Commercial Group Eye Care Benefits
Your Total Eye Care Solution℠
Ocular Benefits, your single contracting partner, has flexible contracting capacity to meet the unique needs of our partners. While we offer integrated solutions, we are also able to easily accommodate vision only or medical-surgical only options.
Total Eye Care - The use of our extensive network of routine vision, medical eye care specialists, facilities, anesthesiologists and in-office ophthalmic pharmacy has demonstrated significant lower overall costs for our partners. In addition to delivering efficiencies and cost containment, added benefits of the total eye care model include:
- Increased member satisfaction. Member’s have a single integrated eye care network for all of their needs.
- Seamless administration. Our Health Plan partners have a single vendor to contract and work with on a day to day basis when using Ocular Benefits fully integrated eye care model.
- Improved HEDIS scores. When considering best practices, working with Ocular Benefits and using a consolidated data set has proved to yield better HEDIS scores. Ocular Benefits works with each plan annually to increase HEDIS scores through member mailings, PCP education and streamlined reporting.
Routine Eye Care – Ocular Benefits provides routine visions services with full flexibility.
Ocular Benefit’s subsidiary company, Group Vision Service, leverages over 50 years of experience to integrate people, technology, processes and quality eye care doctors in order to deliver the very best routine eye care coverage.
- Eye Exams – Ocular Benefits offers full coverage for routine eye exams that are performed by licensed and fully credentialed Doctors of Optometry, (O.D.), or Ophthalmologist (M.D.).
- Eyewear - We provide excellent coverage for basic eye-wear materials, including eyeglasses or contact lenses or custom benefit packages that include coverage for high-end fashion frames, high tech-lenses and advanced contact lenses.
- LASIK - Discounted LASIK benefits at no additional cost!
- Quality - Fully credentialed doctor network that parallels NCQA (National Committee of Quality Assurance) Standards.
- 43,000 PPO Network Providers! Because we have partnered with Luxottica Corporation, a 6.4 billion dollar global organization we are able to deliver our customers one of the largest vision care networks in the USA with more than 43,000 private practices and retail optical provider locations nationwide including: LensCrafters, PearleVision, JC Penny, Sears Optical, and, Target Optical. This large and diverse network of eye care providers deliver exceptional access to local or multi-state employer groups! Plus, we can also administer out of network benefits, so members can see any doctor they like.
- Additional Savings Program - Members have access to eyewear discounts in addition to their covered benefits! Discounts include: lens up-grades/options and additional pair purchases. Members may access this discount program as often as they want during their enrollment in the vision care program. Discounts are available from network provider only.
- Mail Order Contact Lenses – Replacement contact lens mail order program allows member to order directly online!
- Customer Care – Members have access to live customer service representatives 7 days a week located in a U.S. call center:
- • Monday through Saturday: 8:00 a.m. to 11:00 p.m.; Sunday 11:00 a.m. -8:00 p.m. EST
- • Monday through Sunday: 24 Hours/day IVR system is available.
Medical and Surgical Eye Care - Ocular Benefits provides comprehensive medical-surgical eye care from medical exams to complex ocular surgical procedures.
Ocular Benefit’s subsidiary company, Premier Eye Care, leverages over 17 years of experience in delivering medical surgical ophthalmic services. Through Premier, Ocular Benefits is licensed as a Third Party Administrator and Fiscal Intermediary. In addition, we hold a Medical Review License by AHCA and are compliant with HIPAA, AHCA, and CMS guidelines.
Ocular Benefits offers an integrated medical network that includes ophthalmic primary eye care doctors, specialists and subspecialists and eye surgeons. In addition, we provide ambulatory surgical centers, anesthesia and in-office pharmacy.
Ocular Benefits accepts full health plan delegation for claims management, provider credentialing, network management and utilization management.
Ocular Benefits provides complete flexibility to our partners in order to effectively accommodate the individual needs of our partner health plans and government payers. We can customize all benefits to the specific needs of the Health Plan, including the medical-surgical delivery model. The customized delivery models range from straight fee-for-service to full capitation with variations and hybrids in between.
