Vision Benefit Summary for Patients

Takes the benefit details your office gets from the insurance plan (by phone, portal, or card) and turns them into a clear summary a patient can understand.

OptometristHealth and Wellness✓ Checkedv1.0

Before and after

BEFORE · what the owner typed

Patient is Theo Sandoval, coming in thursday at Fawnhollow Eye Care, 4731 Dunhollow St, Birchfield. He has Lumenvue Select, i think, called them this morning and spoke to a rep named Dana. Eligible since 1/1, exam once every 12 months, exam copay $10. Frames allowance $150, then 20% off the amount over. Standard single vision lenses copay $25. Anti-glare isn't covered, our price is $65. Blue light filter not covered, our price $45. Contacts not needed. He wants the Tortoise Vanta frames, our price $230. We'll say he's seeing Dr. Ueda. Total him up please. Phone for office 267-555-0132.

AFTER · what the skill produced

Hi Theo,

Thank you for scheduling with Fawnhollow Eye Care. We called your vision plan this morning and spoke with a representative named Dana. Here is what we were told about your benefits and what we estimate you will owe at your visit with Dr. Ueda on Thursday.

What your plan covers

Eye exam: covered once every 12 months, with a $10 copay
Frames: $150 allowance, plus 20% off the amount over the allowance
Standard single vision lenses: covered with a $25 copay
Your coverage has been active since 1/1

What we estimate you will pay

Exam copay: $10.00
Tortoise Vanta frames: $230.00 price, minus $150.00 allowance = $80.00 over. 20% off $80.00 is $16.00, so you pay $64.00
Standard single vision lens copay: $25.00
Anti-glare coating (not covered by your plan): $65.00
Blue light filter (not covered by your plan): $45.00

Estimated total: $209.00

If you decide not to add the anti-glare or blue light filter, your estimate would be $99.00. The choice is always yours.

This is an estimate based on what your plan told us today. The final amount is set when your plan processes the claim. If you have questions before Thursday, call us at 267-555-0132.

Fawnhollow Eye Care

Questions for the owner

You wrote "Lumenvue Select, i think." Please confirm the exact plan name before sending.
What date and time is Thursday's appointment, so we can add it?
Do you want the patient to know the representative's name, or should it be removed?
Does Dr. Ueda recommend the anti-glare coating or blue light filter for this patient? If so, tell us and we will add that line.

What it does

Takes the benefit details your office gets from the insurance plan (by phone, portal, or card) and turns them into a clear summary a patient can understand. It shows what the plan pays, what the patient is expected to pay, and what still needs to be confirmed.

Use it when: Use when an optometry office needs to turn a patient's vision insurance details into a plain English summary of what the plan covers and what the patient may owe, such as: check this patient's vision benefits, explain their coverage, what will they owe for an exam and glasses, or write up their benefits.