The VSP Estimator helps your practice estimate patient responsibility and expected VSP reimbursement when processing VSP optical orders in RevolutionEHR. By using information from a patient's VSP authorization along with your configured pricing and fee schedules, the estimator automatically calculates charges, generates the appropriate invoices, and streamlines your billing workflow.
Important: The VSP Estimator is not a direct integration with VSP. Your practice must obtain the patient's authorization through VSP and manually enter the authorization details into the order. The estimator uses this information to perform its calculations—it does not retrieve authorizations or eligibility information from VSP.
How It Works
Once the feature has been configured, VSP Estimator is available when creating qualifying optical orders.
During the order process:
- Create a VSP Estimator optical order for the patient.
- Complete the order as you would for a standard eyeglass order.
- Enter the information from the patient's VSP authorization in the Billing tab.
- Generate a billing preview to calculate the patient's responsibility and VSP reimbursement.
- Save the order to generate the necessary invoices.
Based on the authorization information and your configured pricing, the VSP Estimator automatically:
- Calculates the amount the patient is responsible for.
- Generates a patient invoice for the patient's balance.
- Calculates the expected reimbursement from VSP.
- Generates a VSP invoice for the insurance portion of the order.
VSP Reimbursement and Recoupments
Depending on the order, the VSP invoice may display a negative balance.
A negative VSP invoice does not indicate an error. It reflects situations where VSP will recoup more funds than it will reimburse for the order. The estimator accounts for these scenarios automatically so your invoices accurately represent the expected financial outcome.
Before You Begin
Before using the VSP Estimator, your practice must complete the required configuration, including:
- Enabling the VSP Estimator.
- Configuring required accounting reasons.
- Setting up VSP fee schedules.
- Importing VSP inventory.
- Configuring VSP inventory pricing.
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For complete setup and usage instructions, see: