Help minimize unnecessary delays and denials with your vision claims when you:
- Verify eligibility and benefits before rendering services
- Ensure CPT®/HCPCS and diagnosis codes are accurate and match the services provided
- Include required modifiers – missing or incorrect modifiers are a common reason for denials
- Submit claims within the required time frame
- Check authorization requirements before rendering services – some services may require prior authorization
Common denial reasons include:
- Missing or invalid member ID
- Incorrect provider information
- Incomplete documentation
- Services are not covered under the member’s plan
For more details and examples, reference the complete Claim Denial Quick Reference Guide.