Alyssa Lane
Billing for medically necessary contacts under Davis insurance requires knowledge of vision insurance plans and billing codes. Davis Vision requires that contact lenses improve visual acuity by two lines and meet a refractive error requirement. CPT codes 92071 and 92072 are not to be used simultaneously and are used for billing medically necessary contact lenses. UC Davis Health provides information on financial assistance and billing through their website and phone numbers for their Financial Clearance Department and Patient Billing Customer Service Department.
| Characteristics | Values |
|---|---|
| Financial assistance | If eligible, you will not be charged more for emergency or other medically necessary care than the amount generally billed to patients with Medicare coverage |
| Contact | Email: [email protected]; Phone: 916-734-9200 or 1-800-551-9411 (Monday–Friday, 8:30 a.m. to 4:00 p.m.) |
| Email consent | Patients must read and sign an email consent form before any email communications with UC Davis Health's Patient Billing Customer Service Department |
| Paperless billing | UC Davis Health has switched to paperless billing statements |
| Billing intervals | If hospitalized for more than four weeks, insurance companies may be billed at two or more intervals |
| Charity care discount program | UC Davis Health offers a charity care discount program for eligible patients |
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What You'll Learn
- Davis Vision requires contact lenses to improve visual acuity by two lines and meet a refractive error requirement
- CPT codes 92071 and 92072 cannot be used simultaneously
- Financial assistance is available for those who qualify
- Contact UC Davis Health's Financial Clearance Department for inpatient hospital services
- Paperless billing statements are available for most patients
Davis Vision requires contact lenses to improve visual acuity by two lines and meet a refractive error requirement
Contact lenses are a recognised medical device by the FDA. They are often the only treatment option that provides optimal vision for patients with ocular conditions such as keratoconus or systemic conditions that cause severe dry eye, like Sjogren's Syndrome. They can improve visual acuity and reduce visual distortion in ways that glasses cannot, and they are not considered elective.
When it comes to billing for medically necessary contact lenses, Davis Vision requires that contact lenses must improve visual acuity by two lines and meet a refractive error requirement. This means that the patient's vision can be corrected by two lines of improvement on the visual acuity chart when compared to the best-corrected standard spectacle lenses.
Visual acuity is a measure of the spatial resolution of the visual processing system. It is typically measured while fixating, as a measure of central or foveal vision. The most commonly referred-to visual acuity is distance acuity or far acuity, which describes someone's ability to recognise small details at a far distance. This ability is compromised in people with myopia, or short-sightedness.
Refractive errors can be corrected by optical means, such as eyeglasses, contact lenses, or refractive surgery. In the case of myopia, for example, the correction is to reduce the power of the eye's refraction by a so-called minus lens. When billing for medically necessary contact lenses, it is important to select the proper code for the contact lens the patient is being fitted for. CPT codes 92071 and 92072 are not meant to be used simultaneously.
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CPT codes 92071 and 92072 cannot be used simultaneously
When billing for medically necessary contact lenses, it is important to use the correct CPT (Current Procedural Terminology) codes. CPT codes 92071 and 92072 are not meant to be used simultaneously; it is one or the other. CPT code 92071 is used for the fitting of soft contact lenses on the cornea to treat ocular surface disease, not keratoconus. CPT code 92072, on the other hand, is used for the initial fitting of contact lenses to manage keratoconus, a progressive eye condition that causes the cornea to thin and bulge into a cone-like shape.
CPT code 92071 falls under the category of Ophthalmological Examination and Evaluation Procedures. It involves the application of a soft contact lens to the cornea to address ocular surface disease. This code is not applicable in cases of keratoconus management. It is important to note that CPT code 92071 should not be reported in conjunction with code 92072. The supply of the contact lens for CPT code 92071 should be reported separately using the appropriate supply code.
CPT code 92072 specifically addresses the initial fitting of contact lenses for patients diagnosed with keratoconus. This code is used when contact lenses are determined to be the most suitable treatment option, taking into consideration factors such as the severity of keratoconus, the patient's overall eye health, and their ability to tolerate contact lenses. It is important to note that CPT code 92072 should not be used for subsequent fittings or for the management of other ocular conditions beyond keratoconus.
The distinction between CPT codes 92071 and 92072 is crucial in billing for medically necessary contact lenses. These codes serve different purposes and are applicable to specific ocular conditions. By using the correct CPT codes, eye care providers can ensure accurate billing and reimbursement for the services rendered. Proper testing, diagnosis, and billing codes are essential to providing optimal care and improving patients' visual needs, comfort, and overall quality of life.
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Financial assistance is available for those who qualify
If you have health insurance or Medicaid, you may still be able to receive additional financial assistance through charity care programs, which can help with the remaining costs. You can typically apply for charity care through the doctor or hospital providing your treatment. Many hospitals also offer bill forgiveness or debt relief based on income, and some for-profit hospitals provide financial assistance programs. You can also contact the pharmaceutical companies that make your prescription drugs to ask about low-cost options, samples, or discounts, and learn about generic drugs, which can help lower your costs.
There are also free consumer advocacy organizations that can help you understand the billing and payment process, such as the Health Consumer Alliance. If you believe you were wrongly denied financial assistance, you can file a complaint with the Hospital Bill Complaint Program, a state program that reviews hospital decisions regarding financial assistance. Organizations like Dollar For can also help you apply for hospital financial assistance and provide support and resources to reduce your medical bills.
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Contact UC Davis Health's Financial Clearance Department for inpatient hospital services
If you require financial assistance for inpatient hospital services at UC Davis Health, you can contact their Financial Clearance Department. This department can provide information on various programs that you may be eligible for, such as Medi-Cal, California Children's Services, Medicare, or a charity care discount program.
The contact number for the Financial Clearance Department is 916-734-3245, or 4-3245 if you are calling from a hospital phone. Their operating hours are Monday through Friday, 8 am to 4:30 pm.
UC Davis Health has switched to paperless billing statements for most patients, offering a more convenient, secure, and eco-friendly way to manage and pay medical bills. If you have any questions about billing, insurance, or financial arrangements, you can refer to their Help Paying Your Bill page for more information.
Additionally, there are free consumer advocacy organizations that can assist you in understanding the billing and payment process, such as the Health Consumer Alliance (888-804-3536) or the Hospital Bill Complaint Program, which reviews hospital decisions regarding financial assistance.
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Paperless billing statements are available for most patients
UC Davis Health has switched to paperless billing statements for most patients. This method of billing is more convenient, secure, and eco-friendly. To receive paperless billing statements, patients must first read and sign an email consent form and send it to [email protected]. Patients can also request documents by mail by contacting the Patient Billing Customer Service Office at 916-734-9200 or 1-800-551-9411 (Monday–Friday, 8:30 a.m. to 4:00 p.m.).
UC Davis Health offers financial assistance for patients who qualify. This includes patients who do not have health insurance or have inadequate insurance and meet certain low- and moderate-income requirements. Patients can apply for financial assistance through programs such as Medi-Cal, California Children's Services, Medicare, the county Medically Indigent Services Program, or a charity care discount program. For inpatient hospital services, patients can contact a hospital financial counselor through UC Davis Health's Financial Clearance Department at 916-734-3245. For outpatient hospital services, patients can contact UC Davis Health's Patient Billing Customer Service Department at 916-734-9200.
Additionally, there are free consumer advocacy organizations that can help patients understand the billing and payment process, such as the Health Consumer Alliance (888-804-3536) and the Hospital Bill Complaint Program, which reviews hospital decisions about financial assistance. Patients can also visit UC Davis Health's "Help Paying Your Bill" page for more information about charity and financial assistance.
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Frequently asked questions
You may be eligible to receive benefits through programs such as Medi-Cal, California Children’s Services, Medicare, the county Medically Indigent Services Program, or a charity care discount program. Eligibility depends on factors like income and insurance coverage.
For inpatient services, contact UC Davis Health’s Financial Clearance Department at 916-734-3245. For outpatient services, contact the Patient Billing Customer Service Department at 916-734-9200 or 1-800-551-9411.
The working hours are Monday through Friday, 8 a.m. to 4:30 p.m.
There are free consumer advocacy organizations that can help you understand the billing and payment process. You can contact the Health Consumer Alliance at 888-804-3536 or visit healthconsumer.org for more information.
UC Davis Health generally bills your insurance company or health plan within two weeks of your discharge.
