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Insurance (US)

My Vision Express Insurance module streamlines billing, accounts receivable and insurance claims processing. Required fields are automatically highlighted for the claim to be successfully processed reducing errors and resulting in faster reimbursements. The patient insurance and order information that you captured in the Patient and/or Order module can be automatically transferred to the Insurance module and finally to the new HCFA-1500 that contains the additional fields for NPI numbers. HCFA-1500 information is printed in the appropriate boxes on preprinted laser forms. My Vision Express also generates Electronic Claim files in individual and batch mode in ANSI 837 and Print Image format accepted by insurance clearinghouses such as Emdeon.

Create Claims Directly From Orders

Procedure Codes Are Automatically Processed

Insurance Fee Schedules

Insurance Authorizations
Store detailed benefit information, including copays and allowances.

  • Manage unlimited authorizations for medical and vision plans
  • Obtain medical insurance eligibility from inside My Vision Express through our Gateway EDI interface
  • Integrates with Who Is Your Insurance, enabling you quickly identify your patients’ vision insurance and provides easy access to their benefits and authorizations. Visit WhoIsYourInsurance.com for more information

Insurance Claims
The Insurance Claims module streamlines your billing, accounts receivable and insurance claims processing. Required fields are highlighted, reducing errors, to help your claims be successfully processed and resulting in faster reimbursements.

  • My Vision Express automatically fill-ins claim details based on patient and sales records
  • Submit claims individually or in batch
  • Print paper claims on HCFA-1500 forms
  • Submit claims with coding edits to third-party, integrated clearinghouses such as Emdeon and Eyefinity
  • Use the latest ANSI 837 5010 standard for electronic claims
  • Use PQRS codes which are added to your exams and Medicare claims automatically
  • Lookup NPI numbers for providers
  • Use ICD-9 or ICD-10 diagnosis codes. Quickly link corresponding codes
  • Filter claims to be submitted by location, claim status, insurance company, creation date range, etc.

Insurance Fee Schedules
Automate the pricing of insurance options at order time by using fee schedules for insurance plans.

  • Specify wholesale, retail and material frame allowances
  • Enter copayments, contact lens allowances and dispensing fees
  • Price insurance options for spectacle lenses by procedure codes
  • Facilitates and speeds up insurance checkout process
  • Group frames, spectacle lenses, lens treatments and contacts to facilitate pricing

Insurance Payments
Easily allocate payments to outstanding insurance balances.

  • Post insurance and patient payments for multiple orders from the same screen
  • Search for outstanding balances based on patient name, order date range, order status, insurance company name, location, etc.
  • Allocate insurance payments to procedure codes
  • Write-off unpaid balances
  • Transfer balances between insurance and patient, or between insurance companies
  • Save your payment allocation transaction to continue working on it or modify it later

Insurance Electronic Remittance Advice (ERA)
Match insurance payments to the proper sales order, using an electronic remittance advice (ERA) file provided by your insurance or clearinghouse.

  • Import HIPAA X12N 835 files with ERA information
  • Match amounts paid to procedure codes in claims
  • Write-off and transfer balances

5010 837P ‘EDI Health Care Claim Professional’