Am I seeing double? — Vision screening for members and members with diabetes – a double QIP win!

Did you know that many of our non-Kaiser PHC members have a separate vision care plan under Vision Service Plan (VSP)? They do. That information is available on the eligibility screen and also on their PHC card. These services can be provided by an optometrist and help to reserve our ophthalmologist colleagues for other eye care.

If the patient is under 21 years of age, VSP can provide routine eye exams, including refractions, and supply covered lenses and frames every two years (on exception more often). If the patient is 21 years of age or older, while lenses and frames are no longer covered, that patient can still have an eye exam every two years.

For patients with diabetes, the coverage for eye exams, including screening diabetic exams, increases to a yearly benefit. Encounters for these visits are tracked by PHC and count towards the QIP (Quality Improvement Program) requirements.

A double win for the QIP! Fulfill the diabetic eye screening while reducing your specialty referral rate.

If the patient has a need for refraction – send them to a VSP optometrist. VSP providers are listed in the Provider Directory. Have your patients call VSP at 800-877-7195, or PHC’s Member Services Department at 800-863-4155 to find an optometrist who accepts MediCal and make an appointment today!

Marshall Kubota, MD

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