Wiki h40.023-open angle w/borderline finds, high risk bilateral

[dalanicks@aol.com]

Hi would anyone know why Davis Vision deny this dx, for numerous test, im getting frustrated and of course no one there can give you any information. If anyone deals with Optometry/Opthamology billing please I love your input.

Thanks

 

[Cheezum51]

Perhaps Davis Vision is different in your area but in Virginia, Davis Vision only covers exams with refractive diagnosis codes and would thus reject this disease code.

Personally, if you're seeing glaucoma patients and billing Davis Vision, which usually pays very little, you're throwing significant income away by not billing the patients' major medical plans for these visits.

Davis Vision is a vision care discount plan for basic exams and glasses/contact lenses, not a medical eye care plan.

Tom Cheezum, O.D., CPC, COPC

 

[dalanicks@aol.com]

hi tom

yes I know that but we use their ancillary medical through davis, there are two plans that we do not participate with so because of this it goes through their ancillary medical department. I don't know about Virginia but here in new York they are not much help. thanks anyway

 

[Cheezum51]

I understand now. Docs in our area have had the same problems when their major medical plan requires them to file medical eye claims through Davis. Davis's computer systems aren't set up to recognize anything but refractive codes, so they automatically deny the claims.

If the major medical plan hasn't been of any help with this problem, I'd suggest that your doctor file a protest with the state department of insurance. Sometimes that works to make the claims go through.

Unfortunately, Davis's philosophy is to deny, deny and deny more until you get sick of dealing with them.

Tom Cheezum, O.D., CPC, COPC