It Pays to Report Chronic Conditions

That means there are up to six times as many opportunities for early detection of chronic conditions, like diabetes, through a vision care exam, establishing you as an integral part of your patient’s overall continuum of care.

We continually reinvest in private practice. In fact, for those network doctors who do submit patient conditions on VSP claims, they’ve received more than $31 million over the past eight years³ from VSP.

As a health-focused company, VSP is committed to supporting you in helping your patients with eye health as it relates to chronic conditions, like diabetes, diabetic retinopathy, hypertension, and high cholesterol. To further support this, we ask that you indicate these conditions on your VSP claims by using the diagnosis code or checking the box.

Benefits to You:

• Easy Reference on Next Visit: When you indicate a patient’s chronic condition on your claim, that information will be available for you to reference on the patient’s health record on their subsequent visits.
• Drives Patients Back to Your Office: Patients who have been identified as having diabetes or prediabetes will receive a reminder from VSP, directing them back to your office, if they have not received an eye exam in 14 months.
• Additional Income: You can receive $5 when you include the diagnosis code or check the box for a patient who has diabetes or diabetic retinopathy; $2 for hypertension or high cholesterol.⁴
• Ease Administrative Burden: Accurate reporting of conditions, including use of correct Category II codes for Healthcare Effectiveness Data and Information Set (HEDIS^®) quality measures, may ease the administrative burden of pulling chart notes for diabetes patients when requested by a health plan.

Providing this information to VSP is compliant with the Health Insurance Portability and Accountability Act (HIPAA). We do not sell the information, nor do we share it in any way that violates HIPAA.

For more information, visit Submitting Patient Conditions under Administration on VSPOnline at eyefinity.com. If you have questions, please email us at providernetworkdevelopment@vsp.com.

<sup>1. American Journal of Preventive Medicine 2012.
2. VSP Utilization Data.
3. VSP payments calculated from 2012 through 2020 for reporting if a patient with VSP coverage has diabetes, diabetic retinopathy, hypertension, and/or high cholesterol.
4. Earn $5 for reporting if a patient with VSP coverage has diabetes and/or diabetic retinopathy or $2 for reporting if a patient has hypertension and/or high cholesterol. Payment won’t exceed $5 and isn’t cumulative. If two $2 conditions are reported, $2 is paid. The patient’s medical record must indicate any condition reported on a claim.</sup>