Important Notice from Opticare

Posted February 29th, 2012 by mfoster & filed under Newsroom, Provider News.

Attention:  Magnolia Health Plan Providers

 

Effective April 2012, the following requirements for the dispensing of aspheric lenses will be enforced:

Aspheric lenses (V2410, V2430, and V2499) will only be considered medically necessary for prescriptions greater than ±4.00 diopters. 

Medical necessity documentation (i.e., eyeglasses prescription, medical record with documented refraction) and a copy of the laboratory lens invoice must be submitted with the claim to be considered for reimbursement. 

Paper claims:  Supporting documentation may be submitted with the CMS-1500 for claims submitted by paper.

Electronic or Web claims:  Supporting documentation may be submitted by fax for claims submitted electronically or through OptiCare’s Eye Health Manager.  The Fax Cover Sheet for Claim Attachments is available on the Provider Forms page of www.opticare.com and must be included with the supporting documentation.

Claims submitted without the required documentation will be denied.