Medicaid 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.
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.
Whether it is routine Medicaid vision benefits or complex medical-surgical eye care, Ocular Benefits will deliver innovative cost-saving eye care solutions and will serve as a strong partner for your organization!
