Electronic Claim Submission and Order/DOS Compliance

MEMORANDUM

To: All Staff
Subject: Electronic Claim Submission and Order/DOS Compliance
Effective: Immediately

Please be reminded that all EyeMed (EM), HUSKY, and Spectera claims are submitted electronically. Because these claims are generated using the information entered in MVE, it is extremely important that orders and jobs are not altered after the original date of service (DOS) has passed without notifying the appropriate insurance billing point of contact.

Please follow the guidelines below:

Do not change, reopen, remake, or otherwise alter an order/job after the original DOS without first contacting the point of contact responsible for billing that insurance.
If changes are required after the fact, notify the appropriate billing POC and clearly explain what was changed and why.
If a patient provides insurance after the original DOS, all applicable dates in MVE must match the correct DOS.
Once the insurance has been added and the dates have been verified, notify the appropriate billing POC so the claim can be reviewed and submitted correctly.
Do not assume that updating MVE automatically alerts the billing department. Direct notification is required.

Failure to follow these procedures can result in:

Claims being submitted with incorrect or conflicting information
Claim rejections or denials
Delayed insurance payments
Missed timely-filing deadlines
Incorrect patient balances
Duplicate or inaccurate claims
Compliance concerns, audits, or insurance recoupments
Additional work to correct or resubmit claims

These requirements are necessary to maintain accurate patient records and ensure that claims are submitted properly and within the insurance carrier’s filing requirements.

If you are unsure whether a change will affect a claim, please contact the appropriate insurance billing POC before making the change.