California Optometric Association
COA Alerts
October 02, 2009
MEDICARE UPDATE — Surety Bonds
The AOA does not recommend optometrists obtain a surety bond. Instead,
the AOA suggests that members revise their practice arrangements to ensure that
they perform some sort of examination or test for
Medicare beneficiaries
whose first interaction with the practice is to obtain prescription eyeglasses
following cataract surgery. CMS has stipulated that an examination or test
must occur prior to dispensing eyeglasses for the beneficiary to be considered a
patient of the optometrist or ophthalmologist. For example, a visual
acuity test of the prescription in a trial frame could be done before
dispensing the covered eyeglasses. The optometrist should be sure to
create a chart for the patient and record the data from the test or examination
along with other information appropriate for a medical record.
An optometrist could also choose to avoid a surety bond for medical suppliers by not filling prescriptions for Medicare beneficiaries written by another physician. Optometrists may want to inform cataract surgeons who refer patients to them following cataract surgery not to write a prescription. Optometrists who turn away Medicare beneficiaries as a result of the CMS restrictions can encourage those beneficiaries to call 1-800-MEDICARE to complain about the Medicare policy.
AOA will continue to try to convince CMS that their interpretation of the bond requirement is incorrect.
For More Information: Contact Sean South at ssouth@coavision.org and 916-441-3990 x 243.
December 10, 2008
Members -- Don't Miss These Upcoming Deadlines!
Members Only Pricing Package —
Ends December
19th!
Carl Zeiss Meditec has created a pricing package exclusively for members of
the California Optometric Association. Click
here to learn more about their member-only pricing (member login
required).
Contact Carl Zeiss Meditec at 800-342-9821 to learn more about
their solutions for the management and diagnosis of glaucoma. You must mention
that you are a COA member to receive the special price details.
Eligible
purchases during this endorsement period will also benefit COA.
This members-only offer will end December 19, 2008.
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COA Sponsored Delta Dental Program –
New PPO Option!
Enrollment Application Deadline: December 31, 2008
Click
here to download a benefit summary, sample claim comparison and enrollment
form (member login required).
Effective January 1, 2009, there's a new
way to protect your smile!
Delta Dental is introducing a new plan option for COA members and their
employees. The new plan allows members and their employees to enroll now during
Open Enrollment for a January 1, 2009 effective date
to start the year
enjoying the benefits of Delta Dental protection.
- Individual members may only enroll during annual open enrollment periods. Waiting periods for major services will apply.
- Groups may join the program now or throughout the year. Waiting periods for major services will apply.
Delta Dental PPO provides enrollees with two networks from which to choose.
In California, members may receive a 29% average fee savings for services
provided by Delta Dental PPO dentists; a 6% average fee savings in the Delta
Dental Premier network. Premier dentists may bill you the difference
between
the PPO fee and Delta Dental's approved Premier fee amount, but they may never
balance bill you above the Premier fee allowance. Non-Delta
dentists may
balance bill you the entire amount of their submitted charge.
If you have any questions, please call a Client Service Representative at 800-775-2020.
November 20, 2008
Southern California Wildfires Update
According to Dr. David Ardaya of the Orange County Optometric Society, relief
efforts involving the Southern Calfiornia College of Optometry (SCCO), VSP
Vision Care, Alcon, and the Orange County Optometric
Society (OCOS) are
currently underway. SCCO is collecting monetary donations and is serving
as a drop off and organization point for relief supplies (blankets, eye drops,
chapstick etc.). VSP is bringing a team down and a mobile clinic.
They will go to SCCO and compile the supplies and serve as the distribution
team. Alcon has provided artificial tears and supplies and will route them
to the college. Dr. Ardaya has served as a representative for OCOS and
have brought the teams together, procured donations from Alcon, and organized
the communications between everyone involved.
Additionally, SCCO issued a press release earlier this week.In an effort to assist the American Red Cross in the collection of monetary donations to help the Orange County wild fire victims, the Eye Care Center at SCCO has become a collection site.(Monetary donations only, please. Checks to be made out to: OC Wild Fires ‘08.)
Donations are being accepted now through Wednesday, November 26th. The Eye
Care Center operational hours: Monday-Tuesday 9 am – 6 pm; Wednesday 11 am – 8
pm. (Closes at 7 pm on Novmber 26th.); Thursday
10 am – 7 pm; and
Friday-Saturday 8 am – 5 pm. The Eye Care Center is located at 2575 Yorba Linda
Blvd, Fullerton, CA 92831. For more information, please call
714-449-7401.
October 02, 2008
Medicare Update
Doctors of Optometry have been exempted from the CMS DMEPOS Accreditation Process
You should not go through any accreditation process at this time.
If you have any questions, please contact: Sean South at ssouth@coavison.org.
September 12, 2008
Robbers Hit Sacramento Area Practices
COA has been informed recently that there have been a number of thefts
targeting optometric practices in the Sacramento area. According to Dr. John
Okamoto of Granite Pointe Eye Care, Inc. in Roseville, CA,
up to 10
practices in the Sacramento area have been hit, including some hit multiple
times. Robberies are occuring both during the day and at night, and robbers are
aiming for designer women's sunglasses.
To help our members protect themselves from theft around the state,
please review the following tips provided to us by Zurich, the underwriter of
the Business Owners Package Program, one of the COA
Sponsored Insurance
Programs.
Theft Claims
The first step in preventing a theft loss is to have a Central Station Alarm.
This system provides a warning in case of burglary or fire and is monitored by
either an alarm company or the local police
station for a monthly fee. If
you do not already have one, please look into installing one.
Other steps you can take to prevent or limit theft losses:
• All designer and high valued frames should be kept in a locked case.
•
Attempt to have at least two employees within observation range of the display
area. Thieves have been known to work in pairs, one distracting an employee
while the other is slipping frames into an
oversized coat or bag/purse.
•
After hours, designer and high valued frames should be stored out of sight in a
locked environment.
• Window displays should be behind unbreakable
glass.
• Your office should always be well lit with extensive lighting on the
exterior after hours.
• Reinforce doors and secure locks.
• Train your
employees to observe individuals in the office regarding potential theft.
To find out more about COA’s Business Owners Package Program, call a Marsh Client Service Representative at 800-775-2020.
August 07, 2008
COA Sponsored Menu-Labeling Bill Passes Out of Assembly Appropriations
We are pleased to announce that COA’s Menu Labeling Bill SB 1420 (Padilla)
continues its march to the Governor’s desk. Our bill unlike AB 2572 will
put the information customers need most on menu boards.
Enjoy this
video that explains it all… http://www.youtube.com/watch?v=zD4m6WN3Tlg.
July 21, 2008
Medicare Update
The AOA-backed Medicare Improvements for Patients and Providers Act of 2008 (HR 6331) is now law following the votes in Congress on July 16th to override President Bush’s veto.
Summary of Key Provisions of the Medicare Patients and Providers Improvements Act
• Eliminates the 10.6 percent cut that occurred July 1st in the Medicare physician fee schedule. Doctors should submit claims and follow carrier guidance to ensure full payment for services provided since July 1. CMS and Medicare contractors should post the revised fee schedule very soon but the agency warned that it may take 10 days to implement the new rates.
• Exempts physicians from DMEPOS accreditation until CMS creates standards designed specifically for physicians and also gives CMS the authority to exempt physicians permanently from DMEPOS accreditation. AOA is urging CMS to use its new authority to exempt optometrists and other physicians from accreditation due to licensure, education, and training. You should not through any accreditation process at this time.
If you have any questions, please contact: Sean South at ssouth@coavison.org.
May 21, 2008
National Provider Identifier (NPI) Update
MEDI-CAL
Effective May 24, 2008, Medi-Cal will no
longer accept claims billed with a Medi-Cal legacy provider number.
Claims must be submitted using your NPI.
This information is available on the Medi-Cal Web site by clicking here.
If you have any additional questions, please contact: Sean South at 916-441-3990 x 243 or at ssouth@coavison.org
May 09, 2008
National Provider Identifier (NPI) Update
14 days left – Time is running out until full NPI
implementation!
Effective May 23, 2008, Medicare claims must be
submitted using the NPI only in all provider fields on the claim. Legacy
numbers may not be used.
If you have any additional questions, please contact Sean South at
916-441-3990, ext. 243 or at ssouth@coavison.org.
To
download the bulletin, click here.
May 09, 2008
Tips on Protecting Your Practice
COA has been informed recently that there have been a number of thefts
targeting optometric practices in Southern California. To help our members
protect themselves from theft around the state, please
review the following
tips provided to us by Zurich, the underwriter of the Business Owners Package
Program, one of the COA Sponsored Insurance Programs.
Theft Claims
The first step in preventing a theft loss is to have a Central Station Alarm. This system provides a warning in case of burglary or fire and is monitored by either an alarm company or the local police station for a monthly fee. If you do not already have one, please look into installing one.
Other steps you can take to prevent or limit theft losses:
- All designer and high valued frames should be kept in a locked case.
- Attempt to have at least two employees within observation range of the
display area. Thieves have been known to work in pairs, one distracting an
employee while the other is slipping frames into an
oversized coat or bag/purse. - After hours, designer and high valued frames should be stored out of sight in a locked environment.
- Window displays should be behind unbreakable glass.
- Your office should always be well lit with extensive lighting on the exterior after hours.
- Reinforce doors and secure locks.
- Train your employees to observe individuals in the office regarding potential theft.
To find out more about COA’s Business Owners Package Program, call a Marsh Client Service Representative at 800-775-2020.
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For more breaking news, please visit the COA News Alerts section of our Web site at www.coavision.org. Under Media, click COA Alerts.
January 18, 2008
Use of Social Security Numbers for Billing Medi-Cal Prohibited Beginning February 1, 2008
Effective for dates of service on or after February 1, 2008, providers may no longer bill Medi-Cal or the Child Health and Disability Prevention (CHDP) program using a recipient's Social Security Number (SSN). Claims submitted with a recipient’s SSN for a date of service on or after February 1, 2008 will be denied.
Use of the Medi-Cal Benefits
Identification Card Number for Billing
All providers are expected to use the 14-character Medi-Cal identification
number from the recipient’s Benefits Identification Card (BIC) or paper ID card
when submitting claims. The ID number is located on the front of the card and
consists of a 9-digit Client Index Number, a Check Digit and a 4-digit issue
date. The issue date is used to deactivate cards that have been reported as lost
or stolen.
The information above was contained in page 4 of the
Medi-Cal Bulletin. Click
here to download a copy of the bulletin.
For more information, please contact Sean South at (800) 877-5738 or by email at ssouth@coavision.org.
January 11, 2008
GROUP ACTION: ANTITRUST CONSIDERATIONS
It has come to our attention that some members may have been recently solicited by an ophthalmic manufacturer, through its regional or local representatives, to participate in efforts to bring economic pressure on one or more health plans in response to an anticipated change in benefits by an insurer that may affect optometrists.
Legal counsel has concerns that any such activity could violate state and federal anti-trust laws in that concerted activity of that nature can be deemed as external evidence of a conspiracy to engage in a group boycott which, if proven, could result in severe civil and possible criminal penalties for individuals involved. Any such group action should be strictly avoided.
State law and regulations, as administered and enforced by the California Department of Managed Health Care (DMHC), provide administrative appeals and remedies for subscribers and providers affected by a coverage decision made by a registered health plan subject to the Department’s jurisdiction. If you are approached by anyone seeming to solicit your interest or participation in taking any action against a plan, please inform them that COA would be pleased to receive their information and to consider bringing to DMHC’s and other interested parties’ attention, as prescribed by law.
For more information, please contact Tim Hart or Sean South at (800) 877-5738 or by email at timh@coavision.org or ssouth@coavision.org.
