Health Plans: Managed Medical Optometry

Managed Medical Optometry

Integrating medical optometry with routine vision care can give you a good view into your vision benefit program. By fully integrating data for medical optometry and routine vision care claims and eligibility, NVA can analyze this information to identify duplicate services and inappropriate eye care billing, which eliminates excessive costs of both the medical and vision plans.

We eliminate unnecessary and inappropriate expenses through:

• Outlier Behavior (up-coding, practice profiles)
• CPT ICD Matching
• Identification of Procedures Likely to be Abused
• Identification of ICDs Likely to be Abused
• Sophisticated Algorithms with Prospective and Retrospective Review
• System Edits
• Adverse Referral Patterns
• Provider Record Reviews