Genesis frame only orders are a private transaction and the frame will not be covered by VSP.
You can also use Genesis frames to meet the needs of non-Blue Cross of Idaho patients. Order frames through Altair just as you do today. To inquire or request Genesis frames, contact Altair at 800.505.5557.
Other Frames
A patient has the option of supplying their own frame or purchasing a non-Genesis frame from you. The non-Genesis retail frame allowance is $50. We’ll pay you up to 55% of the patient’s retail frame allowance. When the frame exceeds the retail allowance, charge the patient 80% of the retail price exceeding the allowance. Regardless of the frame brand that’s purchased, the benefit for lenses will still follow Advantage Plan pricing (see Lenses section above). In-office finishing equipment or stock lenses may not be used.
Contact Lenses
Patients may select contact lenses instead of glasses. Please refer to the Patient Record Report for details.
The following client details apply to Blue Cross Blue Shield Medicare Advantage (PPO and HMO patients only). Refer to VSP Advantage Plan section for complete coverage details not listed below.
Lenses
Spectacle lens coverage under the VSP Advantage Plan is designed to provide necessary lenses covered in full, including single vision, bifocal, trifocal, or lenticular lenses in plastic or glass. You’ll receive your Advantage Plan lens dispensing fee for covered lenses.
Lens Enhancements
If your patient selects a non-covered lens enhancement, charge the patient according to the VSP Advantage Network Lens Enhancements Chart.
Lab
All orders must be sent to VSPOneTM Columbus. In--office finishing equipment or stock lenses may not be used.
Only in an emergency situation may a private lab be used. See Using Non-Contract Labs for more information. If a non-contract lab is used for an emergency situation, the non-Genesis frame allowance would apply.
Covered Frame
Frames from the Altair® Genesis collection is covered for patients and will be lab supplied though VSPOne™ Columbus. You’ll receive a $19 frame dispensing fee. To ensure correct frame dispensing payment, enter both wholesale and retail frame amounts and choose lab supplied frame option. Genesis frames are fully covered when a complete pair of prescription glasses (lenses and frame) is ordered. Genesis frame only orders are a private transaction and the frame will not be covered by VSP.
You can also use Genesis frames to meet the needs of non-Blue Cross Blue Shield of South Carolina patients. Order frames through Altair just as you do today. To inquire or request Genesis frames, contact Altair at 800.505.5557.
Other Frames
A patient has the option of supplying their own frame or purchasing a non-Genesis frame from you. The non-Genesis retail frame allowance is $50. We’ll pay you up to 55% of the patient’s retail frame allowance. When the frame exceeds the retail allowance, charge the patient 80% of the retail price exceeding the allowance. Regardless of the frame brand that’s purchased, the benefit for lenses will still follow Advantage Plan pricing (see Lenses section above). In-office finishing equipment or stock lenses may not be used.
Contact Lenses
Patients may select contact lenses instead of glasses. Please refer to the Patient Record Report for details.
The following client details apply to Moda Health Medicare Advantage (Moda Health PPO and Moda Health Plan Medicare Supplement patients only). Refer to VSP Advantage Plan section for complete coverage details not listed below.
Lenses
Spectacle lens coverage under the VSP Advantage Plan is designed to provide necessary lenses covered in full, including single vision, bifocal, trifocal, or lenticular lenses in plastic or glass. You’ll receive your Advantage Plan lens dispensing fee for covered lenses.
Lens Enhancements
Members are covered for standard progressives, scratch coating and UV protection. If a patient chooses a covered lens enhancement, you’ll receive the Advantage Plan covered service fee. If your patient selects a con-covered lens enhancement, charge the patient according to the VSP Advantage Network Lens Enhancements Chart.
Lab
All orders must be sent to VSPOne™ Columbus. In--office finishing equipment may not be used.
Only in an emergency situation may a private lab be used. See Using Non-Contract Labs for more information. If a non-contract lab is used for an emergency situation, the non-Genesis frame allowance would apply.
Covered Frame
Frames from the Altair® Genesis collection are covered for patients and will be lab supplied through VSPOne™ Columbus. You’ll receive a $19 frame dispensing fee. To ensure correct frame dispensing payment, enter both wholesale and retail frame amounts and choose lab supplied frame option. Genesis frames are fully covered when a complete pair of prescription glasses (lenses and frame) is ordered. Genesis frame only orders would be a private transaction and the frame will not be covered by VSP.
You can also use Genesis frames to meet the needs of non-Moda Health Plan patients. Order frames through Altair just as you do today. To inquire or request Genesis frames, contact Altair at 800.505.5557.
Other Frames
A patient has the option of supplying their own frame or purchasing a non-Genesis frame from you. The non-Genesis retail frame allowance is $50. We’ll pay you up to 55% of the patient’s retail frame allowance. When the frame exceeds the retail allowance, charge the patient 80% of the retail price exceeding the allowance. Regardless of the frame brand that’s purchased, the benefit for lenses will still follow Advantage Plan pricing (see Lenses section above). In-office finishing equipment or stock lenses may not be used.
Contact Lenses
Patients may select contact lenses instead of glasses. Please refer to the Patient Record Report for details.
The following client details apply to Summit Health Plan patients only. Refer to VSP Advantage Plan section for complete coverage details not listed below.
Lenses
Spectacle lens coverage under the VSP Advantage Plan is designed to provide necessary lenses covered in full, including single vision, bifocal, trifocal, or lenticular lenses in plastic or glass. You’ll receive your Advantage Plan lens dispensing fee for covered lenses.
Lens Enhancements
Members are covered for standard progressives, scratch coating and UV protection. If a patient chooses a covered lens enhancement, you’ll receive the Advantage Plan covered service fee.
If your patient selects a non-covered lens enhancement, charge the patient according to the VSP Advantage Network Lens Enhancements Chart.
Lab
All orders must be sent to VSPOne™ Columbus. In--office finishing equipment or stock lenses may not be used.
Only in an emergency situation may a private lab be used. See Using Non-Contract Labs for more information. If a non-contract lab is used for an emergency situation, the non-Genesis frame allowance would apply.
Covered Frame
Frames from the Altair® Genesis collection are covered for patients and will be lab supplied through VSPOne™ Columbus. You’ll receive a $19 frame dispensing fee. To ensure correct frame dispensing payment, enter both wholesale and retail frame amounts and choose lab supplied frame option. Genesis frames are fully covered when a complete pair of prescription glasses (lenses and frame) is ordered. Genesis frame only orders would be a private transaction and the frame will not be covered by VSP.
You can also use Genesis frames to meet the needs of non-Moda Health Plan patients. Order frames through Altair just as you do today. To inquire or request Genesis frames, contact Altair at 800.505.5557.
Other Frames
A patient has the option of supplying their own frame or purchasing a non-Genesis frame from you. The non-Genesis retail frame allowance is $50. We’ll pay you up to 55% of the patient’s retail frame allowance. When the frame exceeds the retail allowance, charge the patient 80% of the retail price exceeding the allowance. Regardless of the frame brand that’s purchased, the benefit for lenses will still follow Advantage Plan pricing (see Lenses section above). In-office finishing equipment or stock lenses may not be used.
Contact Lenses
Patients may select contact lenses instead of glasses. Please refer to the Patient Record Report for details.
Computer Vision Care (CVC)
Only eligible California State University employees are covered for a Computer VisionCare (CVC). Dependents are not covered. CSU Retirees benefits exclude CVC coverage.
To receive a CVC benefit, employees must obtain a VSP Computer VisionCare Confirmation Form from their CSU campus benefits office and present the form to you at the time of service. Keep a copy of the VSP Computer VisionCare Confirmation Form signed by the patient in their file.
You’ll be reimbursed according to the Advantage Plan Professional Fee Schedule for CVC materials dispensed and your Advantage Plan fees for CVC exams. Refer to the CVC section of the VSP Manual for additional information.
VSP Computer VisionCare Confirmation Form
Advantage Network Fee Schedules
Doctors can access their Advantage Fee Schedule on VSPOnline by going to www.eyefinity.com/goto/fees, clicking on “View Your Fees,” and then clicking on the “Advantage” button.